Identifying and Integrating Parent Priorities for Psychosocial Support Services in a Pediatric Cystic Fibrosis Clinic.

Engaging parents early in the development of psychosocial support programs in cystic fibrosis (CF) clinics may enable services and care team recommendations to be tailored appropriately. This pilot study identified psychosocial priorities of parents of children with CF related to treatment adherence, parent/child mental health, and CF-related communication. Forty parents of children with CF (2 months to 17 years) completed an anonymous 17-item survey during routine clinic visits that assessed priorities related to psychosocial services.

Physicians reentering clinical practice: characteristics and clinical abilities.

Introduction: Limited information exists to describe physicians who return to practice after absences from patient care. The Center for Personalized Education for Physicians (CPEP) is an independent, not-for-profit organization that provides clinical competency assessment and educational programs for physicians, including those reentering practice. This article studies the medical licensure status, performance, and correlates between physician characteristics and performance on initial assessment.

Repair of periprosthetic pelvis defects with porous metal implants: a finite element study.

Periacetabular osteolysis is a potentially difficult surgical challenge, which can often drive the choice of reconstruction methods used in revision hip replacement. For smaller defects, impaction of bone grafts may be sufficient, but larger defects can require filler materials that provide structural support in addition to filling a void. This study utilized finite element analysis (FEA) to examine the state of stress in periprosthetic pelvic bone when subjected to a stair-climbing load and in the presence of two simulated defects, to show the effect of implanting a defect repair implant fabricated from Trabecular Metal.

Mercury cycling in stream ecosystems. 1. Water column chemistry and transport.

We studied total mercury (THg) and methylmercury (MeHg) in eight streams, located in Oregon, Wisconsin, and Florida, that span large ranges in climate, landscape characteristics, atmospheric Hg deposition, and water chemistry. While atmospheric deposition was the source of Hg at each site, basin characteristics appeared to mediate this source by providing controls on methylation and fluvial THg and MeHg transport. Instantaneous concentrations of filtered total mercury (FTHg) and filtered methylmercury (FMeHg) exhibited strong positive correlations with both dissolved organic carbon (DOC) concentrations and streamflow for most streams, whereas mean FTHg and FMeHg concentrations were correlated with wetland density of the basins.

Biomechanics of large femoral heads: what they do and don't do.

The stability and durability of total hip reconstruction is dependent on many factors that include the design and anatomic orientation of prosthetic components. An analysis of femoral component head size and acetabular component orientation shows an interdependency of these variables and joint stability. Increased femoral component head size can increase hip stability by increasing the prosthetic impingement-free range of hip motion and by increasing the inferior head displacement required before hip dislocation.

The role of proximal femoral support in stress development within hip prostheses.

Bone remodeling commonly associated with implant loosening may require revision total hip replacement when there is substantial proximal femoral bone loss. Additionally, the surgical exposure required to remove primary implants may alter the proximal femur's structure. As a result, in many revision hip situations the proximal femur provides compromised support for the revision femoral component.

Determining the efficacy of a pressure ulcer prevention program by collecting prevalence and incidence data: a unit-based effort.

Pressure ulcer prevention falls within the domain of nursing practice. When the results of a quality improvement survey indicated both an increase in the number of pressure ulcers and a higher prevalence than the national average, the nursing staff of a 500-bed Midwest hospital developed a pressure ulcer prevention program guided by the AHCPR guidelines. The literature supports collecting prevalence and incidence data as indicators of prevention program effectiveness, and the best indicator of the effectiveness of prevention strategies to reduce nosocomial pressure ulcers is incidence.

The evolution of chiropractic orthopedists: a bootstrapping of clinical skills.

Spanning half of the chiropractic century, the development of the American Board of Chiropractic Orthopedists (ABCO) is a story of an educational bootstrapping that originated from the concerns of practicing field chirporactors. In the post World War II era, a need was determined to develop various principles and procedures of orthopedics in relation to chiropractic practice. Innovative chiropractors sought to promote greater levels of diagnostic precision within the profession by creating a post graduate program to teach advanced methods of physical and neuromusculoskeletal examination and treatment.

Influence of lactate, ammonia, and osmotic stress on adherent and suspension BHK cells.

Adherent and suspension Baby Hamster Kidney (BHK) 21c13 cells were cultivated in a 2.5-1 stirred-tank reactor with indirect aeration. Cell concentration and viability as well as glucose, lactate, ammonia, and protein concentrations in the medium and intracellular and extracellular activities of the intracellular enzymes were determined off-line.

Internship: what is stressful?

We periodically evaluated 27 interns for mood states and psychophysiologic functions during their internship year. At the end of the year they were questioned as to what they had found to be stressful and/or supportive during the year. Stressful issues were inadequate sleep, inadequate time to pursue personal matters, and inadequate personal interest and support from attending physicians.

A brief history of the internship.

The internship is the focal point of the transition of medical student to physician. From its origins in hospital apprenticeships, this experience of professionalization and initiation into direct patient responsibility has followed an erratic path. Modern US internships began in the late 19th century, and evolution of many of their characteristics has been determined more by socioeconomic-political issues than by consideration of educational objectives.

The internship year: a study of sleep, mood states, and psychophysiologic parameters.

Previous reports have suggested that first-year graduate physicians have a high incidence of psychologic distress and may show cognitive impairment as a result of sleep deprivation. We periodically evaluated 27 interns during their training year to determine amount of sleep, mood states, reaction time, critical flicker fusion, and symptoms of depression. We found the incidence of major depression in our subjects (four of 27) to be lower than previously reported but higher than expected for that age group in the general population.

Alcohol-related advertisements in a college newspaper.

The college newspaper is a powerful socializing force on the university campus. Within the general context of a university-based Alcohol Abuse Prevention Project, the present investigation examined alcohol related advertising in a college newspaper at one southern university. Ads were categorized into those: (1) promoting the responsible use of alcohol, (2) promoting the irresponsible use of alcohol, and (3) having a neutral content.