Dopamine transporter blockade during adolescence increases adult dopamine function, impulsivity, and aggression.

Sensitive developmental periods shape neural circuits and enable adaptation. However, they also engender vulnerability to factors that can perturb developmental trajectories. An understanding of sensitive period phenomena and mechanisms separate from sensory system development is still lacking, yet critical to understanding disease etiology and risk.

Medial Prefrontal Cortex Serotonin Input Regulates Cognitive Flexibility in Mice.

The medial prefrontal cortex (mPFC) regulates cognitive flexibility and emotional behavior. Neurons that release serotonin project to the mPFC, and serotonergic drugs influence emotion and cognition. Yet, the specific roles of endogenous serotonin release in the mPFC on neurophysiology and behavior are unknown.

Occam's Razor and Prehospital Documentation: When the Simpler Solution Resulted in Better Documentation.

Introduction: The Tactical Combat Casualty Care (TCCC) card has undergone several changes since its first introduction in 1996. In 2013, updates to the card included more data points to increase prehospital documentation quality and enable performance improvement. This study reviews the proportions of data collected before and after the implementation of the new TCCC card.

Evaluating Interorganizational Collaborations: Lessons Learned from Five California Geriatric Workforce Enhancement Programs.

Background: Five Geriatric Workforce Enhancement Programs (GWEPs) in California, funded for 4 years, worked collaboratively across different organizations to provide education on aging issues and/or training to enhance services for older adults.

Objectives: To investigate characteristics of the collaborations that were associated with perceptions and experiences of success for participating organizations.

Methods: A survey distributed to 37 organizations participating in 5 GWEPs measured the correlation of resources and dimensions of collaboration with perceived sense of success of the collaborations.

Inclusion of the homeless in health equity curricula: a needs assessment study.

Exposure to homeless patients is a potential strategy to teach about social determinants of health and health inequities. Little is known about student attitudes and preferences for learning about the homeless in curricula addressing vulnerable populations. A needs assessment to determine student readiness may inform strategies for teaching.

Interprofessional, older adult, team-based home visits: A 6-year prospective analysis.

This 6-year prospective study describes the impact on student attitudes of an innovative, interprofessional geriatrics curriculum (IPGC) focused on team-based care with older adults in a home-based community setting. Dental, medical, occupational therapy, pharmacy, physical therapy, and physician assistant students were placed into teams each led by faculty members from all of the professions. The curriculum consisted of five, four-hour sessions over one academic year.

Occupational Therapy Student Learning on Interprofessional Teams in Geriatric Primary Care.

Importance: Geriatric, interprofessional primary care training for occupational therapy students is needed.

Objective: To measure occupational therapy student-reported knowledge, attitudes, and skills after participation in interprofessional geriatric educational programs.

Design: Prospective, observational study with pre- and posttests for the three programs.

Scopolamine Toxicity in an Elderly Patient.

We present a case of a 66-year-old female who was to undergo a scheduled operation and placed on our institution's ERAS (Enhanced Recovery After Surgery) protocol. The intraoperative course was unremarkable. The patient developed delayed emergence in the Post-Anesthesia Care Unit.

AGGRESSIVE ENACTMENTS: CONTAINING THE "NO" IN CLINICAL WORK WITH SURVIVORS OF ABUSE.

Identity development depends on the ability to say 'no.' Setting limits enables a relationship between two separate individuals to develop. Early trauma can leave the individual so vigilant to others' demands that internal prohibitions against intrusion remain silenced, which we conceptualize as a 'no' that could not be sufficiently articulated to keep the person safe.

Mandated wrapping of airway cart instruments: Limited access without the intended safety benefits.

Objectives/hypothesis: Isolated case studies have shown improper sterilization or contamination of equipment from anesthesia carts can lead to transmission of disease and even death. Citing this literature, national accrediting agencies mandated all instruments in the otolaryngology airway carts at San Antonio Military Medical Center be packaged to prevent contamination. This study sought to determine the infection and safety implications of packaged airway cart instruments.

Hippocampal neurogenesis confers stress resilience by inhibiting the ventral dentate gyrus.

Adult neurogenesis in the dentate gyrus of the hippocampus is highly regulated by environmental influences, and functionally implicated in behavioural responses to stress and antidepressants. However, how adult-born neurons regulate dentate gyrus information processing to protect from stress-induced anxiety-like behaviour is unknown. Here we show in mice that neurogenesis confers resilience to chronic stress by inhibiting the activity of mature granule cells in the ventral dentate gyrus (vDG), a subregion that is implicated in mood regulation.

Regional Anesthesia in the Setting of Arm Replantation: A Case Report.

The perioperative implementation of continuous peripheral nerve blocks is poorly described within the literature for replantation surgeries beyond digital replantation. The management of replantation patients presents a challenging balance between pain control and limb perfusion. We report the successful use of a continuous interscalene catheter in a therapeutically anticoagulated patient after midshaft humerus arm replantation.

Intraoperative Endotracheal Cuff Pressure Study: How Education and Availability of Manometers Help Guide Safer Pressures.

Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae.

An evaluation of organ dose modulation on a GE optima CT660-computed tomography scanner.

Organ Dose Modulation or ODM (GE Healthcare, Milwaukee, WI) was evaluated to characterize changes in CTDIvol, image noise, effective dose, and organ dose saving to patients. Three separate investigations were completed: a tube current modulation phantom was scanned with and without ODM, a CTDIvol phantom was scanned with ODM, and Monte Carlo simulations were performed. ODM was found to reduce the CTDIvol by approximately 20% whilst increasing the noise by approximately 14%.

National Trends in Indicators of a Medical Home for Children.

Objectives: The patient centered medical home is now widely supported as a strategy for delivering high quality primary care. The objective of this study was to examine whether children's primary care experiences nationally have become more aligned with the medical home model over time, and how this may have varied for vulnerable children.

Methods: This study analyzed data on 289,672 children, aged 0-17 years, of families responding to one of three iterations of National Survey of Children's Health from 2003, 2007 and 2011-2012.

Multimodal analgesia in abdominal sepsis: a case report of liposome bupivacaine in ultrasound-guided rectus sheath blocks after unexpected open hemi-colectomy.

Objective: Contrasted with open laparotomy, the risk-benefit ratio of epidural anesthesia in laparoscopic surgery frequently disfavors its use. The presence of abdominal sepsis also affects utilization with concerns about the risks of epidural abscess and hypotension. In the unplanned conversion to open laparotomy, postoperative pain control becomes more difficult.

Primary care medical home experience and health-related quality of life among adult medicaid patients with type 2 diabetes.

Purpose: To examine whether patient-reported indicators of medical home performance are associated with health-related quality of life (HRQOL) among adults with type 2 diabetes.

Methods: Cross-sectional survey of 540 patients with Medicaid insurance and type 2 diabetes in Los Angeles County. The Primary Care Assessment Tool was used to measure seven features of medical home performance.

Do experiences consistent with a medical-home model improve diabetes care measures reported by adult Medicaid patients?

Objective: The patient-centered medical home has gained much traction. Little is known about the relationship between the model and specific health care processes for chronic diseases such as diabetes. This study assesses the impact of features of a medical home on diabetes care.

miR-208a as a biomarker of isoproterenol-induced cardiac injury in Sod2+/- and C57BL/6J wild-type mice.

This investigation examined microRNA-208a (miR-208a) as a potential biomarker of isoproterenol (ISO)-induced cardiac injury in superoxide dismutase-2 (Sod2(+/-) ) and the wild-type mice, and the potential sensitivity of Sod2(+/-) mice to ISO-induced toxicity. A single intraperitoneal injection of ISO was administered to age-matched wild-type and Sod2(+/-) mice at 0, 80, or 160 mg/kg. Plasma miR-208a, cardiac troponin I (cTnI), and ISO systemic exposure were measured at various time points postdose.

Workaholism, work engagement and work-home outcomes: exploring the mediating role of positive and negative emotions.

This study examines the mechanisms through which workaholism and work engagement impact work-home conflict and enrichment, respectively. Specifically, we examine the mediating role of positive and negative emotions (e.g.

Engaging employed physicians: reconceptualizing the role of collective identification.

Purpose: This chapter proposes a paradigm shift in considering the collective identification of employed physicians and how it influences physician engagement.

Design/methodology/approach: There are many challenges for organizations employing physicians, particularly in terms of engagement in organizational initiatives. Prior research suggests this conflict stems from how physicians think of themselves as professionals versus employees (as forms of collective identification).

Duration of a well-child visit: association with content, family-centeredness, and satisfaction.

Background: Studies of pediatric primary care suggest that time is an important limitation to the delivery of recommended preventive services. Given the increasingly frenetic pace of pediatric practice, there is an increased need to monitor the length of pediatric visits and the association of visit length with content, family-centered care, and parent satisfaction with care.

Objective: To examine the length of well-child visits and the associations of visit length with content, family-centered care, and parent satisfaction among a national sample of children.

Individual filamentous phage imaged by electron holography.

An in-line electron hologram of an individual f1.K phage was recorded with a purpose-built low energy electron point source (LEEPS) microscope. Cryo-microscopic methods were employed to prepare the specimen so that a single phage could be presented to the coherent low energy electrons: An aqueous phage suspension was applied to a thin carbon membrane with micro-machined slits.