Depressive symptoms predict callous-unemotional behavior in adjudicated adolescent males with conduct disorder

Depressive symptoms were examined in a sample of adjudicated adolescent males with conduct disorder and callous-unemotional behavior as measured by the Inventory of Callous-Unemotional Traits (ICU), the Antisocial Process Screening Device (APSD) and the Youth Psychopathy Inventory (YPI). Results indicate that contrary to previous findings, depressive symptoms, as measured by the Reynolds Adolescent Depression Scale — 2 (RADS-2) are, indeed, present in callous-unemotional youth and significantly predict callous-unemotional behavior in this sample of male adolescents. In addition, dysphoria was negatively associated with callous-unemotional behavior whereas somatic complaints were positively associated with it. These findings suggest that the restricted affective displays in youth with callous-unemotional behavior may, in part, be related to a depressive process. In addition, somatic complaints were significantly related to impulsivity consistent with findings that depressive symptoms independently predict impulsivity in adolescents

Systemic inflammatory response syndrome (SIRS) after extracorporeal membrane oxygenation (ECMO): Incidence, risks and survivals.

INTRODUCTION: Systemic inflammatory response syndrome (SIRS) is frequently observed after extracorporeal membrane oxygenation (ECMO) decannulation; however, these issues have not been investigated well in the past. METHODS: Retrospective chart review was performed to identify post-ECMO SIRS phenomenon, defined by exhibiting 2/3 of the following criteria: fever, leukocytosis, and escalation of vasopressors. The patients were divided into 2 groups: patients with documented infections (Group I) and patients with true SIRS (Group TS) without any evidence of infection. Survival and pre-, intra- and post-ECMO risk factors were analyzed. RESULTS: Among 62 ECMO survivors, 37 (60%) patients developed the post-ECMO SIRS phenomenon, including Group I (n = 22) and Group TS (n = 15). The 30-day survival rate of Group I and TS was 77% and 100%, respectively (p = 0.047), although risk factors were identical. CONCLUSIONS: SIRS phenomenon after ECMO decannulation commonly occurs. Differentiating between the similar clinical presentations of SIRS and infection is important and will impact clinical outcomes

Trying to Help without getting in their Faces: Public Library Staff Descriptions of Providing Consumer Health Information

Several recent studies have analyzed users\u27 descriptions of the reference transaction, but little research has analyzed library staff members\u27 accounts of reference encounters. This article builds on the work of Marie Radford and the authors of the library visit studies by examining library staff members\u27 descriptions of providing consumer health reference services. WE conclude that an in-depth study of staff members\u27 accounts can provide insight into the different ways that library staff members and users construct problems in the reference encounter and can therefore suggest potential solutions

Synchronous climatic change inferred from diatom records in four western Montana lakes in the U.S. Rocky Mountains

Late-Holocene environmental and climatic conditions were reconstructed from diatom assemblages in sediment cores from four western Montana lakes: Crevice Lake, Foy Lake, Morrison Lake, and Reservoir Lake. The lakes show synchroneity in timing of shifts in diatom community structure, but the nature of these changes differs among the lakes. Two of the sites provide highly resolved records of hydrologic balance, while the other two stratigraphic sequences primarily record temperature impact on lake thermal structure. All four lakes show significant change in five discrete intervals: 2200–2100, 1700–1600, 1350–1200, 800–600, and 250 cal yr BP. The similarities in the timing of change suggest overlying regional climatic influences on lake dynamics. The 800–600 cal yr BP shift is evident in other paleorecords throughout the Great Plains and western US, associated with the transition from the Medieval Climate Anomaly to the Little Ice Age. Large-scale climatic mechanisms that influence these lake environments may result from atmospheric circulation patterns that are driven by interactions between Pacific and Atlantic sea-surface temperatures, which are then locally modified by topography

Assessing Healthcare Leader Competency Proficiency Levels in Evaluating Graduate Healthcare Leadership Student Competency Proficiency Levels and Curriculum

Healthcare leaders must possess specific competencies to perform their job requirements by identifying what competencies may need development and take steps to further their education, knowledge, and proficiency. This exploratory research aims to utilize industry data when evaluating student competency proficiency and how that data might impact curriculum development. The research question that is addressed: At what competency proficiency level do working healthcare leaders rate themselves utilizing Benner’s Novice to Expert Theory (1982)? Graduate programs should evaluate current industry data to evaluate how students’ progress in their programs and determine if curriculum changes are needed. Graduate programs should also determine a competency proficiency level goal that students will achieve based off stakeholder input. Twenty-two healthcare leaders from a Midwest, non-profit healthcare organization were invited to participate in an online survey that utilized a 5-point Likert scale in which participants rated their level of proficiency across five domains: (a) leadership, (b) professionalism, (c) communication and relationship building, (d) knowledge of the healthcare environment, and (e) business skills. The corresponding competencies were adapted from the American College of Healthcare Executives (ACHE) Competencies Tool (2019) and the Healthcare Leadership Alliance (HLA) Competency Directory (2010). The majority of participants rated themselves between competent and intermediate/advanced on the competencies. Corresponding means and modes were rated highest with levels above three (intermediate) and four (between intermediate/advanced) related to the domains of leadership, professionalism, and communication and relationship building. The domains of knowledge of the healthcare environment and business skills had intermediate and intermediate/advanced ratings with lower means compared to the other three domains. The results of this study could help graduate programs define a program goal for student competency proficiency level and design a plan to utilize industry data to design, evaluate, and update graduate curriculum to help students meet the identified competency proficiency goal

Synchronous climatic change inferred from diatom records in four western Montana lakes in the U.S. Rocky Mountains

Late-Holocene environmental and climatic conditions were reconstructed from diatom assemblages in sediment cores from four western Montana lakes: Crevice Lake, Foy Lake, Morrison Lake, and Reservoir Lake. The lakes show synchroneity in timing of shifts in diatom community structure, but the nature of these changes differs among the lakes. Two of the sites provide highly resolved records of hydrologic balance, while the other two stratigraphic sequences primarily record temperature impact on lake thermal structure. All four lakes show significant change in five discrete intervals: 2200–2100, 1700–1600, 1350–1200, 800–600, and 250 cal yr BP. The similarities in the timing of change suggest overlying regional climatic influences on lake dynamics. The 800–600 cal yr BP shift is evident in other paleorecords throughout the Great Plains and western US, associated with the transition from the Medieval Climate Anomaly to the Little Ice Age. Large-scale climatic mechanisms that influence these lake environments may result from atmospheric circulation patterns that are driven by interactions between Pacific and Atlantic sea-surface temperatures, which are then locally modified by topography