Barriers to and supports of family participation in a rural system of care for children with serious emotional problems.

Researchers have not adequately addressed the unique characteristics of rural areas that influence the accessibility of services for families with children who have serious emotional problems. Understanding rurality is particularly important to "systems of care" grant sites because these grants are intended to restructure mental health service delivery by building upon the strengths of a community and addressing the community's needs. This qualitative study examines the barriers to and supports for participation in services within a rural system of care site through the reported experiences of eight caregivers and nine staff.

Diagnostic yield of renal biopsies: a retrospective single center review.

Background: Previous studies have examined the spectrum of diseases identified with a kidney biopsy and the complications of the procedure. However, few studies have examined the utility of the test to clarify the diagnosis and guide treatment of pediatric patients. This retrospective, single-center chart review was performed to test the hypothesis that at least 80% of native kidney biopsies provide clinically valuable information that rationally guides diagnosis and patient management.

Parry-Romberg syndrome presenting as status migrainosus.

Parry-Romberg is a rare syndrome of unknown origin, characterized by hemiatrophy of the face including subcutaneous tissue, skeletal muscle, and bones, along with various ocular and central nervous system abnormalities. Some investigators consider that injury to the sympathetic fibers of the trigeminal nerve is a cause for evolution of this syndrome. Various central nervous system symptoms have been reported in correlation with the syndrome, including epilepsy and hemiparesis.

Affective forecasting and advance care planning: anticipating quality of life in future health statuses.

That sicker people evaluate quality of life in future health status more positively, compared to healthier people, is viewed as an instance of affective forecasting error and explained by Prospect Theory, which holds that two prospects (poor health vs death) are more distinguishable when they are imminent than when distant. In a sample of 230 elderly people, we tested whether life in nine health scenarios would be more acceptable to less healthy individuals than to healthier ones. An interaction between current health status and health scenario supported the relative acceptability of poor-health prospects to sicker individuals, confirming the hypothesis.

Can a priori defined reference criteria be used to select reference sites in Danish streams? Implications for implementing the Water Framework Directive.

An important step in the implementation of the Water Framework Directive is to define and characterize the natural status, designated as the reference condition (RC). Here we present the results of a type-specific screening for reference stream sites in Denmark using two different approaches. First, we performed a screening applying physicochemical, hydro-morphological and pressure criteria at the catchment, reach and site level of a total of 128 sites a priori selected by the regional water authorities as representing the best sites in Denmark.

Mother-infant interactions in free-ranging rhesus macaques: relationships between physiological and behavioral variables.

Studies of mother-infant relationships in nonhuman primates have increasingly attempted to understand the neuroendocrine bases of interindividual variation in mothering styles and the mechanisms through which early exposure to variable mothering styles affects infant behavioral development. In this study of free-ranging rhesus macaques on Cayo Santiago, Puerto Rico, we aimed to: 1) compare lactating and nonlactating females to investigate whether lactation is associated with changes in plasma cortisol, prolactin and oxytocin, as well as changes in CSF levels of serotonin and dopamine metabolites (5-HIAA and HVA); 2) examine the extent to which interindividual variation in maternal physiology is associated with variation in maternal behavior; 3) examine the extent to which interindividual variation in infant physiology and behavior is accounted for by variation in maternal physiology and behavior. Lactating females had higher plasma concentrations of cortisol, prolactin, and oxytocin but lower CSF concentrations of HVA than nonlactating females.

Assessment of the accuracy of two gutta-percha gauges used to alter gutta-percha tip diameter.

This study sought to compare the accuracy of two gauges used to alter gutta-percha (GP) cone tips. Randomly selected size 20 cones (with tapers of 0.02, 0.

IgA nephropathy: a twenty year retrospective single center experience.

IgA nephropathy (IgAN) is a common glomerular disease whose etiology is unknown. Previous studies have described the clinical and laboratory features but none have specifically compared patients during different time periods. This 20 year retrospective study was performed to assess trends in the severity of IgAN from 1989-2008.

Discovery of localized regions of excess 10-TeV cosmic rays.

The 7 year data set of the Milagro TeV observatory contains 2.2 x 10(11) events of which most are due to hadronic cosmic rays. These data are searched for evidence of intermediate scale structure.

Severe pruritus after completing pegylated interferon for hepatitis C.

Porphyria cutanea tarda is a disease of disordered accumulation of heme, which is needed for biosynthesis of hepatic cytochromes. It most commonly occurs in a sporadic form among persons infected with hepatitis C virus (HCV); however, HIV infection is also a reported risk factor. Hepatic iron overload appears to play an important role in the pathogenesis of porphyria cutanea tarda.

Comparison of gestational age at birth based on last menstrual period and ultrasound during the first trimester.

Reported last menstrual period (LMP) is commonly used to estimate gestational age (GA) but may be unreliable. Ultrasound in the first trimester is generally considered a highly accurate method of pregnancy dating. The authors compared first trimester report of LMP and first trimester ultrasound for estimating GA at birth and examined whether disagreement between estimates varied by maternal and infant characteristics.

Evaluation of pediatric patients with mild-to-moderate hypertension: yield of diagnostic testing.

Objective: Children and adolescents with newly diagnosed hypertension undergo various tests to define the cause and target organ consequences of the elevated blood pressure. We tested the hypothesis that the diagnostic yield of individual components of the currently recommended assessment does not justify performance for all patients with mild-to-moderate hypertension.

Methods: A retrospective chart review was conducted of patients who were referred between July 2002 and June 2007 for mild-to-moderate hypertension, defined as maximum blood pressure at >or=95% + 20/10 mmHg.

Intraoperative assessment of endoscopic third ventriculostomy success.

Object: The authors' aim in this study was to determine if standardizing the evaluation of intraoperative findings during endoscopic third ventriculostomy (ETV) could predict patients with hydrocephalus in whom endoscopic treatment will fail and require ventriculoperitoneal shunt treatment. The creation of a uniform scale with predictive outcomes may reduce returns to the operating room for shunt treatment and reliance on postoperative externalized ventricular monitoring and MR imaging.

Methods: The authors evaluated the preoperative history, intraoperative findings, and postoperative monitoring and imaging findings in 109 consecutive patients undergoing 112 consecutive attempted ETVs for obstructive hydrocephalus.

Multiple congenital skull fractures as a presentation of Ehlers-Danlos syndrome type VIIC.

We describe a newborn infant with multiple congenital skull fractures and intracranial hemorrhage. He also had multiple skin folds suggesting a connective tissue abnormality. Electron microscopy of the skin biopsy showed collagen abnormalities with a "hieroglyphic appearance.

Intruder configurations in the A=33 isobars: 33Mg and 33Al.

The beta decay of 33Mg (N=21) presented in this Letter reveals intruder configurations in both the parent and the daughter nucleus. The lowest excited states in the N=20 daughter nucleus, 33Al, are found to have nearly 2p-2h intruder configuration, thus extending the "island of inversion" beyond Mg. The allowed direct beta-decay branch to the 5/2{+} ground state of the daughter nucleus 33Al implies positive parity for the ground state of the parent 33Mg, contrary to an earlier suggestion of negative parity from a g-factor measurement.

Transcavum interforniceal endoscopic surgery of the third ventricle.

Object: Intraventricular anatomy has been detailed as it pertains to endoscopic surgery within the third ventricle, particularly for performing endoscopic third ventriculostomy (ETV) and endoscopic colloid cyst resection. The expanding role of endoscopic surgery warrants a careful appraisal of these techniques as they relate to frequent anatomical variants. Given the common occurrence of cavum septum pellucidum (CSP) and cavum vergae (CV), the endoscopic surgeon should be familiar with that particular anatomy especially as it pertains to surgery within the third ventricle.

Stepwise chromatin remodelling by a cascade of transcription initiation of non-coding RNAs.

Recent transcriptome analyses using high-density tiling arrays and data from large-scale analyses of full-length complementary DNA libraries by the FANTOM3 consortium demonstrate that many transcripts are non-coding RNAs (ncRNAs). These transcriptome analyses indicate that many of the non-coding regions, previously thought to be functionally inert, are actually transcriptionally active regions with various features. Furthermore, most relatively large ( approximately several kilobases) polyadenylated messenger RNA transcripts are transcribed from regions harbouring little coding potential.

Mothers' and fathers' differential expectancies and behaviors: parent x child gender effects.

In 3 studies using 6 subscales, the authors investigated (a) others' parenting expectancies for mothers and fathers and (b) parents' reports of the frequency of their parenting behaviors with their 3- to 6-year-old sons and daughters. Mothers rated higher for physical care and emotional support than did fathers, and mothers reported engaging in the parenting behaviors assessed more frequently than did fathers across subscales. In each study, the authors obtained Parent x Child Gender interactions only for personal-interaction parenting (e.

Sleep problems of parents of typically developing children and parents of children with autism.

Few researchers have investigated the relation of children's sleep problems to their parents' sleep problems. Children with autism have been reported to evidence greater sleep problems than do typically developing children (C. D.

Sex differences in survival costs of reproduction in a promiscuous primate.

In sexually promiscuous mammals, female reproductive effort is mainly expressed through gestation, lactation, and maternal care, whereas male reproductive effort is mainly manifested as mating effort. In this study, we investigated whether reproduction has significant survival costs for a seasonally breeding, sexually promiscuous species, the rhesus macaque, and whether these costs occur at different times of the year for females and males, namely in the birth and the mating season, respectively. The study was conducted with the rhesus macaque population on Cayo Santiago, Puerto Rico.

Eroding access among nonelderly U.S. adults with chronic conditions: ten years of change.

Both the connection to health care and its affordability worsened for many nonelderly U.S. adults living with chronic conditions between 1997 and 2006.

Drinking water disinfection by-product exposure and fetal growth.

Background: Previous studies suggest that elevated exposure to drinking water disinfection by-products (DBPs)--in particular, total trihalomethanes (TTHMs)--may lead to fetal growth restriction. We examined the effects of exposure to TTHMs, haloacetic acids, and total organic halide on the probability of delivering a small-for-gestational-age (SGA) infant and on birth weight at term.

Methods: Women early in pregnancy (< or =12 weeks' gestation) or planning a pregnancy were enrolled in a prospective pregnancy study conducted in 3 US communities from 2000 through 2004.

Drinking water disinfection by-product exposure and duration of gestation.

Background: Recent studies suggest elevated exposure to drinking water disinfection by-products (DBPs) may be associated with decreased risk of preterm birth. We examined this association for exposure to total trihalomethanes (TTHMs), 5 haloacetic acids (HAA5), and total organic halides.

Methods: Analysis included 2039 women in a prospective pregnancy study conducted from 2000 through 2004 in 3 study sites.

Broadening the patient safety agenda to include safety in long-term care.

The recent patient safety literature has included less of an emphasis on long-term settings than on research in the acute care sector. Recognizing this knowledge gap in our understanding of safety in the long-term care sector, the Canadian Patient Safety Institute, Capital Health (Edmonton) and CapitalCare (Edmonton) have collaborated to create a research and action agenda for improving resident safety in Canadian long-term care settings. This collaboration resulted in the development of a background paper highlighting the current state of the science and 14 key-informant interviews with stakeholders across Canada.