Comments On The Name “Wichita”

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99659/1/aa.1942.44.1.02a00350.pd

The Auxiliary Verb in Natchez

Natchez verbs are inflected for person (first, second, and third), for number (singular, dual, and plural), and for tense-mode (present, past, optative). There are two main kinds of verbs. There are, first, active verbs which are directly inflected only for the distinction between singular and plural. All the rest of the inflectional paraphernalia is carried by the auxiliary verb with which it obligatorily occurs. Secondly, there are inflected verbs which occur in two subcategories, (i) inpendent inflected verbs and auxiliary verbs. The two inflected subcategories are inflected alike except for the plural number. The independent inflected verbs have their own special type of plural formation. The auxiliary verbs, on the other hand, do not since that is shown by the active verb

The Parallel Encounter: An Alternative to the Traditional Serial Trainee–Attending Patient Evaluation Model

BackgroundThe emergency department environment requires the clinician‐educator to use adaptive teaching strategies to balance education with efficiency and patient care. Recently, alternative approaches to the traditional serial trainee–attending patient evaluation model have emerged in the literature.MethodsThe parallel encounter involves the attending physician and resident seeing the patient independently. Instead of the trainee delivering a traditional oral case presentation, the trainee does not present the history and examination to the attending physician. Rather, the attending and trainee come together following their independent evaluations to jointly discuss and formulate the assessment and plan.ResultsThe parallel encounter has the potential to enhance the teaching encounter by emphasizing clinical reasoning, reduce cognitive bias by integrating two independent assessments of the same patient, increase attending workflow flexibility and efficiency, and improve patient satisfaction and outcomes by reducing time to initial provider contact. The attending must be mindful of protecting resident autonomy. This model tends to work better for more senior learners.ConclusionsThe parallel encounter represents a novel approach to the traditional serial trainee–attending patient evaluation model that may enhance the teaching encounter and improve patient care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163487/2/aet210491_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163487/1/aet210491.pd

Too Big Too Fast? Potential Implications of the Rapid Increase in Emergency Medicine Residency Positions

Emergency medicine (EM) has expanded rapidly since its inception in 1979. Workforce projections from current data demonstrate a rapid rise in the number of accredited EM residency programs and trainee positions. Based on these trends, the specialty may soon reach a point of saturation, particularly in urban areas. This could negatively impact future trainees entering the job market as well as the career plans of medical students. More time and resources should be devoted to obtaining accurate projections, assessing the distribution of emergency physicians in rural versus urban settings, and implementing central workforce planning to protect the future of graduating trainees.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/1/aet210400.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/2/aet210400_am.pd

The killing fields of KZN: Local government elections, violence and democracy in 2016

Various government initiatives focus on the promotion of social cohesion for nation building. The impact of social cohesion on levels of violence is also the subject of research. This article argues that despite official rhetoric organs of state - are used  in KwaZulu-Natal to  serve party political interests by targeting cohesive groupings struggling for their constitutional rights. Violence is promoted and nation building retarded.  The main case study cited is that of violence-wracked Glebelands hostel in Durban. Since it is also argued that what is happening in Glebelands is not an isolated case reference is also made to the similar targeting of the shack dwellers’ movement Abahali baseMjondolo

Outcomes of second-line antiretroviral therapy among children living with HIV: a global cohort analysis.

INTRODUCTION Limited data describe outcomes on second-line antiretroviral therapy (ART) among children globally. Our objective was to contribute data on outcomes among children living with HIV after initiation of second-line ART in the context of routine care within a large global cohort collaboration. METHODS Patient-level data from 1993 through 2015 from 11 paediatric HIV cohorts were pooled. Characteristics at switch and through two years of follow-up were summarized for children who switched to second-line ART after starting a standard first-line regimen in North America, Latin America, Europe, Asia, Southern Africa (South Africa & Botswana) and the rest of sub-Saharan Africa (SSA). Cumulative incidences of mortality and loss to follow-up (LTFU) were estimated using a competing risks framework. RESULTS Of the 85,389 children on first-line ART, 3,555 (4%) switched to second-line after a median of 2.8 years on ART (IQR: 1.6, 4.7); 69% were from Southern Africa or SSA and 86% of second-line regimens were protease inhibitor-based. At switch, median age was 8.4 years and 50% had a prior AIDS diagnosis. Median follow-up after switch to second-line ranged from 1.8 years in SSA to 5.3 years in North America. Median CD4 counts at switch to second-line ranged from 235 cells/mm3 in SSA to 828 cells/mm3 in North America. Improvements in CD4 counts were observed over two years of follow-up, particularly in regions with lower CD4 counts at second-line switch. Improvements in weight-for-age z-scores were not observed during follow-up. Cumulative incidence of LTFU at two years was <5% in all regions except SSA (7.1%) and Southern Africa (7.4%). Risk of mortality was <3% at two years of follow-up in all regions, except Latin America (4.9%) and SSA (5.5%). CONCLUSIONS Children switched to second-line ART experience CD4 count increases as well as low to moderate rates of LTFU and mortality within two years after switch. Severe immune deficiency at time of switch in some settings suggests need for improved recognition and management of treatment failure in children

QUALITY OF LIFE RELATED TO BREAST CANCER IN WOMEN IN POSTMENOPAUSE: A SYSTEMATIC REVIEW

Objective: To verify the quality of life related to post-menopausal breast cancer in women using HT, through a systematic review. Methods: For the selection of studies, the combination [(Hormone Replacement Therapy) AND (use) AND (breast cancer) AND (menopausal women) AND (quality of life) AND (randomized controlled trial)) was used]. The search was performed in the Medline, LILACS, Bireme, SciELO, ScienceDirect and Google Scholar databases as a gray search. Randomized articles were included, without language restriction, published between January 2010 and March 2020, which obtained a minimum score of 10 on the modified scale of the literature. Articles that did not have a title, abstract or body of the article related to the research objective were excluded. Result: 1217 articles were retrieved, however two articles met the inclusion criteria, being classified as high quality. It has been observed that HT increases the risk of developing breast cancer during post-menopause. Conclusion: HT combined with different progestogens improves symptoms caused by postmenopause. However, one should evaluate the advantages and disadvantages of use among women, especially when they present some risk factor for developing the disease. Lower rates of breast cancer risk were observed when HT administered with estrogen alone.Objetivo: Verificar la calidad de vida relacionada con el cáncer de mama en mujeres posmenopáusicas que utilizan TH, a través de una revisión sistemática. Métodos: Para la selección del estudio, se utilizó la combinación [(terapia de reemplazo hormonal) Y (uso) Y (cáncer de mama) Y (mujeres menopáusicas) Y (calidad de vida) Y (ensayo clínico aleatorizado)]. La búsqueda se realizó en las bases de datos Medline, LILACS, Bireme, SciELO, ScienceDirect y Google Scholar en el formulario de búsqueda gris. Se incluyeron artículos aleatorizados sin restricción de idioma, publicados entre enero de 2010 y marzo de 2020, con una puntuación mínima de 10 en la escala modificada de la literatura. Se excluyeron los artículos que no contenían el título, resumen o cuerpo del artículo relacionado con el objetivo de la investigación. Resultado: se recuperaron 1217 artículos, pero dos artículos cumplieron los criterios de inclusión y se clasificaron como de alta calidad. Se ha demostrado que la TH aumenta el riesgo de desarrollar cáncer de mama durante las mujeres posmenopáusicas. Conclusión: la TH combinada con diferentes progestágenos mejora los síntomas post menopáusicos. Sin embargo, se deben evaluar las ventajas y desventajas de su uso entre las mujeres, especialmente cuando presentan algún factor de riesgo para el desarrollo de la enfermedad. Se observaron tasas de riesgo de cáncer de mama más bajas cuando se administró TH solo con estrógeno.Objetivo: Verificar a qualidade de vida relacionada ao câncer de mama na pós-menopausa em mulheres usuárias de TH, por meio de revisão sistemática. Métodos: Para a seleção do estudo, a combinação [(terapia de reposição hormonal) AND (uso) AND (câncer de mama) AND (mulheres na menopausa) AND (qualidade de vida) AND (ensaio clínico randomizado)] foi usada. A busca foi realizada nas bases de dados Medline, LILACS, Bireme, SciELO, ScienceDirect e Google Scholar na forma de busca cinza. Foram incluídos artigos randomizados, sem restrição de idioma, publicados entre janeiro de 2010 e março de 2020, com pontuação mínima de 10 na escala modificada da literatura. Foram excluídos os artigos que não continham título, resumo ou corpo do artigo relacionado ao objetivo da pesquisa. Resultado: Foram recuperados 1217 artigos, porém dois artigos atenderam aos critérios de inclusão e foram classificados como de alta qualidade. Foi demonstrado que a TH aumenta o risco de desenvolver câncer de mama durante a pós-menopausa. Conclusão: A TH combinada com diferentes progestagênios melhora os sintomas causados ​​pela pós-menopausa. Porém, deve-se avaliar as vantagens e desvantagens do uso entre as mulheres, principalmente quando estas apresentam algum fator de risco para o desenvolvimento da doença. Taxas mais baixas de risco de câncer de mama foram observadas quando o HT foi administrado apenas com estrogêni

The connected educator: personal learning networks

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156138/3/tct13146.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156138/2/tct13146_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156138/1/tct13146-sup-0001-AppendixA.pd