Accelerating entry into supported employment for persons with severe psychiatric disabilities.

Tested the hypothesis that Ss with severe mental illnesses would achieve better vocational outcomes with an accelerated approach to supported employment (AASE), as compared to gradual approaches (GA) with prevocational training. 86 Ss (mean age 35.1 yrs) with a diagnosis of a serious mental illness, were randomly assigned to either the AASE, or the GA, which included a minimum of 4 mo prevocational training. Data were obtained on indicators of vocational outcomes over 2 yrs, and for a limited number of Ss (n=36), during the 4th yr of inception into the program. Initially, only 5% of Ss preferred prevocational training. After 1 yr, AASE Ss showed better outcomes for a range of indicators, including achievement of competitive employment, duration of employment and mean earnings. During the 4th yr, 59% of these Ss were competitively employed, as compared to only 6% of GA Ss. Rehabilitation is more effective using AASE than GA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anatomical suitability of abdominal aortic aneurysms for endovascular repair

BACKGROUND: Aortic aneurysm anatomy is crucial when considering patients for endovascular repair. The aim of this study was to determine the proportion of patients with aortic aneurysm suitable for endovascular repair with three different graft-stent systems. METHODS: Spiral computed tomographic angiography was used to assess the anatomy of 154 abdominal aortic aneurysms. Measurements were made of aneurysm neck length and diameter, renal artery to aortic bifurcation length, common iliac artery diameter and length, and external iliac artery diameter. Aneurysms were assessed for anatomical suitability for currently available aortoaortic, aortobi-iliac and aortouni-iliac devices. RESULTS: Six patients (4 per cent) had a distal aortic neck suitable for implantation of a straight aortic graft. Fifteen patients (10 per cent) had arterial anatomy suitable for implantation of a bifurcated graft and 85 (55 per cent) patients were suitable for endovascular repair with an aortouni-iliac graft. The primary reasons for unsuitability were: proximal neck length less than 1.5 cm (44 patients), proximal neck diameter greater than 3.0 cm (12), and angulation of the proximal neck (three). A further ten patients were considered unsuitable for an aortouni-iliac graft because of bilateral common iliac artery aneurysms (four), tortuous iliac arteries (four) and narrow external iliac arteries (two). CONCLUSION: The aortouni-iliac device has the widest applicability of the currently available endovascular systems but open repair remains the only option for a large proportion of patients.     

An outbreak of malignant catarrhal fever in young rusa deer (Cervus timorensis)

On the basis of clinical signs and histological findings eight 9-month-old male rusa deer (Cervus timorensis) were diagnosed with sheep associated-malignant catarrhal fever. Following a variable course involving rectal temperatures around 40.5 degrees C, depression, inappetence, diarrhoea, corneal opacity and hypopyon all animals died or were euthanased over a 5-week period. Severe multifocal vasculitis, mainly periglomerular and in the arcuate vessels were consistent histological findings which in the past have been adequate to confirm clinical diagnosis of sheep associated-malignant catarrhal fever. A nested polymerase chain reaction test has been used to detect a sheep associated-malignant catarrhal fever PRC product, 238 base-pairs in size, in DNA extracted from lymphocyte preparations. The result supported the diagnosis of sheep associated-malignant catarrhal fever in these deer.     

A controlled evaluation of an elementary school primary prevention program for eating problems

Researchers have recently called for the development of primary prevention of eating disorders programs aimed at elementary school students. The present study reports on the development of a curriculum for fifth graders designed to encourage healthy eating, exercise, and body image while discouraging calorie-restrictive dieting, exercising for weight loss, and the development of body dissatisfaction. The program consisted of ten lessons taught by the classroom teachers. The influence of the curriculum on (1) knowledge about nutrition, body fat, and dieting; (2) attitudes about fat people and own body (body esteem); and (3) behaviors, including attempts at weight reduction, consumption of fruits and vegetables, and exercising, were evaluated in a pre-post controlled experimental design. There were 222 white public school children who participated in both the pre- and posttesting, 167 of whom were in the classrooms receiving the curriculum. Results indicated that knowledge was broadly improved by the curriculum. There were information improvements in terms of nutrition, effects of dieting, and causes of body fat. Attitudinal changes were less pronounced, although the curriculum did positively affect attitudes about fat people. Behavior, including eating patterns, exercise patterns, weight reduction attempts, and teasing of fat children, was not changed by participation in the curriculum.     

Ultrastructural studies of the ileum neobladder

Of 101 women, 15-50 years of age, presenting with vaginal discharge, 34 had bacterial vaginosis and were randomly assigned to a seven-day course of oral treatment with either erythromycin (0.5 g b.i.d.) or metronidazole (0.4 g b.i.d.) in a single-blind, cross-over study. Treatment failure (> or = three clinical signs of bacterial vaginosis) occurred in 13 (81%) of 16 patients given erythromycin, as compared with three (17%) of 18 women treated with metronidazole (p < 0.001). Persistence of Gardnerella vaginalis, Mobiluncus species and/or Mycoplasma hominis was found in 14 of 16 patients treated with erythromycin, and in four of 16 patients treated with metronidazole. Treatment with metronidazole was successful (< or = two clinical signs of bacterial vaginosis) in eight of 10 cases of erythromycin treatment failure. Neither of two cases of metronidazole treatment failure was cured with erythromycin. At three-month follow-up of 31 women, persistence or recurrence of bacterial vaginosis was diagnosed in 11 cases (36%).     

Arterial blood pressure response to transient arousals from NREM sleep in nonapneic snorers with sleep fragmentation

STUDY OBJECTIVES: To assess the hemodynamic effects of graded arousals during nonrapid eye movement (NREM) sleep in patients with partial upper airway obstruction during sleep without obstructive sleep apnea/hypopnea, overnight beat-to-beat BP was recorded in six patients. SETTING: At the end of each nonapneic obstructive event, EEG responses were graded as follows: grade 2, grade 1, and grade 0 were defined as increased high-frequency EEG lasting >15 s, 3 to 15 s, and no EEG arousals according to the American Sleep Disorders Association, respectively. MEASUREMENTS AND RESULTS: The following were observed during grade 0, 1, and 2 EEG patterns (mean+/-SD): systolic pressure increased by 7.1+/-1.5, 11.7+/-1.9, and 14.2+/-3.4 (p<0.005), respectively; diastolic pressure increased by 4.6+/-0.6, 6.7+/-1.7, and 9.4+/-3.0 (p<0.005), respectively; heart rate increased by 2.9+/-0.4, 3.9+/-2.2, and 8.6+/-4.6 (p<0.005), respectively. CONCLUSIONS: We conclude that nonapneic-nonhypopneic obstructive events are followed by arterial systemic pressure increases whose magnitude varies with the grade of the arousal.