IMPLEMENTATION OF CLINICAL PRACTICE GUIDELINES FOLLOWING ACUTE SPINAL CORD INJURY

Individuals with spinal cord injuries who use a wheelchair for full time mobility are at high risk for developing upper limb pain and dysfunction, which can negatively impact functional mobility and quality of life. Due to the detrimental effects, the Consortium for Spinal Cord Medicine and the Paralyzed Veterans of America developed a clinical practice guideline (CPG) to educate clinicians on upper limb preservation methods. Past research has found that passive implementation of a CPG does not change clinical practice and a structured program is needed for effective education. In this dissertation, we have developed a strict protocol to implement the CPG and performed a randomized clinical trial to determine if new wheelchair users who were strictly educated on the CPG have better functional mobility skills, wheelchair characteristics and lower pain. During the course of the study, we found no objective method to evaluate the quality of a transfer. Therefore, an original outcome measure was developed. We evaluated the tool and found that it is safe, can be completed in a short amount of time and has a wide range of reliability and validity. Refinements are necessary, but the tool fills a substantial void in the area of transfer evaluation. The newly created outcome measure was used to evaluate the transfer skills of participants in the randomized trial. A trend in the data found that participants who were strictly educated on the CPG performed better transfers at six months post discharge. The same group of participants was evaluated on wheelchair set up, selection and manual wheelchair propulsion skills. No differences were found between groups based on wheelchair set up and selection; however those strictly educated on the CPG propelled with significantly lower normalized peak resultant forces at six months post discharge. Finally, results found that individuals who were strictly educated on the CPG reported higher pain during movement activities at six months post discharge, although this may be due to increased awareness. The new outcome measure and structured education program are important tools to improve care provided during acute rehabilitation for full time wheelchair users with spinal cord injuries

The Ethics of Materiality: Sensation, Pain, and Sympathy in Victorian Literature

Taking as my point of departure the generally accepted version of Victorian sympathy predicated on distance, imagination, and vision, I identify within Victorian literature an alternative, far more corporeal, version of sympathy predicated on immediacy, sensation, and touch. In discussing representations of bodily sensation and the ways in which such sensation functions within Victorian literature, my dissertation addresses the connections between sensation, particularly pain, and moral development by examining how psychological and emotional experience is represented in physiological terms. As a supplement to recent studies concerning vision, my dissertation focuses on touch in order to address the fundamental problems of sensory perception, materiality, and psychological experience in the Victorian period. This connection between physiological sensation and ethical development suggests a fundamental connection between corporeality and morality, an alignment that resists the totalizing equation of spirituality with morality and of materiality with sin present either implicitly or explicitly within much of Christian orthodoxy during the nineteenth century. My first chapter explores the connections and points of resistance between and among scientific and theological explanations of human existence both physical and emotional. My second chapter reinterprets Charlotte Brontë's Villette as a novel not about vision and surveillance but about touch and materiality, one which presents writing as the ideal, even sacramental, form of embodiment. My third chapter, on George Eliot's "The Lifted Veil," considers Latimer's mind-reading in relation to the vivid representations of his experiences of his own body as well as of the bodies of his companions, suggesting that clairvoyance for Latimer consists more accurately of acute sensitivity to his own bodily experience. My fourth chapter explores the consequences of symbolic and realistic representations of bodies in poetry by A. C. Swinburne and D. G. Rossetti in connection to both Christian orthodoxy and alternative moral systems. My final chapter, on H. G. Wells's The Island of Dr. Moreau and Gerard Manley Hopkins's terrible sonnets, argues that these texts insist upon material embodiment as a necessary precondition for morality, and equate the non-materiality of a purely spiritual existence with amorality

The Iowa Homemaker vol.37, no.2

They Say it’s Love, Ann Baur, page 4 Marry in a College Chapel, Merna Borror, page 6 Learned by Heart, Beth Cummings Paschal, page 7 I’d Like to Know, Sandy Newman, page 8 Blueprint for Packing, Carolyn McIntyre, page 10 The Honeymoon, Reverie to Reality, Jackie Andre, page 11 Present Picker, Marilyn Jensen Nadler, page 12 An Electric Dinner, Ann Walters, page 14 Say Yes… To Entertaining, Rosemary McBride and Roma Walker, page 15 ABC’s of Money Management, Linda Nelson and Marie Budolfson, page 16 What’s in a Wedding Custom, Janice Furman, page 18 Plain Clothes Man? Ha!, Norma Scholes, page 22 Why All This Fuss Over Sex, Gail A. McClure, page 2

Assessing competency to stand trial. A case study of technology diffusion in four states

During the 1970's, in the wake of major court decisions affirming the due process rights of criminal defendants suspected of incompetency to stand trial, state criminal justice and forensic mental health systems instigated changes both in the organization of systems through which alleged incompetents were processed and in the specific format and objectives of the competency examination itself. The early part of this period coincided with the latter phases of a project sponsored by the National Institute of Mental Health to develop reliable instruments that would translate the essentially legal criteria for competency into terms capable of being assessed by the mental health professionals now charged with competency evaluations in most states. l The hope was that these instruments, properly used, would provide a more reliable and consistent basis for competency determination than the unelaborated legal criteria by themselves. Dr. A. Louis McGarry, director of the NIMH project and the man whose name is most frequendy associated with the instruments, developed them at the Harvard Laboratory for Community Psychiatry and employed them for a time, with some success, at Bridgewater and Boston State Hospitals in Massachusetts. As other states showed interest, Dr. McGarry also made visits to demonstrate the instruments or to give depositions concerning aspects of the competency determination process. This paper reports the findings of a project designed to explore the factors influencing four states to use or not use the results of the NIMH-supported research directed by Dr. McGarry. The states are Tennessee, Ohio, North Carolina, and West Virginia. Since the instruments came on the scene at a time of general ferment in the area of psychiatric diversion from the criminal justice system, and since their adoption or non-adoption (and the modes thereoO are heavily influenced by the structure of state forensic service systems and their relationship to criminal justice systems, it was not possible to study the use of the instruments, or the states' encounter with McGarry's work, in isolation. Instead the project sought to explore these issues in the context of on-going developments in forensic service organization in each state. As will be documented later on, these developments, as much as th

A Minimally Replicative HIV-2 Live-Virus Vaccine ProtectsM. nemestrinafrom Disease after HIV-2287Challenge

AbstractM. nemestrinaimmunized with an apathogenic HIV-2 molecular clone (HIV-2KR) were protected from CD4 decline and disease upon challenge with HIV-2287, after any immunizing virus could be detected. Higher but not lower inocula of HIV-2KRwere protective against intravenous inoculation of either 105or 101TCID50of HIV-2287. Protected animals displayed substantial reductions in PBMC proviral burden (1–3 logs), viral titers (1–2 logs), and plasma viral RNA (2–4 logs) compared to unprotected or naive animals as early as 1 week postinfection. Plasma viral RNA became undetectable after 24 weeks in protected animals, but remained high in unprotected animals. No viral RNA was present in the spleen of the protected animal necropsied more than a year after challenge (though viral DNA was still present). No neutralizing responses could be demonstrated, but CTL activity was detected sooner and at higher levels after challenge in protected than in unprotected macaques. In this novel HIV-2 vaccine model, protection was clearly dose-dependent, and clearance of challenge virus RNA from the plasma did not require detectable ongoing replication of the immunizing virus at the time of challenge

The Ursinus Weekly, January 8, 1951

Group attends NSA meeting during holiday • French Club conducts meeting and lists plans • Final examinations to continue January 18-26; Schedule posted • Chess Club to play • Rice to give talk on Atlantic Union • Sophomore class to sponsor square dance Friday night • President McClure issues statement on present draft situation at Ursinus • College offers new two-term Summer school • Graduate featured in magazine story • Curtain Club announces next group production • Students participate in television show • Forty attend Philly luncheon of Ursinus Women\u27s Club • New Rosicrucians feted • Miller appears on Quaker City TV University • Ursinus grad to hold state executive office • Opinions on Korea: Ursinus representatives speak their minds • Double-duty secretary gowns directors for processions, manages switchboard • Downpour predicted; Waterproof notes, dry textbooks, precautions prescribed • Prognostication shows alteration of future strife in college life • Bears upset F&M 73-55 in pre-holiday thriller • Grapplers win opener over Muhlenberg, 23-9 • Grizzlies absorb second cage loss to Pharmacy five • Bruins top Drexel 80-74 in initial league contest • Trials highlight MSGA pre-vacation meetinghttps://digitalcommons.ursinus.edu/weekly/1556/thumbnail.jp

Late outcomes comparison of nonelderly patients with stented bioprosthetic and mechanical valves in the aortic position: A propensity-matched analysis

ObjectiveOur study compares late mortality and valve-related morbidities between nonelderly patients (aged <65 years) undergoing stented bioprosthetic or mechanical valve replacement in the aortic position.MethodsWe identified 1701 consecutive patients aged <65 years who underwent aortic valve replacement between 1992 and 2011. A stented bioprosthetic valve was used in 769 patients (45%) and a mechanical valve was used in 932 patients (55%). A stepwise logistic regression propensity score identified a subset of 361 evenly matched patient-pairs. Late outcomes of death, reoperation, major bleeding, and stroke were assessed.ResultsFollow-up was 99% complete. The mean age in the matched cohort was 53.9 years (bioprosthetic valve) and 53.2 years (mechanical valve) (P = .30). Fifteen additional measurable variables were statistically similar for the matched cohort. Thirty-day mortality was 1.9% (bioprosthetic valve) and 1.4% (mechanical valve) (P = .77). Survival at 5, 10, 15, and 18 years was 89%, 78%, 65%, and 60% for patients with bioprosthetic valves versus 88%, 79%, 75%, and 51% for patients with mechanical valves (P = .75). At 18 years, freedom from reoperation was 95% for patients with mechanical valves and 55% for patients with bioprosthetic valves (P = .002), whereas freedom from a major bleeding event favored patients with bioprosthetic valves (98%) versus mechanical valves (78%; P = .002). There was no difference in stroke between the 2 matched groups.ConclusionsIn patients aged <65 years, despite an increase in the rate of reoperation with stented bioprosthetic valves and an increase in major bleeding events with mechanical valves, there is no significant difference in mortality at late follow-up