De novo congenital melanoma: analysis of 2 cases with array comparative genomic hybridization.

Congenital melanoma is extraordinarily rare, and 3 types have been described: transplacental metastases from the mother, de novo congenital melanoma, and melanoma occurring in association with a congenital melanocytic nevus. We describe 2 reports of array comparative genomic hybridization analysis of de novo congenital melanoma. The first patient was male, and the second was female; both had a scalp lesion present at birth, which grew quickly.

Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

Background: Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong.

Objectives: The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong.

Severe enterocolitis associated with antiepileptic-induced drug reaction with eosinophilia and systemic symptoms.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but serious drug-induced reaction with cutaneous, hematologic, and solid-organ injury. Antiepileptic drugs are one of the most common classes of drugs implicated in DRESS. A high morbidity and mortality may result, especially if the offending drug is not withdrawn promptly.

Mixed feelings about the diagnosis of type 2 diabetes mellitus: a consequence of adjusting to health related quality of life.

This study aims to explore patients' reactions to the diagnosis of type 2 diabetes mellitus (T2DM) and their health related quality of life. We adopted a qualitative exploratory study design using a thematic analysis. Twelve patients with T2DM for more than a 2-year duration were interviewed using a semi-structured interview guide.

A forgotten clinical sign making a comeback.

We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet.

The effects of humor therapy on nursing home residents measured using observational methods: the SMILE cluster randomized trial.

Objectives: To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment.

Design: Single-blind cluster randomized controlled trial.

Setting: A total of 35 Sydney nursing homes.

The relationship between the quality of the built environment and the quality of life of people with dementia in residential care.

While there is considerable evidence on the impact of specific design features on problems associated with dementia, the link between the quality of the built environment and quality of life of people with dementia is largely unexplored. This study explored the environmental and personal characteristics that are associated with quality of life in people with dementia living in residential aged care. Data were obtained from 275 residents of 35 aged care homes and analysed using linear regression.

Urban American Indian Adolescent Girls: Framing Sexual Risk Behavior.

Purpose: The purpose of this study was to explore factors that influence urban adolescent American Indian (AI) girls' sexual risk behavior.

Design: A qualitative study was conducted with grounded theory methodology to reveal factors and processes that influence sexual risk behavior.

Method: Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15- to 19-year-old girls to explore influences on sexual risk behavior.

The role of maternity care providers in promoting shared decision making regarding birthing positions during the second stage of labor.

Introduction: Through the use of a variety of birthing positions during the second stage of labor, a woman can increase progress, improve outcomes, and have a positive birth experience. The role that a maternity care provider has in determining which position a woman uses during the second stage of labor has not been thoroughly explored. The purpose of this qualitative investigation was to explore how maternity care providers communicate with women during the second stage of labor regarding birthing position.

Rab5 and Ndfip1 are involved in Pten ubiquitination and nuclear trafficking.

The spatial regulation of Pten is critical for its role as a tumour suppressor with both nuclear and cytoplasmic locations being implicated with distinct functions. In the cytoplasm, Pten plays a central role in opposing PI3K/Akt cell signalling, whereas in the nucleus, Pten is important for maintaining genome stability and enhancing the tumour suppressor activity of APC-CDH1. Despite this diversity in protein function at different subcellular locations, there is limited knowledge on how Pten is able to find different cellular niches.

TIMES-SS--recent refinements resulting from an industrial skin sensitisation consortium.

The TImes MEtabolism Simulator platform for predicting Skin Sensitisation (TIMES-SS) is a hybrid expert system, first developed at Bourgas University using funding and data from a consortium of industry and regulators. TIMES-SS encodes structure-toxicity and structure-skin metabolism relationships through a number of transformations, some of which are underpinned by mechanistic 3D QSARs. The model estimates semi-quantitative skin sensitisation potency classes and has been developed with the aim of minimising animal testing, and also to be scientifically valid in accordance with the OECD principles for (Q)SAR validation.

Consumer information on fetal heart rate monitoring during labor: a content analysis: a content analysis.

Electronic fetal monitoring (EFM) is used for the majority of births that occur in the United States. While there are indications for use of EFM for women with high-risk pregnancies, its use in low-risk pregnancies is less evidence-based. In low-risk women, the use of EFM is associated with an increased risk for cesarean birth compared with the use of intermittent auscultation of the fetal heart rate.

Computer-assisted direct observation of behavioral agitation, engagement, and affect in long-term care residents.

Objectives: The objectives of the current research were (1) to test and evaluate the investigator-designed Behavior, Engagement, and Affect Measure (BEAM) touchpad direct observational data collection tool, and (2) to implement this tool to investigate residents' patterns of behavioral agitation, engagement, affect, behaviors associated with positive mood, general time-activity use, and social interactions within long-term care.

Design: Raters collected cross-sectional observational data and conducted semistructured interviews with participants of the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) Study. Researchers tested the BEAM's reliability and validity and evaluated the instrument's discriminate validity for sampling resident behaviors.

Community care for the Elderly: Needs and Service Use Study (CENSUS): Who receives home care packages and what are the outcomes?

Aim: Investigate factors associated with waiting times for home care packages and outcomes for care recipients and carers.

Method: Analyses of data collected every four months for 12 months from 55 community-dwelling older adults eligible for government-subsidised packaged care and their carers.

Results: Thirty of fifty-five participants were offered a package; they waited from one to 237 days.

Moving toward patient-centered care: Women's decisions, perceptions, and experiences of the induction of labor process.

Background: Patient preferences and clinician practices are possible causative factors to explain the increase in induction of labor, but scientific studies that demonstrate this link are limited. The purpose of this study is to identify factors that influence inductions from the perspective of women.

Methods: A qualitative investigation using grounded theory methodology was conducted.

The clinical significance of aldosterone synthase deficiency: report of a novel mutation in the CYP11B2 gene.

Background: Aldosterone synthase (CYP11B2) deficiency is a rare autosomal recessive disorder, usually presenting with severe salt-wasting in infancy or stress-induced hyperkalaemia and postural hypotension in adulthood. Neonatal screening for congenital adrenal hyperplasia, another cause of salt wasting, using 17-hydroxyprogesterone measurement would fail to detect aldosterone synthase deficiency, a diagnosis which may be missed until the patient presents with salt-wasting crisis. Due to this potential life-threatening risk, comprehensive hormonal investigation followed by genetic confirmation for suspected patients would facilitate clinical management of the patient and assessment of the genetic implication in their offspring.

Correlates of psychological distress in study partners of older people with and without mild cognitive impairment (MCI) - the Sydney Memory and Ageing Study.

Objectives: Psychological effects of supporting someone with mild cognitive impairment (MCI) are often overlooked. We aimed to establish correlates of psychological distress in study partners of individuals with and without nonclinical MCI.

Methods: Demographic, psychosocial and health measures were obtained cross-sectionally from 714 participants (39% MCI) and study partners of a longitudinal community-based study on cognitive aging.

Varicella encephalitis and pneumonia in a patient with end stage renal failure.

We describe a patient with end stage renal failure (ESRF) on hemodialysis who was admitted to our department for primary varicella infection complicated by varicella pneumonia and encephalitis. Varicella infections results in serious morbidity and mortality in ESRF dialysis and transplant patients. Evidence published thus far suggests that live attenuated varicella vaccines are effective and safe in ESRF and renal transplant patients.

Metabolic brain activity suggestive of persistent pain in a rat model of neuropathic pain.

Persistent pain is a central characteristic of neuropathic pain conditions in humans. Knowing whether rodent models of neuropathic pain produce persistent pain is therefore crucial to their translational applicability. We investigated the spared nerve injury (SNI) model of neuropathic pain and the formalin pain model in rats using positron emission tomography (PET) with the metabolic tracer [18F]fluorodeoxyglucose (FDG) to determine if there is ongoing brain activity suggestive of persistent pain.

What do clients expect of community care and what are their needs? The Community care for the Elderly: Needs and Service Use Study (CENSUS).

Objective: To investigate the relationship between objectively assessed care needs and expectations for care of older people and their carers, before commencement of community care services.

Method: Cross-sectional research on 55 community-dwelling older adults and carers, recruited after receiving approval for government-subsidised community care services. Care needs and expectations of care were assessed at interview.

Facilitating women's choice in maternity care.

Maternity careproviders often have strong views concerning a woman's choice of where to give birth.These views may be based on the ethical principle of autonomy, or on the principle of beneficence. The authors propose that an approach utilizing shared decision making allows careproviders and women to move beyond disagreements regarding which evidence on risk should "counts' instead adopting a process of increased knowledge and support for women and their partner while they make choices regarding place of birth.

Nuclear trafficking of Pten after brain injury leads to neuron survival not death.

There is controversy whether accumulation of the tumor suppressor PTEN protein in the cell nucleus under stress conditions such as trauma and stroke causes cell death. A number of in vitro studies have reported enhanced apoptosis in neurons possessing nuclear PTEN, with the interpretation that its nuclear phosphatase activity leads to reduction of the survival protein phospho-Akt. However, there have been no in vivo studies to show that nuclear PTEN in neurons under stress is detrimental.

Caregivers' experience of the decision-making process for placing a person with dementia into a nursing home: comparing caregivers from Chinese ethnic minority with those from English-speaking backgrounds.

Background: The experience of care transitions for people with dementia from ethnic minority groups has been poorly researched. Few studies have examined the decision to put someone on a waiting list for a nursing home and then actually accept a place. Many nursing homes have long waiting lists, but sometimes offers of a place are declined.

Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life.

Background: Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers.