Pathogenesis of porcine Actinobacillus pleuropneumonia: Part I. Effects of surface components of Actinobacillus pleuropneumoniae in vitro and in vivo

The aim of this study was to evaluate the quality of pain management in prehospital emergency care and to get more information about the administration of analgesics in prehospital patients. METHODS: Patients with painful diseases or injuries who had been brought to Munich hospital's were included in the study. Immediately after having reached the hospitals' emergency department, they were evaluated using a 101-point visual analogue scale for the severity of pain at four predefined periods. Information about the patient, the diagnosis, and the analgesic treatment used by the emergency teams were drawn from the patient's chart. RESULTS: A total of 462 patients were included in the study. The mean pain score on arrival of the emergency team was 64 points; 36.5% of the patients were treated with analgesics. In 28.1% the emergency team tried to reduce pain through external measures (i.e., setting of fractures). In 35.3% there was no therapeutic intervention. In cases in which analgesic therapy was initiated, a definite reduction in pain was achieved during emergency care. Visual analogue scores decreased from 70 points at the beginning to 29 points at arrival to the hospital's emergency department. Analgesics were most frequently used for patients with cardiopulmonary diseases (47.2%), followed by patients with traumatic accidents (35.5%) and patients with acute abdominal pain (25.2%). Of the analgesics, opioids were given most frequently (87.0%). Nonopioid analgesic agents were used in 32.1%. The results of our investigation demonstrate that in many cases the administration of analgesics is not individualized to the patients needs. CONCLUSION: During the prehospital period of emergency care many patients suffer from severe pain. The development of patient-oriented concepts concerning pain management could contribute to improvement of pain therapy in prehospital emergency medicine.     

Review of The secret illness: Part one: Understanding obsessive compulsive disorder. Part two: Managing obsessive compulsive behavior in schools..

Reviews the two-video set, The secret illness: Part one: Understanding obsessive compulsive disorder. Part two: Managing obsessive compulsive behavior in schools produced by Clare Mullen (2000). Producer Mullen undertook the production of this video set with a group of clinicians, educators, and parents of children with Obsessive Compulsive Disorder (OCD) in an effort to help families and teachers understand and cope with the disorder. Part I, entitled "Understanding Obsessive Compulsive Disorder in Children," deals with the impact of the disorder on children and their families, while Part II, "Managing Obsessive Compulsive Behaviour in Schools," offers education about the disorder and outlines behavioural management strategies for school personnel. The reviewer notes that certain segments are excellent, while others are somewhat pedestrian. Part I commences with an overview of OCD provided by a psychologist and a psychiatrist. The information presented is generally accurate, but certain key findings in the literature have been either minimized or omitted. Part II is the more focused of the videotapes even though many of the recommended interventions and strategies are appropriate for children with different kinds of behavioural problems. From the technical aspect, the videos are very well produced with excellent camera work and editing. The cost of the videos is in line with that of similar educational videos. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance abuse issues in cancer patients. Part 1: Prevalence and diagnosis

Although rare, drug abuse problems present a complex set of physical and psychosocial issues that complicate cancer treatment and pain/ symptom management. Most oncologists are not be well versed in either the conceptual or practical issues related to addiction. As a result, they often struggle in their attempts to effectively treat patients who are or have been substance abusers, and they find it difficult to understand issues of addiction in patients with pain who have no history of substance abuse. In the first installment of a two-part series, the authors explore the epidemiology of substance abuse. An examination of the distinctions between abuse and dependence leads to definitions of these terms appropriate for the oncology setting. Guidelines for assessing aberrant drug-taking behavior are also offered. Part 2, which will appear in the next issue of ONCOLOGY, will discuss the clinical management of cancer patients with a history of substance abuse.     

Determining laboratory value: Part 1

This article will describe how to determine a fair market value for a dental laboratory. Part one addresses how to define fair market value, how value is perceived and how to prepare for laboratory evaluation. Part two, to be printed in April, will address how to apply an appropriate valuation methodology to determine worth.     

Determination of sulfadimethoxine withdrawal time from milk. Part II: Statistical assessment

A statistical method is proposed to establish milk discard time for the data set described in Part I (preceding paper). Results are compared with those from the Food and Drug Administration (FDA)-recommended method. The milk discard time is established on the basis of a calculated tolerance limit. This limit provides 95% confidence that 99% of the population residue would assay below the permitted concentration (10 ppb for SDM). Unlike the FDA method, the proposed method allows easy calculation and requires no assumptions in drug depletion rate over time. For a permitted concentration of 10 ppb, both methods confirm the present 60-h discard time for SDM when it is assumed that no more than 1/3 of the milk came from treated cows.     

Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part II: Clinical application.

The four-part assessment of personality psychopathology proposed for DSM-5 focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we described the components of the new model and presented brief rationales for them. In Part II, we illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, selected from the DSM–IV–TR Casebook, to show how assessments might be conducted and diagnoses reached. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Hydrodynamics of gas stirred melts: Part II. Axisymmetric flows

A predictive model of gas stirred melt is presented. Based on the differential approach and following a review of previous models, the importance of natural convection or buoyancy driven phenomena is underscored. Predicted flow patterns are shown to be consistent with laboratory and pilot scale experiments, and with the macroscopic plume model in Part I of this paper.     

Applied genetics for the practicing optometrist. Part II

Part I included a discussion of the four modes of single gene inheritance and examples of ocular anomalies which follow these modes. Part II will conclude the discussion by presenting other transmission forms in conjunction with examples of ocular anomalies characteristic of each. These two articles are designed to serve only as a guide for familiarizing the practicing O.D. with the various types of inheritance patterns, and not as a comprehensive text on the genetics of ophthalmic diseases. The reader is referred to the reference list for in-depth information regarding specific disorders.     

Empirically supported interventions and school psychology: Conceptual and practice issues—Part II.

In Part II of this 2-part article (Part I, see record 2000-03347-005), the authors present some conceptual and practice issues on the use of empirically supported interventions in school and community settings. Conceptual issues discussed include the foci of effective intervention studies, specification of interventions, and intervention manuals and procedural guidelines. The authors conclude with a discussion of essential practice issues, given a dual goal of advancing research in empirically supported interventions and of producing a knowledge base that has a direct meaning and application to school and community settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Management development: preparing nurse managers for the future. Part 1, Program model

Nurse executives need to develop programs to help nurse managers meet rapidly changing role expectations and prepare for new healthcare challenges. This two-part series reports on one such program for nurse managers at The Johns Hopkins Hospital. Part 1 describes the program model, its conceptual framework, and its various components. Part 2 will present an in-depth evaluation of the program and recommendations for future development.     

Psychiatric liability: Part 2

Psychiatric health care providers' liability extends from clinical cases--medication errors, misdiagnosis, etc.--to particular issues unique to the mental health care setting. Part 2 continues discussion begun in the July issue of lawsuits common to this setting.     

Development of new feeding-distance rules using casting simulation: Part I. Methodology

A methodology is developed to relate measured shrinkage porosity levels in steel castings to predictions from casting simulations, in order to determine feeding distances. Low-alloy steel casting trials were conducted to acquire a statistically meaningful set of experimental data for top-risered cast steel sections having various ASTM shrinkage X-ray levels. Simulations of the casting trials were then performed, using casting data recorded at the foundries during the trials. The actual casting soundness resulting from these trials, measured in terms of the ASTM shrinkage X-ray level, is quantitatively compared to the soundness predicted by simulations, measured in terms of a local thermal parameter known as the Niyama criterion. A relationship is shown to exist between the X-ray level and both the minimum Niyama criterion value as well as the area (in the plane of the X-ray) with Niyama values below a threshold value. Once the correlations developed in Part I of this article were established, an extensive set of additional casting simulations was performed to determine the feeding distances for castings with a wide variety of casting parameters. These data were then used to develop a new set of feeding-distance rules, which are given in Part II of this article.     

Culture and test session behavior: Part I.

The relationship between culture (circumscribed by race, ethnicity, country of origin, language, and/or social class) and test session behavior (TSB) on group and individual tests of intelligence and/or achievement is evaluated with respect to the quality of evidence offered in support of knowledge claims. Four relevant categories in the literature are identified: (1) speculative theories, (2) studies of standardized measures of test session behavior, (3) TSB experimental research, and (4) research in cross-cultural test development. In Part I of a two-part series, key literature from the first two categories is reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidality in nursing home residents: Part II. Special issues.

Professional psychologists working with suicidal nursing home residents often deal with a host of special issues that may not be relevant to other populations. This review article (Part 2 of a series) was written to acquaint professionals with the concept of indirect self-destructive behavior and dealing with ethical concerns. This article also summarizes health care systems issues, including how to involve staff and family members in assessment and management, as well as understanding Medicare/Medicaid related concerns and public policy regarding long-term care. The article concludes with information about training and continuing education offerings for psychologists who need more information about working in nursing home settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part I: Description and rationale.

A major reconceptualization of personality psychopathology has been proposed for DSM-5 that identifies core impairments in personality functioning, pathological personality traits, and prominent pathological personality types. A comprehensive personality assessment consists of four components: levels of personality functioning, personality disorder types, pathological personality trait domains and facets, and general criteria for personality disorder. This four-part assessment focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we describe the components of the new model and present brief theoretical and empirical rationales for each. In Part II, we will illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, to show how assessments might be conducted and diagnoses reached. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Education in emergency nursing: a new beginning. Part 2

Continuing from the previous issue, this paper discusses the process of developing the content of new courses under the umbrella of the Graduate Diploma/Masters in Emergency Care Nursing offered at Griffith University Gold Coast, Australia. Part 2 of this paper includes information on course structure, implementation, content, assessing methods and competences and the logistics of the course.     

The consultant as expert witness in school and workplace cases—Part 2.

This article provides a review of both Part 1 and Part 2 of a series of the Consulting Psychology Journal on the consultant as an expert witness in school and workplace cases. Part 1 covered topics such as professional consultants as expert witnesses from a legal perspective, sexual harassment and retaliation cases in the workplace, and special education consultants in due process hearings. In part 2, three articles focus on violence in the workplace and two articles alert the consulting psychologist to the issues related to malingering by clients and how to detect it. These articles are meant to provide a sampling of contemporary issues for which the mental health consultant may provide expert testimony in litigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Venous leg ulcers. Part 1: Aetiology

Cardiogenic pulmonary edema is a frequent cause of reparatory failure. We investigated the effects of nasal continuous positive airway pressure (CPAP) in patients with severe pulmonary edema associated with acute myocardial infarction. Twenty-nine consecutive patients were divided into 3 groups: firstly, 7 intubated patients who received mechanical ventilation at study entry comprised the intubation group. The rest of the patients were randomly assigned to either of the following 2 groups: 11 patients who received oxygen plus CPAP delivered by a nasal mask (CPAP group), and 11 patients who received oxygen only via face mask (oxygen group). All patients in the intubation group had cardiogenic shock. Two patients (18%) in the CPAP group and 8 patients (73%) in the oxygen group required mechanical ventilation with endotracheal intubation (p=0.03). The hospital mortality rate in the CPAP group (9%) was significantly lower than the oxygen group (64%, p=0.02). The pulmonary artery wedge pressure and heart rate were significantly lower in the CPAP group than in the oxygen group 24 h after study entry (p<0.05 and p<0.01). The mean pulmonary artery pressure 48 h after study entry was 18+/-5 mmHg in the CPAP group and 25+/-8 mmHg in the oxygen group (p<0.05). The PaO2/FiO2 ratio increased in the intubation group (168+/-69 to 240+/-57, p<0.05) and the CPAP group (137+/-17 to 253+/-67, p<0.01) 24 h after study entry. Arterial plasma endothelin-1 concentrations decreased significantly earlier in the CPAP group than in the oxygen group (p<0.05). In patients without cardiogenic shock, nasal CPAP lead to an early improvement in oxygenation and hemodynamics, and decreased the mortality rate. Early and active respiratory management is recommended in patients with pulmonary edema associated with acute myocardial infarction.     

Contact of crack surfaces during fatigue: Part 1. formulation of the model

A model has been developed to predict crack opening and closing behavior for propagating fatigue cracks which undergo significant sliding displacements at crack flanks. Crack surfaces were described statistically by assuming a random distribution of asperity heights and a mean density of asperities and asperity radii. The propagating crack was subdivided into strips, and each strip was treated as a contact problem between two randomly rough surfaces. The remote tensile stresses were varied in a cyclical manner. The contact stresses at minimal load were determined by analyzing the local crushing of asperities via a sliding mechanism. Then, upon loading, the crack opening stress levels were computed when the contact stresses were overcome. Part 1 of this article includes a discussion of the previous models, then introduces statistical contact mechanics concepts which are utilized in the fatigue crack growth simulations. In addition, the numerical algorithms for the modeling work and the sensitivity of results to model parameters are described. The role of stress ratio, maximum stress level, crack length, and the geometry of crack surfaces on the crack growth behavior will be discussed in Part 2 of this article.