Barriers to Client Engagement and Strategies to Improve Participation in Mental Health and Supported Employment Services.

Objective: A few clients in every mental health center present challenging behaviors, have difficulty engaging in services, and create stress within the treatment team. The authors provided consultations on clients with these characteristics over 4 years in the Social Security Administration's Supported Employment Demonstration (SED).

Methods: Four experienced community mental health leaders provided consultations on 105 of nearly 2,000 clients receiving team-based behavioral health and employment services in the SED.

The Psychiatric Nurse Care Coordinator on a Multi-disciplinary, Community Mental Health Treatment Team.

Community mental health nurses sometimes join multi-disciplinary teams, but the role has not been defined and studied carefully. This article describes the psychiatric Nurse Care Coordinator (NCC)-a unique position created to support care management, facilitate systematic medication management, and coordinate medical care in the Social Security Administration's 30-site Supported Employment Demonstration. The authors reviewed the study's NCC manual, supervised and consulted with the NCCs weekly over nearly three years, and reviewed data on NCC activities.

The Physical Health Care Fidelity Scale: Psychometric Properties.

Mental health programs need an instrument to monitor adherence to evidence-based physical health care for people with serious mental illness. The paper describes the Physical Health Care Fidelity Scale and study interrater reliability, frequency distribution, sensitivity to change and feasibility. Four fidelity assessments were conducted over 18 months at 13 sites randomized to implementation support for evidence-based physical health care.

Oas1b-dependent Immune Transcriptional Profiles of West Nile Virus Infection in the Collaborative Cross.

The oligoadenylate-synthetase () gene locus provides innate immune resistance to virus infection. In mouse models, variation in the gene influences host susceptibility to flavivirus infection. However, the impact of variation on overall innate immune programming and global gene expression among tissues and in different genetic backgrounds has not been defined.

Transcriptional profiles of WNV neurovirulence in a genetically diverse Collaborative Cross population.

West Nile Virus (WNV) is a mosquito-transmitted virus from the Flaviviridae family that causes fever in 1 in 5 infected people. WNV can also become neuro-invasive and cross the blood-brain barrier leading to severe neurological symptoms in a subset of WNV infected individuals [1]. WNV neuro-invasion is believed to be influenced by a number of factors including host genetics.

Identifying protective host gene expression signatures within the spleen during West Nile virus infection in the collaborative cross model.

Flaviviruses are hematophagous arthropod-viruses that pose global challenges to human health. Like Zika virus, West Nile Virus (WNV) is a flavivirus for which no approved vaccine exists [1]. The role host genetics play in early detection and response to WNV still remains largely unexplained.

Endogenous retroviruses mobilized during friend murine leukemia virus infection.

We have demonstrated in a mouse model that infection with a retrovirus can lead not only to the generation of recombinants between exogenous and endogenous gammaretrovirus, but also to the mobilization of endogenous proviruses by pseudotyping entire polytropic proviral transcripts and facilitating their infectious spread to new cells. However, the frequency of this occurrence, the kinetics, and the identity of mobilized endogenous proviruses was unclear. Here we find that these mobilized transcripts are detected after only one day of infection.

Hypersensitivity pneumonitis in workers exposed to metalworking fluids.

Background: This study used data from a large UK outbreak investigation, to develop and validate a new case definition for hypersensitivity pneumonitis due to metalworking fluid exposure (MWF-HP).

Methods: The clinical data from all workers with suspected MWF-HP were reviewed by an experienced panel of clinicians. A new MWF-HP Score was then developed to match the "gold standard" clinical opinion as closely as possible, using standard diagnostic criteria that were relatively weighted by their positive predictive value.

Activating older adults with serious mental illness for collaborative primary care visits.

Objective: Persons with serious mental illness frequently receive inadequate medical care and are more likely to experience difficulty navigating the health care system compared with the general population. To address this gap in quality, we developed a program of peer co-led collaborative activation training for primary care (CAT-PC) designed to improve "patient activation" and person-centered care in primary care visits for middle-aged and older adults with serious mental illness and cardiovascular risk. This report presents pilot study feasibility and participant outcomes for CAT-PC.

Profound amplification of pathogenic murine polytropic retrovirus release from coinfected cells.

Previous studies indicate that mice infected with mixtures of mouse retroviruses (murine leukemia viruses [MuLVs]) exhibit dramatically altered pathology compared to mice infected with individual viruses of the mixture. Coinoculation of the ecotropic virus Friend MuLV (F-MuLV) with Fr98, a polytropic MuLV, induced a rapidly fatal neurological disease that was not observed in infections with either virus alone. The polytropic virus load in coinoculated mice was markedly enhanced, while the ecotropic F-MuLV load was unchanged.

Standards of care for occupational asthma: an update.

Background: The British Thoracic Society (BTS) Standards of Care (SoC) Committee produced a standard of care for occupational asthma (OA) in 2008, based on a systematic evidence review performed in 2004 by the British Occupational Health Research Foundation (BOHRF).

Methods: BOHRF updated the evidence base from 2004-2009 in 2010.

Results: This article summarises the changes in evidence and is aimed at physicians, nurses and other healthcare professionals in primary and secondary care, occupational health and public health and at employers, workers and their health, safety and other representatives.

The glycosylated Gag protein of a murine leukemia virus inhibits the antiretroviral function of APOBEC3.

APOBEC proteins have evolved as innate defenses against retroviral infections. Human immunodeficiency virus (HIV) encodes the Vif protein to evade human APOBEC3G; however, mouse retroviruses do not encode a Vif homologue, and it has not been understood how they evade mouse APOBEC3. We report here a murine leukemia virus (MuLV) that utilizes its glycosylated Gag protein (gGag) to evade APOBEC3.

"Popcorn worker's lung" in Britain in a man making potato crisp flavouring.

This case involves a 36 year old non-smoker who worked in a factory producing food flavourings for potato crisps. He developed exertional breathlessness associated with fixed airway obstruction shortly after an uncharacteristically high exposure to the food flavouring chemical diacetyl. Unfortunately, even though he was removed from further exposure to this agent, his symptoms and spirometry did not improve.

"Popcorn worker's lung" in Britain in a man making potato crisp flavouring.

The case history is presented of a patient who developed "popcorn worker's lung" following exposure to 2,3-butanedione (diacetyl). Other similar cases are reviewed, and it is concluded that "food flavourer's lung" may be a more suitable diagnostic label.

Are we failing workers with symptoms suggestive of occupational asthma?

Aims: To assess the route to secondary care for patients with possible occupational asthma, and to document the duration of workrelated symptoms and referral times.

Methods: Consecutive patients with suspected occupational asthma were recruited to a case series from six secondary care clinics with an interest in occupational asthma. Semi-structured interviews were performed and hospital case notes were reviewed to summarise relevant investigations and diagnosis.

Discordance between cross-sectional and longitudinal studies for the effect of dust on COPD: why?

Regression analyses for the effect of an environmental agent on lung function often give discordant results when derived from cross-sectional compared with longitudinal studies. To evaluate why this occurs, a normal population was created by computer, and modeled to simulate functional change during life. Thus, factors known to influence lung function measurement (including those that may cause COPD) were manipulated experimentally so that their contributions to any discordance could be assessed.

Occupational asthma: an assessment of diagnostic agreement between physicians.

Objectives: To investigate the levels of agreement between expert respiratory physicians when making a diagnosis of occupational asthma.

Methods: 19 cases of possible occupational asthma were identified as part of a larger national observational cohort. A case summary for each case was then circulated to 12 physicians, asking for a percentage likelihood, from the supplied information, that this case represented occupational asthma.

Relation of expired carbon monoxide to smoking history, lapsed time, TLCO measurement and passive smoking.

We quantified the influence of lapsed time, measurement of gas-transfer factor (TLCO), and passive smoking on expired carbon monoxide (CO) levels, and then evaluated the accuracy of smoking histories against expired CO measurements in patients newly attending 'occupational' compared with 'general' chest clinics. Expired CO levels had an estimated average rate of decline of 3.4 ppm/h in the presumed absence of further smoking, though individual rates depended necessarily on the initial levels (2.

Apparent but not real increase in asthma prevalence during the 1990s.

The authors investigated changes in asthma prevalence and perception of bronchoconstriction over 6 yrs in adults of Newcastle-upon-Tyne. Postal questionnaires were sent to 6,000 subjects aged 20-44 yrs in 1992-1993 and 1998-1999. Random samples of 600 responders had assessments of atopy, airway responsiveness, and their ability to perceive methacholine-induced bronchoconstriction.