Spacelab experiment computer study. Volume 2: Study elements and approach

For abstract, see volume 1 N77-13097

Informed consent for epidural analgesia in labour

Consent for epidural analgesia for labour is unique. The issues of patient autonomy and competence are controversial because of the limited antenatal education that most South African patients receive, and the absence of a culture of structured birth planning. Frequently, such patients are first encountered by the anaesthetist when in advanced labour and limited time is available for explanation. Overall, this represents the most extreme example of obtaining consent in compromised circumstances

Relearning in semantic dementia: word retraining programs to help rebuild vocabulary

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record

Some quality factors of pond water in selected areas of Missouri

Done under Department of Agriculture Engineering Research Project 155, 'Farm Water Supplies'--P. [2].Digitized 2007 AES.Includes bibliographical references (page 12)

Ethical Decision-Making Aid for Patients with Diminished Capacity

Many patients, especially the elderly and those with mental illness, have diminished or no capacity to participate in decision-making. Consider, for example, the patient who influenced by her paranoid schizophrenia refuses to allow her aortic stenosis to be managed by catheritization with valvuloplasty even though her prognosis is excellent if she does so and poor if she does not. Another example is the patient without any next of kin who has dementia, diabetes, and osteomyelitis with gangrene who needs an amputation of his foot and rehabilitation but who refuses. A last example is the medically fragile young adult with severe developmental delay who simply cannot understand the importance of dental extraction of a mesioangular impacted wisdom tooth. In these and similar cases, patients often can still express, sometimes very forcefully, their will – through words or deeds: the patient who wants to leave the hospital; the patient who makes threatening physical gestures when staff approach; or the patient pulls out a nasogastric tube or, worse, a PEG tube. Moreover, a surrogate may agree to an intervention or care plan justified by the patient’s “best interests” however that plan may be contrary to the patient’s “expressed” will. Is it fair to the patient to simply follow the surrogate or, in the absence of a surrogate, to simply move ahead based on a presumption that the patient must be protected from his or her lack of capacity? In other words, is the consent of a surrogate or the benefit of a clinical plan sufficient to ethically justify moving ahead regardless of the patient’s expressed will? This paper will address the ethical significance of the incapacitated will of a patient and offer a methodology for caregivers to use to address the ethical issues of these types of patients who need, but do not want, beneficial care. It will do so by exploring the ethical rationale for keeping the decision as close to the patient as possible and will offer a decision aid used in our ethics consultations to guide decisions and care planning for patients with diminished capacity

A Re-Examination Of The Property Tax Burden

The property tax is the major source of own revenues for most city and county governments, yet economists have had very little definitive information to share with policymakers about the burden that it imposes on local citizens.  This is because most previous studies of property taxes have used a Suits index analysis which does not allow for any independent variables other than income.  We estimate a regression model using current income and various socio-demographic variables in order to take a more fine grained approach.  We use data obtained from the Florida Department of Revenue from 326,976 single family homeowners in four northeast Florida counties geo-coded with the 2010 block group census data.  We find that the property tax is regressive with respect to current income. With respect to demographic variables, we find that homeowners over the age of 65 pay a higher average tax rate based on their current incomes.  African Americans pay a lower tax rate than other races based on their current income. When we combine income and demographic variables to predict the tax rate paid by a hypothetical low socio-economic status household versus a high socio-economic status household, we find that the high SES household pays a higher average tax rate.  Thus, the demographic variables temper the regressivity of the property tax based on current income alone

One-Particle Excitation of the Two-Dimensional Hubbard Model

The real part of the self-energy of interacting two-dimensional electrons has been calculated in the t-matrix approximation. It is shown that the forward scattering results in an anomalous term leading to the vanishing renormalization factor of the one-particle Green function, which is a non-perturbative effect of the interaction U. The present result is a microscopic demonstration of the claim by Anderson based on the conventional many-body theory. The effect of the damping of the interacting electrons, which has been ignored in reaching above conclusion, has been briefly discussed.Comment: 7 pages, LaTeX, 1 figure, uses jpsj.sty, to be published in J. Phys. Soc. Jpn. 66 No. 3 (1997

Novel use Of Hydroxyurea in an African Region with Malaria (NOHARM): a trial for children with sickle cell anemia

Hydroxyurea treatment is recommended for children with sickle cell anemia (SCA) living in high-resource malaria-free regions, but its safety and efficacy in malaria-endemic sub-Saharan Africa, where the greatest sickle-cell burden exists, remain unknown. In vitro studies suggest hydroxyurea could increase malaria severity, and hydroxyurea-associated neutropenia could worsen infections. NOHARM (Novel use Of Hydroxyurea in an African Region with Malaria) was a randomized, double-blinded, placebo-controlled trial conducted in malaria-endemic Uganda, comparing hydroxyurea to placebo at 20 ± 2.5 mg/kg per day for 12 months. The primary outcome was incidence of clinical malaria. Secondary outcomes included SCA-related adverse events (AEs), clinical and laboratory effects, and hematological toxicities. Children received either hydroxyurea (N = 104) or placebo (N = 103). Malaria incidence did not differ between children on hydroxyurea (0.05 episodes per child per year; 95% confidence interval [0.02, 0.13]) vs placebo (0.07 episodes per child per year [0.03, 0.16]); the hydroxyurea/placebo malaria incidence rate ratio was 0.7 ([0.2, 2.7]; P = .61). Time to infection also did not differ significantly between treatment arms. A composite SCA-related clinical outcome (vaso-occlusive painful crisis, dactylitis, acute chest syndrome, splenic sequestration, or blood transfusion) was less frequent with hydroxyurea (45%) than placebo (69%; P = .001). Children receiving hydroxyurea had significantly increased hemoglobin concentration and fetal hemoglobin, with decreased leukocytes and reticulocytes. Serious AEs, sepsis episodes, and dose-limiting toxicities were similar between treatment arms. Three deaths occurred (2 hydroxyurea, 1 placebo, and none from malaria). Hydroxyurea treatment appears safe for children with SCA living in malaria-endemic sub-Saharan Africa, without increased severe malaria, infections, or AEs. Hydroxyurea provides SCA-related laboratory and clinical efficacy, but optimal dosing and monitoring regimens for Africa remain undefined. This trial was registered at www.clinicaltrials.gov as #NCT01976416

Senator James O. Eastland; Russell B. Long; Kaneaster Hodges, Jr.; Dale Bumpers; J. Bennett Johnston; John Tower; Floyd K. Haskell; John Melcher; Herman E. Talmadge; Edward Zorinsky; Birch Bayh; Robert Dole; George McGovern; & Jesse Helms to James T. McIntyre, 3 May 1978

Copy typed letter signed dated 3 May 1978 from Eastland; Russell B. Long; Kaneaster Hodges, Jr.; Dale Bumpers; J. Bennett Johnston; John Tower; Floyd K. Haskell; John Melcher; Herman E. Talmadge; Edward Zorinsky; Birch Bayh; Robert Dole; George McGovern; & Jesse Helms to James T. McIntyre, Director of the Office of Management & Budget, re: Food for Peace program, grain & rice; 2 pages.https://egrove.olemiss.edu/joecorr_h/1010/thumbnail.jp