Advance Care Planning Bundle: Using Technical and Adaptive Solutions to Promote Goal Concordant Care.

Background: Advance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system.

Measures: A survey of rapid response providers assessed usefulness of the ACP quality improvement bundle and perceptions of use and adherence.

Looking through the lens: a photovoice study examining access to services for newcomer children.

Purpose: Canadian new immigrant families (also known as newcomers) encounter challenges navigating systems when trying to access programmes critical for their children's healthy development. The purpose of this study is to understand how newcomer families find and use early childhood programmes and services from the perspective of families and early childhood educators (ECEs) working within a settlement organization.

Methods: Using photovoice methodology, newcomer family members ( = 8) with young children and ECEs ( = 6) participated in a series of virtual workshops to share photos and reflect on their experiences.

New Insights for Tracking Global and Local Trends in Exposure to Air Pollutants.

Over six million people die prematurely each year from exposure to air pollution. Current air quality metrics insufficiently monitor exposure to air pollutants. This gap hinders the ability of decisionmakers to address the public health impacts of air pollution.

Understanding the Influence of High School Preparation on the Success Strategies of Canadian University Students.

There is a general expectation that high schools prepare students both academically and with life skills. We examine the perceptions of university students about how well-prepared for university they believed they were. The findings highlight inequities based on race, gender, and type and location of high schools, underscoring a need for further analysis using a critical theoretical framework.

Community-based priorities for improving nutrition and physical activity in childhood.

Overweight among America's youth has prompted a large response from foundations, government, and private organizations to support programmatic interventions. The architecture for many of these programs was derived from "experts," whereas the perspective of families, and communities--those most affected and most instrumental in altering behavior--is rarely the driving force. Shaping America's Youth (SAY) was established to assess programs that target nutrition and physical activity and to promote the necessary family and community input.

Dysfunctional labor and myometrial lactic acidosis.

Objective: Inefficient uterine contractions are the most common cause of poor progress in labor. The global increase in cesarean delivery rate is a cause of considerable concern, and the greatest reason for increase is the result of failure to progress in labor. Following in vitro studies that showed acidification could depress uterine contraction, we hypothesized that it could contribute to dysfunctional labors.

Amniocentesis and chorionic villus sampling for prenatal diagnosis.

Background: A major disadvantage of second trimester amniocentesis is that the result is usually available only after 18 weeks' gestation. Chorionic villus sampling (CVS) and early amniocentesis can be done between 9 and 14 weeks and offer an earlier alternative.

Objectives: The objective was to assess comparative safety and accuracy of second trimester amniocentesis, early amniocentesis, transcervical and transabdominal CVS.

Inverse relationship between bioconcentration factor and exposure concentration for metals: implications for hazard assessment of metals in the aquatic environment.

The bioconcentration factor (BCF) and bioaccumulation factor (BAF) are used as the criteria for bioaccumulation in the context of identifying and classifying substances that are hazardous to the aquatic environment. The BCF/BAF criteria, while developed as surrogates for chronic toxicity and/or biomagnification of anthropogenic organic substances, are applied to all substances including metals. This work examines the theoretical and experimental basis for the use of BCF/BAF in the hazard assessment of Zn, Cd, Cu, Pb, Ni, and Ag.

The concept of persistence as applied to metals for aquatic hazard identification.

The criteria persistence (P), bioaccumulation (B), and toxicity (T) are applied by domestic and international regulators and modelers to the hazard identification of chemical substances, including metals and metalloids, that may present harm to the environment. In this paper, we critically examine the literature to determine the weight of evidence for the application of water column partition half-times as a surrogate for the persistence criterion in the aquatic hazard identification of metals and metal compounds. Dissolved metals such as Fe, Mn, Cu, Pb, Co, Cs, Hg, and Zn, as well as the metalloids As and Se, tend to partition from the water column by adsorption onto sinking particulates, with reported and calculated partition half-times in the range 4 to 30 d, with outliers of 0.

A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage.

Recurrent miscarriage is a difficult clinical problem occurring in approximately 1-2% of fertile women. Following investigation, most cases fail to reveal an identifiable cause and are therefore classified as idiopathic. The aim of this study was to identify important gestational milestones for pregnancy success prediction in women following idiopathic recurrent miscarriage.

Hereditary myeloperoxidase deficiency due to a missense mutation of arginine 569 to tryptophan.

Hereditary deficiency of myeloperoxidase (MPO) is a common disorder but its genetic basis is unknown. We have reported that neutrophils from individuals with MPO deficiency lack enzymatic and immunochemical evidence for mature MPO but have a 90-kDa precursor protein. We have thus hypothesized that hereditary MPO deficiency reflects a defect in processing of a mutated primary translation product.

Maternal-fetal transport of vitamin K1 and its effects on coagulation in premature infants.

We conducted a prospective study to determine (1) the maternal-fetal vitamin K1 transport in premature infants after vitamin K1 was given to the mothers antenatally and (2) the vitamin K1 effects on blood coagulation in the babies. Women in labor at less than or equal to 34 weeks of gestation were randomly selected to receive antenatal vitamin K1, 5 mg given intramuscularly (vitamin K1 group), or no vitamin K1 (control group). Eight infants, including one set of twins, were in the vitamin K1 group and six in the control group.

Human beta-globin gene expression after gene transfer using retroviral vectors.

A retroviral vector containing a 4.4-kb Pst I human beta S-globin gene and a neomycin resistance gene was used to infect NIH-3T3 and mouse erythroleukemia cells (MELC). In MELC, human beta-globin mRNA transcripts are transcribed and properly initiated and spliced.

Cell-mediated cytotoxicity of peripheral blood mononuclear cells stimulated in vitro for infectious bovine rhinotracheitis virus-infected cells.

Peripheral blood mononuclear cells (PBMC) from calves infected with and hyperimmunized to infectious bovine rhinotracheitis virus (IBRV) were stimulated in vitro with viral antigens to evaluate their cytotoxicity for a variety of cells. The 51-Cr release assay was used to measure cytotoxicity. Cytotoxicity was not present in fresh nonstimulated cells, but was detected in cultured, IBRV-stimulated cells at day 3, was maximal at day 7, and declined thereafter.

Sex differences in affective responses as evidenced on the Bene-Anthony Test.

This study investigates changes in a child's perception of the relationship with male and female parents during the course of the critical ages of 5, 6, 7, and 8. Correspondingly, since the paper concerns itself with nonpathological normal children, it also provides normative data on the Bene-Anthony Family Relations Test. Findings indicate variable gender and age differences in the feelings experienced by children aged 5, 6, 7, and 8 towards male and female parents.

Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair.

The presence of periprosthetic gas on computerized axial tomography (CT) of the abdomen following abdominal aortic reconstruction has been proposed to be a reliable indicator of prosthetic graft infection, a complication that requires intervention entailing significant mortality and morbidity. To evaluate the reliability of this finding in the early postoperative period, prosthetic grafts in 26 patients undergoing elective aneurysm repair were evaluated with postoperative CT examinations. Serial scans were obtained at mean intervals of 3, 7, and 52 days postoperatively.

Family correlates of male childhood gender disturbance.

In the context of a review of adult cases of gender disturbance, a clinical study was pursued on the status of fathers, father-substitutes, and older male siblings for 46 boys with deviations in male role development. Significantly fewer male role models were found in the family backgrounds of the severely gender-disturbed boys as compared to the mild-to-moderately gender-disturbed boys. Male childhood gender disturbance was also found to be correlated with a high incidence of psychiatric problems in both the mothers and fathers and with atypical patterns of the boys' involvement with their mothers and fathers, as measured by the Bene-Anthony Family Relations Test and the Rekers Behavior Checklist for Childhood Gender Problems.

Contingency management in the treatment of adolescent alcohol drinking problems.

Three case studies demonstrated that social and monetary reinforcement for abstinence reduced the rate of excessive alcohol drinking in adolescents. The self-monitoring and extrinsic reinforcement procedures (ABA reversal design) resulted in complete abstinence in a 15-year-old boy with a 10-year history of excessive alcohol abuse and hospitalization for an alcohol-induced psychosis. In the cases of the 13-year-old and 15-year-old girls with extensive alcohol abuse histories, the behavioral interventions decreased the rate of alcohol consumption during treatment phases, but alcohol abuse increased markedly with the removal of the intervention procedures.

Uridine 5'-diphosphate galactose: glycoprotein galactosyl transferase activity in exfoliated bladder epithelial cells in rats fed N-(4-(5-nitro-2-furyl)-2-thiazolyl) formamide.

Urine samples of normal male Fischer rats or rats fed 0.2% N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide for 6,8 or 30 weeks were collected and centrifuged 50 weeks after beginning treatment. After being sonicated and assayed (with purified desialylated ovine submaxillary mucin as acceptor glycoprotein), the exfoliated bladder cells obtained from the urines of treated rats showed uridine 5'-diphosphate galactose:glycoprotein transferase activity.