Time to manage: patient strategies for coping with an absence of care coordination and continuity.

This paper examines how people with chronic illnesses respond to absences of continuity and coordination of care. Little work has been done on how the ill person might mitigate flaws in a less than optimal system. Our qualitative research, carried out among 91 participants in Australia, reveals that people with chronic illnesses create strategies to facilitate the management of their care.

Prevalence and Determinants of Fatigue Following Total Knee Replacement: A Longitudinal Cohort Study.

Objective: To evaluate the prevalence and determinants of clinically important fatigue before and up to 12 months after total knee replacement (TKR) surgery.

Methods: This study was a secondary analysis of a prospective cohort study conducted among 422 patients (ages 45-74 years) undergoing primary TKR for osteoarthritis (OA) who participated in the Maximum Recovery After Knee Replacement randomized clinical trial. Assessments were carried out before, and at 6 weeks, 6 months, and 12 months after surgery.

Is there a role for a primary health nurse in a learning support team in a disadvantaged high school? Evaluation of a pilot study.

Disadvantaged children experience more health problems and have poorer educational outcomes compared with students from advantaged backgrounds. This paper presents the quantitative and qualitative findings from a pilot study to determine the impact of the Healthy Learner model, where an experienced primary care nurse was embedded in a learning support team in a disadvantaged high school. Students entering high school with National Assessment Program, Literacy and Numeracy (NAPLAN) scores in the lowest quartile for the school were assessed by the nurse and identified health issues addressed.

"Why Didn't it Work?" Lessons From a Randomized Controlled Trial of a Web-based Personally Controlled Health Management System for Adults with Asthma.

Background: Personally controlled health management systems (PCHMS), which may include a personal health record (PHR), health management tools, and information resources, have been advocated as a next-generation technology to improve health behaviors and outcomes. There have been successful trials of PCHMS in various health settings. However, there is mixed evidence for whether consumers will use these systems over the long term and whether they ultimately lead to improved health outcomes and behaviors.

Predicting Outcome in dogs with Primary Immune-Mediated Hemolytic Anemia: Results of a Multicenter Case Registry.

Background: Outcome prediction in dogs with immune-mediated hemolytic anemia (IMHA) is challenging and few prognostic indicators have been consistently identified.

Objectives: An online case registry was initiated to: prospectively survey canine IMHA presentation and management in the British Isles; evaluate 2 previously reported illness severity scores, Canine Hemolytic Anemia Score (CHAOS) and Tokyo and to identify independent prognostic markers.

Animals: Data from 276 dogs with primary IMHA across 10 referral centers were collected between 2008 and 2012.

Activation of Muscarinic M1 Acetylcholine Receptors Induces Long-Term Potentiation in the Hippocampus.

Muscarinic M1 acetylcholine receptors (M1Rs) are highly expressed in the hippocampus, and their inhibition or ablation disrupts the encoding of spatial memory. It has been hypothesized that the principal mechanism by which M1Rs influence spatial memory is by the regulation of hippocampal synaptic plasticity. Here, we use a combination of recently developed, well characterized, selective M1R agonists and M1R knock-out mice to define the roles of M1Rs in the regulation of hippocampal neuronal and synaptic function.

Viability of Bioprinted Cellular Constructs Using a Three Dispenser Cartesian Printer.

Tissue engineering has centralized its focus on the construction of replacements for non-functional or damaged tissue. The utilization of three-dimensional bioprinting in tissue engineering has generated new methods for the printing of cells and matrix to fabricate biomimetic tissue constructs. The solid freeform fabrication (SFF) method developed for three-dimensional bioprinting uses an additive manufacturing approach by depositing droplets of cells and hydrogels in a layer-by-layer fashion.

Psychological distress among Vietnamese adults attending Vietnamese-speaking general practices in South Western Sydney: prevalence and associations.

The aim of the present study was to determine the prevalence of psychological distress among Vietnamese adults attending Vietnamese-speaking general practices and explore possible risk factors in this population. A cross-sectional survey of Vietnamese adult patients was conducted at 25 general practices with Vietnamese-speaking general practitioners (GPs) in south-western Sydney between October 2012 and February 2013. Patients completed the Kessler (K10) scale and a demographic questionnaire, available in Vietnamese or English.

Does the hand that controls the cigarette packet rule the smoker? Findings from ethnographic interviews with smokers in Canada, Australia, the United Kingdom and the USA.

Throughout the twentieth century, packaging was a carefully cultivated element of the appeal of the cigarette. However, the tobacco industry's control over cigarette packaging has been steadily eroded through legislation that aims to rebrand the packet from a desirable to a dangerous commodity-epitomized in Australia's introduction of plain packaging in 2012. Evident in both the enactment of cigarette packaging legislation and industry efforts to overturn it is the assumption that packets do things-i.

Human hippocampus represents space and time during retrieval of real-world memories.

Memory stretches over a lifetime. In controlled laboratory settings, the hippocampus and other medial temporal lobe brain structures have been shown to represent space and time on the scale of meters and seconds. It remains unclear whether the hippocampus also represents space and time over the longer scales necessary for human episodic memory.

Primary health care-level interventions targeting health literacy and their effect on weight loss: a systematic review.

Background: Enhancing individual's health literacy for weight loss is important in addressing the increasing burden of chronic disease due to overweight and obesity. We conducted a systematic review and narrative synthesis to determine the effectiveness of lifestyle interventions aimed at improving adults' knowledge and skills for weight loss in primary health care. The literature search included English-language papers published between 1990 and 30 June 2013 reporting research conducted within Organisation for Economic Cooperation and Development member countries.

Dramatic Increase in the Incidence and Mortality from Merkel Cell Carcinoma in the United States.

Merkel cell carcinoma is a cutaneous neuroendocrine neoplasm that has been poorly studied in contemporary cohorts. Patients with Merkel cell carcinoma from 1986 to 2011 were identified in the Surveillance Epidemiology and End Results registry. A total of 5211 patients met the inclusion criteria.

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

Issue Addressed: Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program.

Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy.

Purpose: To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy.

Methods: A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions.

Increasing incidence of duodenal neuroendocrine tumors: Incidental discovery of indolent disease?

Background: There has been a marked increase in the recognized incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Studies have often combined duodenal neuroendocrine tumors (D-NETs) with other small bowel GEP-NETs. As a result, the natural history and clinical ramifications of these D-NETs is poorly understood.

Prior-list intrusions in serial recall are positional.

Henson (1996) provided a number of demonstrations of error patterns in serial recall that contradict chaining models. One such error pattern concerned when participants make intrusions from prior lists: Rather than originating from random positions in the prior list, intrusions tend to be recalled in the same position as their position in the prior list, a finding which led to the endorsement of positional models of serial recall. However, all of the demonstrations of positional intrusions occurred in designs in which relatively small sets of items were repeatedly employed as stimuli.

Decellularized cartilage may be a chondroinductive material for osteochondral tissue engineering.

Extracellular matrix (ECM)-based materials are attractive for regenerative medicine in their ability to potentially aid in stem cell recruitment, infiltration, and differentiation without added biological factors. In musculoskeletal tissue engineering, demineralized bone matrix is widely used, but recently cartilage matrix has been attracting attention as a potentially chondroinductive material. The aim of this study was thus to establish a chemical decellularization method for use with articular cartilage to quantify removal of cells and analyze the cartilage biochemical content at various stages during the decellularization process, which included a physically devitalization step.

Corn Yield and Soil Nitrous Oxide Emission under Different Fertilizer and Soil Management: A Three-Year Field Experiment in Middle Tennessee.

Background: A three-year field experiment was conducted to examine the responses of corn yield and soil nitrous oxide (N2O) emission to various management practices in middle Tennessee.

Methodology/principal Findings: The management practices include no-tillage + regular applications of urea ammonium nitrate (NT-URAN); no-tillage + regular applications of URAN + denitrification inhibitor (NT-inhibitor); no-tillage + regular applications of URAN + biochar (NT-biochar); no-tillage + 20% applications of URAN + chicken litter (NT-litter), no-tillage + split applications of URAN (NT-split); and conventional tillage + regular applications of URAN as a control (CT-URAN). Fertilizer equivalent to 217 kg N ha(-1) was applied to each of the experimental plots.

A regional assessment of the cost and effectiveness of mitigation measures for reducing nutrient losses to water and greenhouse gas emissions to air from pastoral farms.

Using a novel approach that links geospatial land resource information with individual farm-scale simulation, we conducted a regional assessment of nitrogen (N) and phosphorous (P) losses to water and greenhouse gas (GHG) emissions to air from the predominant mix of pastoral industries in Southland, New Zealand. An evaluation of the cost-effectiveness of several nutrient loss mitigation strategies applied at the farm-scale, set primarily for reducing N and P losses and grouped by capital cost and potential ease of adoption, followed an initial baseline assessment. Grouped nutrient loss mitigation strategies were applied on an additive basis on the assumption of full adoption, and were broadly identified as 'improved nutrient management' (M1), 'improved animal productivity' (M2), and 'restricted grazing' (M3).

The fill-in effect in serial recall can be obscured by omission errors.

Henson (1996) provided a number of demonstrations of error patterns in serial recall that contradict chaining models. Chaining models predict that when participants erroneously recall an item too early, recall should proceed from the point of error. In contradiction to such a prediction, Henson found evidence for a fill-in effect: participants were much more likely to revisit an erroneously skipped item than to continue onward to later list items.

Sources of interference in item and associative recognition memory.

A powerful theoretical framework for exploring recognition memory is the global matching framework, in which a cue's memory strength reflects the similarity of the retrieval cues being matched against the contents of memory simultaneously. Contributions at retrieval can be categorized as matches and mismatches to the item and context cues, including the self match (match on item and context), item noise (match on context, mismatch on item), context noise (match on item, mismatch on context), and background noise (mismatch on item and context). We present a model that directly parameterizes the matches and mismatches to the item and context cues, which enables estimation of the magnitude of each interference contribution (item noise, context noise, and background noise).

Transfer of Escherichia coli O157:H7 from simulated wildlife scat onto romaine lettuce during foliar irrigation.

A field trial in Salinas Valley, California, was conducted during July 2011 to quantify the microbial load that transfers from wildlife feces onto nearby lettuce during foliar irrigation. Romaine lettuce was grown using standard commercial practices and irrigated using an impact sprinkler design. Five grams of rabbit feces was spiked with 1.

Transposable elements as agents of rapid adaptation may explain the genetic paradox of invasive species.

Rapid adaptation of invasive species to novel habitats has puzzled evolutionary biologists for decades, especially as this often occurs in the face of limited genetic variability. Although some ecological traits common to invasive species have been identified, little is known about the possible genomic/genetic mechanisms that may underlie their success. A common scenario in many introductions is that small founder population sizes will often lead to reduced genetic diversity, but that invading populations experience large environmental perturbations, such as changes in habitat and environmental stress.