Tour of the Ruin

The Poems in this collection trace natural and urban spaces as well as real and dream-like worlds. The poems are interested in loose form. Narrative is employed, especially in the prose poems, as a definition of experience. All the poems pull physical details from the natural world, from the speaker's family, and from several literary sources in an effort to quietly detail, on the whole an often flat tone

Eliciting Intelligence With the Scharff Technique:Interviewing More and Less Cooperative and Capable Sources

The objective was to compare the efficacy of the Scharff technique (conceptualized as 5 tactics) with the direct approach (open and direct questions) as a means of eliciting intelligence from human sources. The interview techniques were used with 4 different types of sources varying in their levels of both cooperation and capability to provide information as follows: (a) less willing/less able, (b) less willing/ more able, (c) more willing/less able, and (d) more willing/more able. The sources (N ﰁ 200) were given information about a notional planned terrorist attack and instructed to strike a balance between not revealing too much or too little information in a subsequent interview. Overall, the Scharff technique resulted in significantly more new information than the direct approach, particularly for the less cooperative sources. Furthermore, sources interviewed with the Scharff technique had a more difficult time reading the interviewer’s information objectives and consistently underestimated how much new information they revealed. The study substantiates the Scharff technique as an effective human- intelligence gathering tool

Maternal age and other predictors of newborn blood pressure

Objective To investigate perinatal predictors of newborn blood pressure. Study design Among 1059 mothers and their newborn infants participating in Project Viva, a US cohort study of pregnant women and their offspring, we obtained five systolic blood pressure readings on a single occasion in the first few days of life. Using multivariate linear regression models, we examined the extent to which maternal age and other pre- and perinatal factors predicted newborn blood pressure level. Results Mean (SD) maternal age was 32.0 (5.2) years, and mean (SD) newborn systolic blood pressure was 72.6 (9.0) mm Hg. A multivariate model showed that for each 5-year increase in maternal age, newborn systolic blood pressure was 0.8 mm Hg higher (95% CI, 0.2, 1.4). In addition to maternal age, independent predictors of newborn blood pressure included maternal third trimester blood pressure (0.9 mm Hg [95% CI, 0.2, 1.6] for each increment in maternal blood pressure); infant age at which we measured blood pressure (2.4 mm Hg [95% CI 1.7, 3.0] for each additional day of life); and birth weight (2.9 mm Hg [95% CI, 1.6, 4.2] per kg). Conclusions Higher maternal age, maternal blood pressure, and birth weight were associated with higher newborn systolic blood pressure. Whereas blood pressure later in childhood predicts adult hypertension and its consequences, newborn blood pressure may represent different phenomena, such as pre- and perinatal influences on cardiac structure and function. Development of risk for adult cardiovascular disease begins very early in life, even before birth.1 Data are scarce, however, regarding blood pressure in the newborn period, which may reflect pre- and perinatal influences on cardiac structure and function. The few studies that have examined determinants of newborn blood pressure suggest a direct association with birth weight,2.; 3.; 4.; 5.; 6.; 7.; 8.; 9. ; 10. in contrast to the inverse association seen with older infants, children, and adults.11 However, most of these studies have at least one important limitation, such as a relatively small sample size of term newborns, lack of data on potentially confounding variables, and limited data on maternal predictors. Maternal age is of particular interest given the known associations of advanced age with adverse reproductive outcomes, including reduced fertility, preterm birth, impaired fetal growth, multiple birth, and congenital anomalies.12.; 13. ; 14. The additional associations of advanced maternal age with diabetes and hypertension,15. ; 16. with possible diminished uterine vascular and placental function,17. ; 18. and in at least two reports with blood pressure level in childhood and in adolescence19. ; 20. warrant examination of its influence on newborn blood pressure. The purpose of this analysis was to investigate associations of pre- and perinatal factors, including maternal age, with systolic blood pressure level during the first few days of life among members of Project Viva, a cohort study of pregnant women and their children

Personal and Ambient Air Pollution is Associated with Increased Exhaled Nitric Oxide in Children with Asthma

BACKGROUND: Research has shown associations between pediatric asthma outcomes and airborne particulate matter (PM). The importance of particle components remains to be determined. METHODS: We followed a panel of 45 schoolchildren with persistent asthma living in Southern California. Subjects were monitored over 10 days with offline fractional exhaled nitric oxide (Fe(NO)), a biomarker of airway inflammation. Personal active sampler exposures included continuous particulate matter < 2.5 μm in aerodynamic diameter (PM(2.5)), 24-hr PM(2.5) elemental and organic carbon (EC, OC), and 24-hr nitrogen dioxide. Ambient exposures included PM(2.5), PM(2.5) EC and OC, and NO(2). Data were analyzed with mixed models controlling for personal temperature, humidity and 10-day period. RESULTS: The strongest positive associations were between Fe(NO) and 2-day average pollutant concentrations. Per interquartile range pollutant increase, these were: for 24 μg/m(3) personal PM(2.5), 1.1 ppb Fe(NO) [95% confidence interval (CI), 0.1–1.9]; for 0.6 μg/m(3) personal EC, 0.7 ppb Fe(NO) (95% CI, 0.3–1.1); for 17 ppb personal NO(2), 1.6 ppb Fe(NO) (95% CI, 0.4–2.8). Larger associations were found for ambient EC and smaller associations for ambient NO(2). Ambient PM(2.5) and personal and ambient OC were significant only in subjects taking inhaled corticosteroids (ICS) alone. Subjects taking both ICS and antileukotrienes showed no significant associations. Distributed lag models showed personal PM(2.5) in the preceding 5 hr was associated with Fe(NO). In two-pollutant models, the most robust associations were for personal and ambient EC and NO(2), and for personal but not ambient PM(2.5). CONCLUSION: PM associations with airway inflammation in asthmatics may be missed using ambient particle mass, which may not sufficiently represent causal pollutant components from fossil fuel combustion

Group versus individual academic detailing to improve the use of antihypertensive medications in primary care: a cluster-randomized controlled trial

Purpose To compare group versus individual academic detailing to increase diuretic or β-blocker use in hypertension. Methods We conducted a cluster-randomized controlled trial in a large health maintenance organization. Subjects (N=9820) were patients with newly treated hypertension in the year preceding the intervention (N=3692), the 9 months following the intervention (N=3556), and the second year following intervention (N=2572). We randomly allocated 3 practice sites to group detailing (N=227 prescribers), 3 to individual detailing (N=235 prescribers), and 3 to usual care (N=319 prescribers). Individual detailing entailed a physician-educator meeting individually with clinicians to address barriers to prescribing guideline-recommended medications. The group detailing intervention incorporated the same social marketing principles in small groups of clinicians. Results In the first year following the intervention, the rates of diuretic or β-blocker use increased by 13.2% in the group detailing practices, 12.5% in the individual detailing practices, and 6.2% in the usual care practices. As compared with usual care practices, diuretic or β-blocker use was more likely in group detailing practices (adjusted odds ratio (OR), 1.40; 95% confidence interval (CI), 1.11 – 1.76) and individual detailing practices (adjusted OR, 1.30; 95% CI, 0.95 – 1.79). Neither intervention affected blood pressure control. Two years following this single-visit intervention, there was still a trend suggesting a persistent effect of individual (OR, 1.22; 95% CI, 0.92 – 1.62), but not group, detailing (OR, 1.06; 95% CI, 0.80 – 1.39), as compared with usual care. Conclusion Both group and individual academic detailing improved antihypertensive prescribing over and above usual care but may require reinforcement to sustain improvements

Toward an understanding of transfusion-related acute lung injury: statement of a consensus panel

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73845/1/j.0041-1132.2004.04347.x.pd

Ab-initio theory of NMR chemical shifts in solids and liquids

We present a theory for the ab-initio computation of NMR chemical shifts (sigma) in condensed matter systems, using periodic boundary conditions. Our approach can be applied to periodic systems such as crystals, surfaces, or polymers and, with a super-cell technique, to non-periodic systems such as amorphous materials, liquids, or solids with defects. We have computed the hydrogen sigma for a set of free molecules, for an ionic crystal, LiH, and for a H-bonded crystal, HF, using density functional theory in the local density approximation. The results are in excellent agreement with experimental data.Comment: to appear in Physical Review Letter