BLUEPRINT OF THE VIRGINIA STATE FREEDMEN'S BUREAU SCHOOL SYSTEM

In the late summer of 1861 the American Missionary Association sent missionaries to teach and distribute relief goods to the contraband Negroes at Fortress Monroe. This effort began missions that eventually grew into successful experiments to settle and educate the thousands of refugee slaves that flocked to the Hampton Roads area during the Civil War. During 1862 the missions underwent a difficult period struggling to progress in the midst of active military campaigns and conservative politics. The ability of the contrabands to overcome the difficulties of this early period to establish homes and schools, and labor peacefully on the farms influenced federal policy to carry out emancipation. After the Emancipation Proclamation of 1863 Norfolk and Portsmouth became the sites of two experiments to discover a workable method of acquainting the newly freed slaves with free labor status in a complex society. The educational aspect of these experiments led to the development of a system of schools encompassing the student population in the Twin Cities, adjoining experimental farms, the efforts of many benevolent societies, and the army. Two factors set the consistency needed to insure steady progress to develop the schools from infancy. The AMA kept a tight rein on the activities of their missionaries, and the army personnel remained in the system throughout the war period. The resulting systemization of the schools in an urban-rural cross section in the mainstream of the active military conflict cast the mold for a workable system for Postwar Reconstruction. The blueprint became the prototype used to organize the Freedmen's Bureau schools in Virginia. These schools matured into one of the most successful state systems within the Bureau, and made education the most lasting contribution of the Reconstruction era

Epidemiology and outcomes of people with dementia, delirium and unspecified cognitive impairment in the general hospital: prospective cohort study of 10,014 admissions

Background  Cognitive impairment of various kinds is common in older people admitted to hospital, but previous research has usually focused on single conditions in highly-selected groups and has rarely examined associations with outcomes. This study examined prevalence and outcomes of cognitive impairment in a large unselected cohort of people aged 65+ with an emergency medical admission.  Methods  Between January 1, 2012, and June 30, 2013, admissions to a single general hospital acute medical unit aged 65+ underwent a structured specialist nurse assessment (n = 10,014). We defined ‘cognitive spectrum disorder’ (CSD) as any combination of delirium, known dementia, or Abbreviated Mental Test (AMT) score < 8/10. Routine data for length of stay (LOS), mortality, and readmission were linked to examine associations with outcomes.  Results  A CSD was present in 38.5% of all patients admitted aged over 65, and in more than half of those aged over 85. Overall, 16.7% of older people admitted had delirium alone, 7.9% delirium superimposed on known dementia, 9.4% known dementia alone, and 4.5% unspecified cognitive impairment (AMT score < 8/10, no delirium, no known dementia). Of those with known dementia, 45.8% had delirium superimposed. Outcomes were worse in those with CSD compared to those without – LOS 25.0 vs. 11.8 days, 30-day mortality 13.6% vs. 9.0%, 1-year mortality 40.0% vs. 26.0%, 1-year death or readmission 62.4% vs. 51.5% (allP < 0.01). There was relatively little difference by CSD type, although people with delirium superimposed on dementia had the longest LOS, and people with dementia the worst mortality at 1 year.  Conclusions  CSD is common in older inpatients and associated with considerably worse outcomes, with little variation between different types of CSD. Healthcare systems should systematically identify and develop care pathways for older people with CSD admitted as medical emergencies, and avoid only focusing on condition-specific pathways such as those for dementia or delirium alone

Exomorfología y anatomía de órganos vegetativos aéreos en especies de Flourensia DC. (Asteraceae) con importancia fitoquímica

El género Flourensia DC. es americano y comprende 32 especies. Son arbustos resinosos utilizados en medicina popular; poseen un potencial valor económico, por lo que, en algunas especies representantes, se han caracterizado sus compuestos químicos y determinado algunos posibles usos. En el presente trabajo, se estudió la exomorfología y anatomía de órganos vegetativos de F. hirta S. F. Blake, F. leptopoda S. F. Blake, F. niederleinii S. F. Blake y F. tortuosa Griseb., especies endémicas del centro de Argentina. Se observó que todas son similares en cuanto a la anatomía de hoja y tallo. En cuanto al estudio de la epidermis foliar, se concluye que es posible diferenciar las especies teniendo en cuenta la frecuencia estomática y la presencia de tricomas. Finalmente, las diferencias más notables se encontraron en la exomorfología foliar ya que se observó una gran variación en cuanto a la forma de las hojas y tamaño de las láminas y pecíolos. Con respecto a las estructuras secretoras, se encontraron tricomas y conductos secretores esquizógenos en las hojas y los tallos de todas las especies, las cuales serían responsables de la producción y secreción de las resinas.The genus Flourensia DC. is American and comprises 32 species. They are resiniferous shrubs used in folk medicine. As they have potential economic value, its chemical compounds have been characterized and some possible uses identified. In this work, the exomorphology and anatomy of vegetative organs of F. hirta S. F. Blake, F. leptopoda S. F. Blake, F. niederleinii S. F. Blake and F. tortuosa Griseb., endemic species from central Argentina, have been studied. All species are similar in leaf and stem anatomy. Regarding the epidermis, it is possible to differentiate the species according to the stomatal frequency and the presence of trichomes. Finally, the most remarkable differences were found in leaf exomorphology, since there was a large variation in shape and size of blades and petioles. Concerning the secretory structures, trichomes and secretory ducts were found in the leaves and stems of all species, which would be responsible for the production and secretion of the resins

[How to assess the nutritional status of my patient]

Protein-energy-malnutrition is a growing problem in industrialised countries. Many studies have found malnourishment in 20-60% of hospitalized medical or surgical patients, as well as out-patients. Malnutrition negatively influences patients' prognosis, immune system, muscle strength, and quality of life. As it is a largely treatable co-morbidity, systematic screening for malnutrition and effective management will improve patient outcomes and reduce healthcare costs. Early diagnosis and assessment depends on a simple and standardised screening tool that identifies at-risk patients, allowing the medical team in charge to solve patients' nutritional problems with an interdisciplinary approach

Maladies et incapacites, allocations et modes de transports: correlations chez les membres d'une association de patients avec maladies neuromusculaires. Pour l'Association Suisse Romande contre la Myopathie. [Correlation of diseases and disabilities and allocation and modes of transport among the members of an association of patients with neuromuscular diseases. For the Association Suisse Romande contre la Myopathie]

Seventy-nine patients with various chronic neuromuscular disorders returned a questionnaire. We analyzed the linkage between demographic and socio-economic data, type of disease and disability, and types of transportation used. This study shows that whatever type of disability, all patients attach a significant priority to the use of their private vehicle, and that (i) there is a significant correlation between severity of disability and use of disabled people transportation system but not with revenue nor with type of professional activity, and (ii) satisfaction rate is inversely proportional to severity of disability. The relationship between disability and disabled people transportation system appears as logical, but those between revenue and type of transportation is rather complex (role of family, of special refunds from insurance industry, possibility of special loans from the patient organization). The absence of correlation between severity of disability and professional activity must be explained by our choice concerning the scale of disability, which appears too simplistic according to the complexity of the different neuromuscular disorders. It is concluded that (i) co-operation and consultation are needed to give patients better access to disabled people transportation system and to improve technical aids to drive private vehicle and (ii) a more appropriated scale to quantitate disability in neuromuscular disorder patients is needed