Training in firearm safety counseling in family practice residency programs

We have studied the function of partial orthotopic liver transplantation in the rat by evaluating prothrombin time (PT), liver blood flow, basal and glucose-stimulated insulin secretion and glucose tolerance, and the reticuloendothelial function (RES) in hepatectomized rats subjected to partial liver transplantation. A graft corresponding to 68% of a normal liver was transplanted to totally hepatectomized rats. Comparison was made between control rats and rats subjected to 32% liver resection. PT was not significantly different in the transplanted group compared with liver-resected and control rats. Laser Doppler flowmetry showed that at 28 days after surgery, blood flow had increased in the transplanted livers. Furthermore, on the third day after transplantation, basal plasma insulin was increased and the plasma insulin response to glucose was exaggerated, suggesting reduced insulin action and impaired insulin degradation. Finally, uptake of radioactive-labeled E. coli bacteria, as a measure of RES function, was not compromised in transplanted animals. Based on these results, we conclude that reduced-size liver transplant in out-bred rats results in fast normalization of liver function after surgery although, immediately after surgery, glucose intolerance is seen.     

Relation between sexual abuse in childhood and adult depression: case-control study

OBJECTIVE: To examine the association between sexual abuse in childhood and adult depression in women. DESIGN: Two stage, case detection and case identification design, using the 30-item general health questionnaire and the Beck depression inventory for screening and the affective items relating to current functioning on the schizophrenia and affective disorders schedule to identify depressed cases. Details of sexual abuse in childhood were elicited retrospectively by semistructured interview, and social problems by the social problems questionnaire. SETTING: Three general practices, in middle class suburban, deprived inner city, and rural areas. SUBJECTS: 1189 women were screened and 237 subsequently interviewed; 132 were depressed. RESULTS: 49 (37%) of the depressed interviews and 24 (23%) of the non-depressed interviews reported experience of sexual abuse when they were aged under 16 years. A positive association existed between the more severe abuse and depression--all those who had experienced penetration were depressed as adults. A relation was also found between sexual abuse in childhood and sexual problems, housing problems, and problems with their children at school. CONCLUSION: A positive association between child sexual abuse and depression was confirmed, but this was confined to more severe abuse (penetration or attempted penetration).     

Changes in medical stability upon admission to a rehabilitation unit

The implementation of Medicare's prospective payment system in acute care has coincided with a steady increase in medically unstable admissions to our freestanding rehabilitation facility. We investigated the consequences of these admissions by collecting medical information regarding transfers beginning in 1983. Patients requiring transfer back to the acute setting within 1 day of admission were considered medically unstable and their charts were reviewed. The number of patients requiring transfer back within 1 day increased from 1.5% of all first admissions to 3.1% in 1988 (Mantel - Haenszel chi 2 = 8.03, (df = 1), p < .01), but the increase among Medicare patients alone was not significant. This progressive increase was most pronounced in the cerebrovascular accident and spinal cord injury populations. Beginning in 1988, an intensified preadmission evaluation program was implemented, resulting in a significant decline in unstable patient transfers from hospitals where our consultants were on staff. Physiatric consultations at referral institutions decreased the number of unstable patients at admission.     

Spherical-multipole analysis of electromagnetic and acousticalscattering by a semi-infinite elliptic cone

The spherical-multipole analysis of scalar scattering by an acoustically soft or hard elliptic cone, and of electromagnetic scattering by a perfectly conducting elliptic cone, are presented. The series expansions of the exact solutions are of poor convergence, if both source and field points are far from the cone's tip. A mathematical transformation for the acceleration of convergence-due to Euler-is applied to these expansions, to numerically determine the scattering cross sections of these objects. This powerful method can also be used for the numerical evaluation of diffraction coefficients. The paper contains a review of scientific work concerning scattering by objects with edges, corners, tips, etc     

Family practice physicians' firearm safety counseling beliefs and behaviors

The purpose of this study was to identify family physicians' firearm safety counseling beliefs and behaviors. A survey was mailed to a random sample of 600 members of the American Academy of Family Physicians. A three wave mailing technique was used to maximize the response rate and yielded 271 usable surveys (55% response rate). Outcome measures included training experience in firearm safety counseling, the prevalence of firearm safety counseling by family physicians, and their perceptions regarding such counseling. The majority (78%) of family physicians lacked formal training on how to counsel patients about firearm safety and 49% believed more time should be spent in residency programs on firearm safety counseling. The majority (84%) of respondents never or rarely counseled patients on firearm safety and 50% believed firearm safety counseling should be a low priority in their delivery of primary care. The majority of respondents did not regularly counsel patients about firearm safety, did not believe firearm safety counseling should be a priority, and did not believe firearm safety counseling would be effective in reducing firearm-related trauma.     

Beugung am Kegel elliptischen Querschnitts und die Sommerfeldsche Lösung des Halbebenenproblems

Übersicht In dieser Arbeit wird die Beugung am Kegel elliptischen Querschnitts behandelt. Wir leiten zwei Greensche Funktionen ab, die der Dirichlet- bzw. der Neumann-Bedingung auf dem Kegel genügen und die Ausstrahlungsbedingung erfüllen. Das Randwertproblem wird zurückgeführt auf die Lösung eines zweiparametrigen Eigenwertproblems mit zwei gekoppelten Laméschen Differentialgleichungen. Wir analysieren insbesondere die Beugung einer ebenen Welle an der sektorförmigen Fläche. Im Grenzfall eines Sektoröffnungswinkels von 180° gehen die Reihenentwicklungen unter Zuhilfenahme eines speziellen Gegenbauerschen Additionstheorems und einer erzeugenden Funktion für Besselfunktionen mit ganzzahligem und halbzahligem Index über in die Sommerfeldsche Lösung des Halbebenenproblems.

---

Diffraction by an elliptic cone and Sommerfeld's half-plane solution

Contents In this article we examine the diffraction by an elliptic cone. We derive two Green's functions satisfying the Dirichlet-resp. Neumann-condition on the boundary of the cone. The boundary value problem is reduced to a two-parametric eigenvalue problem with two coupled Lamé equations. We analyse the diffraction of a plane wave by a plane angular sector. In the limiting case of a sector angle of 180° the series expansions pass — using a special form of Gegenbauer's addition theorem and the generating function for Bessel functions with integral and half-integral indices — into Sommerfeld's half-plane solution.

     

Numerical evaluation of dyadic diffraction coefficients andbistatic radar cross sections for a perfectly conducting semi-infiniteelliptic cone

In this paper, the scattering of electromagnetic waves by a perfectly conducting semi-infinite elliptic cone is treated. The exact solution of this boundary value problem in problem-adapted spheroconal coordinates in the form of a spherical multipole expansion is of poor convergence if both the source point and the field point are far away from the cone's tip. Therefore, an appropriate sequence transformation of these series expansions (we apply the Shanks transformation) is necessary to numerically determine the dyadic diffraction coefficients and bistatic radar cross sections (RCS) for an arbitrary elliptic cone. Our far-field data for an elliptic cone, a circular cone, and a plane angular sector are compared with some other results obtained with the aid of quite different methods     

In vivo analysis of murine serum sulfate metabolism and splenic glycosaminoglycan biosynthesis during acute inflammation and amyloidosis

OBJECTIVE: Highly sulfated glycosaminoglycans (GAG) have been demonstrated in every form of amyloid examined to date. Based on temporal studies in murine amyloidogenesis heparan sulfate is deposited coincidentally with the amyloid protein. Our purpose was to follow in vivo GAG synthesis by monitoring 35SO4 incorporation during amyloidogenesis. Several necessary previously unexamined nonamyloidogenic controls were also examined. METHODS: Murine splenic amyloid was induced with lipopolysaccharide (LPS) and amyloid enhancing factor (AEF). Splenic GAG synthesis was monitored by 35SO4 incorporation. Corrections were made for alterations in SO4 metabolism which occur during inflammation. RESULTS: All animals with an inflammatory reaction had a marked increase in GAG synthesis. Those animals receiving AEF, or AEF+LPS, had a significant increase in heparan sulfate synthesis. This was particularly profound in the group developing amyloid (i.e., AEF+LPS). CONCLUSION: Our results indicate that critical factors in amyloid deposition include quantitative as well as qualitative changes that take place in tissue GAG synthesis. A distinct metabolic effect of AEF is demonstrated for the first time.