African American Adults’ Experiences with the Health Care System: In Their Own Words

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and attitudes, and (5) improving health care experiences. These findings indicate that perceptions of discrimination and racism were prevalent among African Americans in this study, and that the expectation of a negative interaction is a barrier to seeking care. Authors discuss prevention and public health implications of these findings and make recommendations for health care practitioners

Kaposi sarcoma in a HIV uninfected man who has sex with men

Kaposi's sarcoma (KS) is a rare angioproliferative tumor associated with human herpesvirus 8 (HHV-8) infection. Four clinical variants of KS have been described: classic, endemic, iatrogenic and HIV-associated. We describe a 53-year-old men who had sex with men with a rapidly growing nodule on his left foot. Histologically KS was confirmed. Our patient did not match the clinical subgroups as HIV infection or other immune disorders could be ruled out. KS in HIV-negative MSM has only been reported sporadically. It was shown that KS in these patients clinically resembles classic KS but occurs at a younger age, is limited to the skin, and is associated with a good prognosis

Primary merkel cell carcinoma clinically presenting as deep oedematous mass of the groin

Merkel cell carcinoma (MCC) is a relatively rare, polyomavirus associated, primary neuroendocrine carcinoma of the skin which is usually arising from dermal skin layers. However, the origin of MCC in the subcutaneous tissue is debatable. We report a 58-yearold female patient with an oedematous mass on her left groin that was firm in consistency and had no discoloration or other visible abnormality of the overlying skin. On histology and immunohistology the tumour was consistent with the diagnosis of MCC showing a predominant subcutanous growth pattern. Pelvic magnetic resonance tomography revealed a tumour conglomerate reaching from the subcutis of the left groin to the left paraaortal and parailiacal region indicating widespread lymphogenic metastisation. Despite complete medical work-up no other MCC primary could be detected. In conclusion, predominant subcutaneous growth pattern as well as tumour localization in the groin are uncommon features of MCC. MCC showing the aforementioned features may be associated with significant delay of diagnosis and therefore represents an unfavourable prognostic factor

Coupling a single atomic quantum bit to a high finesse optical cavity

The quadrupole S$_{1/2}$ -- D$_{5/2}$ optical transition of a single trapped Ca$^+$ ion, well suited for encoding a quantum bit of information, is coherently coupled to the standing wave field of a high finesse cavity. The coupling is verified by observing the ion's response to both spatial and temporal variations of the intracavity field. We also achieve deterministic coupling of the cavity mode to the ion's vibrational state by selectively exciting vibrational state-changing transitions and by controlling the position of the ion in the standing wave field with nanometer-precision

Investigations on the influence of conservation tillage strategies on the composition of the soil mesofauna by using the litter-bag-method

Elemente der Bodenmesofauna gehören gerade in pfluglosen Anbausystemen zu den bedeutendsten Primärzersetzern von Ernterückständen. Für den Rotteprozess, der nicht nur für die Pflanzengesundheit von größter Bedeutung ist, spielen sie damit eine entscheidende Rolle. Während Effekte der Bodenbearbeitung auf die mikrobielle Biomasse in den letzten Jahrzehnten Gegenstand zahlreicher Feldstudien waren, sind entsprechende Erhebungen zur Bodenmesofauna vergleichsweise rar und darüber hin in ihren Aussagen teilweise widersprüchlich. Positive Effekte auf Streuabbau durch reduzierte Intensität der Bodenbearbeitung konnten Heiber & Eisenbeis (1999) nachweisen. Vorliegende Untersuchungen sollten klären, welche Auswirkungen die Bodenbearbeitung auf die vielfältigen Zönosen der Bodenmesofauna eines intensiv ackerbaulich genutzten Lößstandortes hat.The soil mesofauna has an important role for the decomposition of organic materials in non-till cultivation systems. The investigations have been carried out on fields of Lüttewitz (Saxony, Germany). There were investigated 4 cultivation variants, which were still used on each plot more than 10 years: plough; mulch sowing with deep loosening; mulch till with shallow loosening and direct drilling. In each variant 20 litterbags (mesh size: 2 mm; litter weight: 20 g); (exposition period: spring till early summer 2006) were placed under the soil surface. To investigate the possible effects of the litter size on the colonization by the soil mesofauna, two litter variants (Maize chopped straw fine/cereals straw rough) were used. The litterbags were controlled at three times. At first a wet-extraction was carried out to estimate the dense of Enchytraeidae (Oligochaeta). Afterwards a dry extraction of the mesofauna with the Tullgren-method followed to find out the amount of mites (Oribatida and Acaridida) and Collembola, which are important for decomposition of the litter. Among the Oribatida the species Tectocepheus velatus and Oppiella nova reached high densities. The predatory Gamasina were dominated by the families Rhodacaridae, Parasitidae, Ascidae, Veigaiaidae, Macrochelidae and Zerconidae. All times the fine litter in all plots was stronger colonized. In rough litter the part of Gamasina as predators was lower than the decomposer groups. With the declining of the intensity of tillage the colonization of the litter-bags increased. In the variant mulch-till (with shallow loosening) the highest densities of individuals were found. The registered numbers often were higher as in the plots with direct drilling