Short Interval Occurance of Papillary Thyroid Carcinoma Following Radiotherapy for Hodgkin’s Disease: a Case Report

Introduction: Hodgkin’s disease (HD) is a common pediatric malignancy that is treated with a combination of chemotherapy and radiation. Although cure rates are very high (~90%), secondary malignancies are not uncommon and radiation has been shown to be a risk factor for their development. Secondary malignant neoplasms (SMNs) of the thyroid gland are common solid tumors found in patients treated for HD. Current literature shows that these SMNs generally appear an average of 5-15 years later, even in patients under surveillance.Presentation of Case: We present 16 year old patient with secondary thyroid papillary carcinoma four years after completion of radiotherapy.Conclusion: This case may have implications for the future management and post radiation care of these patients

Counseling students’ attitudes toward complementary and alternative medicine integration in counseling practice

This study explored counseling students’ attitudes toward beliefs and personal experience with complementary and alternative medicine (CAM) integration in counseling practices. A total of 113 clinical mental health counseling students completed a demographic questionnaire, the CAM use, and the Complementary and Alternative Medicine Beliefs Inventory. Data were analyzed using descriptive statistics, nonparametric Chi-Square testing, Mann–Whitney U test, and logistic regression analysis to determine the prevalence of CAM use, CAM beliefs, and predictive factors of CAM integration. The results indicated differences in ethnicity, gender, and age for CAM use, CAM beliefs, and predictors of attitudes toward CAM integration. Recommendations for counseling practice and education regarding CAM use and community-based health promotion were discussed

Adiabatic Output Coupling of a Bose Gas at Finite Temperatures

We develop a general theory of adiabatic output coupling from trapped atomic Bose-Einstein Condensates at finite temperatures. For weak coupling, the output rate from the condensate, and the excited levels in the trap, settles in a time proportional to the inverse of the spectral width of the coupling to the output modes. We discuss the properties of the output atoms in the quasi-steady-state where the population in the trap is not appreciably depleted. We show how the composition of the output beam, containing condensate and thermal component, may be controlled by changing the frequency of the output coupler. This composition determines the first and second order coherence of the output beam. We discuss the changes in the composition of the bose gas left in the trap and show how nonresonant output coupling can stimulate either the evaporation of thermal excitations in the trap or the growth of non-thermal excitations, when pairs of correlated atoms leave the condensate.Comment: 22 pages, 6 Figs. To appear in Physical Review A All the typos from the previous submission have been fixe

Effects of interatomic collisions on atom laser outcoupling

We present a computational approach to the outcoupling in a simple one-dimensional atom laser model, the objective being to circumvent mathematical difficulties arising from the breakdown of the Born and Markov approximations. The approach relies on the discretization of the continuum representing the reservoir of output modes, which allows the treatment of arbitrary forms of outcoupling as well as the incorporation of non-linear terms in the Hamiltonian, associated with interatomic collisions. By considering a single-mode trapped condensate, we study the influence of elastic collisions between trapped and free atoms on the quasi steady-state population of the trap, as well as the energy distribution and the coherence of the outcoupled atoms.Comment: 25 pages, 11 figures, to appear in J. Phys.

The Equity Impact Vaccines May Have On Averting Deaths And Medical Impoverishment In Developing Countries.

With social policies increasingly directed toward enhancing equity through health programs, it is important that methods for estimating the health and economic benefits of these programs by subpopulation be developed, to assess both equity concerns and the programs' total impact. We estimated the differential health impact (measured as the number of deaths averted) and household economic impact (measured as the number of cases of medical impoverishment averted) of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. Our analysis indicated that benefits across these vaccines would accrue predominantly in the lowest income quintiles. Policy makers should be informed about the large health and economic distributional impact that vaccines could have, and they should view vaccination policies as potentially important channels for improving health equity. Our results provide insight into the distribution of vaccine-preventable diseases and the health benefits associated with their prevention

Models of peer support to remediate post-intensive care syndrome: A report developed by the SCCM Thrive International Peer Support Collaborative

Objective: Patients and caregivers can experience a range of physical, psychological, and cognitive problems following critical care discharge. The use of peer support has been proposed as an innovative support mechanism. Design: We sought to identify technical, safety and procedural aspects of existing operational models of peer support, among the Society of Critical Care Medicine Thrive Peer Support Collaborative. We also sought to categorize key distinctions between these models and elucidate barriers and facilitators to implementation. Subjects: 17 Thrive sites from the USA, UK, and Australia were represented by a range of healthcare professionals. Interventions: Via an iterative process of in-person and email/conference calls, members of the Collaborative, defined the key areas on which peer support models could be defined and compared; collected detailed self-reports from all sites; reviewed the information and identified clusters of models. Barriers and challenges to implementation of peer support models were also documented. Results: Within the Thrive Collaborative, six general models of peer support were identified: Community based, Psychologist-led outpatient, Models based within ICU follow-up clinics, Online, Groups based within ICU and Peer mentor models. The most common barriers to implementation were: recruitment to groups, personnel input and training: sustainability and funding, risk management and measuring success. Conclusion: A number of different models of peer support are currently being developed to help patients and families recover and grow in the post-critical care setting

Value of syndromic surveillance within the Armed Forces for early warning during a dengue fever outbreak in French Guiana in 2006

<p>Abstract</p> <p>Background</p> <p>A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response.</p> <p>Methods</p> <p>Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants.</p> <p>Results</p> <p>It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance.</p> <p>Conclusion</p> <p>Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.</p

Nature and consequences of interactions between Salmonella enterica serovar Dublin and host cells in cattle

International audienceAbstractSalmonella enterica is a veterinary and zoonotic pathogen of global importance. While murine and cell-based models of infection have provided considerable knowledge about the molecular basis of virulence of Salmonella, relatively little is known about salmonellosis in naturally-affected large animal hosts such as cattle, which are a reservoir of human salmonellosis. As in humans, Salmonella causes bovine disease ranging from self-limiting enteritis to systemic typhoid-like disease and exerts significant economic and welfare costs. Understanding the nature and consequences of Salmonella interactions with bovine cells will inform the design of effective vaccines and interventions to control animal and zoonotic infections. In calves challenged orally with S. Dublin expressing green fluorescent protein (GFP) we observed that the bacteria were predominantly extracellular in the distal ileal mucosa and within gut-associated lymph nodes 48 h post-infection. Intracellular bacteria, identified by flow cytometry using the GFP signal, were predominantly within MHCII+ macrophage-like cells. In contrast to observations from murine models, these S. Dublin-infected cells had elevated levels of MHCII and CD40 compared to both uninfected cells from the same tissue and cells from the cognate tissue of uninfected animals. Moreover, no gross changes of the architecture of infected lymph nodes were observed as was described previously in a mouse model. In order to further investigate Salmonella-macrophage interactions, net replication of S. enterica serovars that differ in virulence in cattle was measured in bovine blood-derived macrophages by enumeration of gentamicin-protected bacteria and fluorescence dilution, but did not correlate with host-specificity

Understanding the political motivations that shape Rwanda’s emergent developmental state

Twenty years after its horrific genocide, Rwanda has become a model for economic development. At the same time, its government has been criticized for its authoritarian tactics and use of violence. Missing from the often-polarized debate are the connections between these two perspectives. Synthesizing existing literature on Rwanda in light of a combined year of fieldwork, we argue that the GoR is using the developmental infrastructure to deepen state power and expand political control. We first identify the historical pressures that have motivated the Rwanda Patriotic Front (RPF) to re-imagine the political landscape. Sectarian unrest, political rivalry, wider regional insecurity, and aid withdrawal have all pressured the RPF to identify growth as strategic. However, the country’s political transformation extends beyond a prioritisation of growth and encompasses the reordering of the social and physical layout of the territory, the articulation of new ideologies and mindsets, and the provision of social services and surveillance infrastructure. Growth and social control go hand in hand. As such, the paper’s main contribution is to bring together the two sides of the Rwandan debate and place the country in a broader sociological literature about the parallel development of capitalist relations and transformations in state power