Emergency burr holes:" How to do it"

This paper describes a simple approach to emergency burr hole evacuation of extra-axial intracranial haematoma that can be used in the uncommon situation when life saving specialist neurosurgical intervention is not available

Exploring Hearing Aid Use in Older Adults through Narratives

This study explores the lived experience of hearing aid use and non-use of older individuals with hearing loss. A narrative approach was used to gain an in-depth understanding of the meaning and contextual issues that impact upon the adaptation process of older adults and their transitions in using hearing devices. Four women over the age of sixty took part in two face-to-face interviews. All of these women were identified as being consistent hearing aid users. Wengraf s biographic-narrative-interview guiding framework was used to gather data in this study. Data were analyzed both holistically and thematically from a phenomenological perspective to identify the meaning and essence of the participants’ experience with hearing aids and hearing loss. Results revealed an overarching theme of meaningful participation in life situations and events that was linked to purposeful use and non-use of hearing aids. Barriers and facilitators related to participation, which in turn affect hearing aid use and acceptance, were uncovered. The results of this study have implications for audiologic research, practice, and audiologist education

Feminist Services and Research Mental Health Collectives: Cooperation for Survival

Cette -présentation décrit l 'histoire et la arise financière actuelle du Toronto Women's Counselling Referral and Education Centre (WCREC). Le WCREC sert à référer à des spécialistes nonsexistes les femmes ayant besoin de soins et, en général, tente de combler le vide dans les services de santé mentale pour femmes, surtout en ce qui concerne les femmes immigrantes, les femmes à faible revenu et les mères célibataires. En plus, le WCREC favorise les alternatives aux techniques traditionnelles, tels que les groupes de soutien que des femmes maltraitées organisent d'elles-mimes, etc. Il constitue une alternative féministe essentielle au système d'assurance maladie, fondé sur la loi du profit

The Florida Intrigues of Jose Alvarez de Toledo

This article is an outgrowth of an extended project undertaken by the writer for the Florida State Historical Society. The material upon which it is based consists in part of photostatic reproductions of documents provided by this Society, and in part of like material loaned by the Manuscript Division of the Library of Congress. The Research Board of the University of California has generously given the project financial support. To all these agencies the writer acknowledges his indebtedness

The Role of Emotions and Individual Differences in the Trust Repair Process

Organizational trust and trust repair are topics that have primarily been considered from a cognitive perspective. Although a number of scholars have called for further investigation into the role of emotions and individual differences in these processes, little empirical research has been conducted. A reason for this may concern how trust is usually measured in the organizational literature, through measures relating to the trustworthiness characteristics of others. This thesis argues against such a “perceived trustworthiness paradigm” (Möllering, 2013a) and empirically tests the approach conceptualised by Dietz and Den Hartog (2006) which asserts that that trust is a process consisting of attitudinal and behavioural processes comprising of belief, decision, and action. It primarily investigates the influence of emotion and emotion-related individual differences in repairing trust, and whether they are integral to the proposed process model. Three studies are conducted to investigate these questions. Studies 1 (N = 82) and 2 (N = 253) are experiments carried out to determine to what extent change in affect influenced participants’ change in perceptions of a coach company from post-violation (a coach crash) to post-trust repair effort (CEO’s response), and their willingness to trust in it. Study 3 (N = 135) is a cross-sectional survey of Volkswagen vehicle owners in the aftermath of the 2015 Emissions Scandal undertaken to measure the trust process in its entirety with people actively involved in a trust violation. Results indicate that negative emotions are influential predictors of trust repair effects and relate strongly to distrusting acts. Individual difference effects were generally not found, but the proposed process model of trust was supported, with willingness to trust mediating the relationship between perceptions of trustworthiness and distrusting acts. Emotions appeared to become more influential as the trust process developed, and findings imply that purely cognitive models are not sufficient to fully understand the nature of trust and its repair

Public Education in Spanish St. Augustine

A school for white children existed in St. Augustine as early as 1606. Whether it continued to function during the rest of this first period of Spanish dominion is a question that cannot now be answered. But if it did survive, it must have come to a close on the cession of the province to the British in 1763; for the change of sovereignty was followed by a general abandonment of the territory by the Spanish inhabitants. When the Spanish came back twenty years later the British in turn departed. With the restoration of sovereignty went the restoration of the school

The shootings in Oslo and Utøya island July 22, 2011: Lessons for the International EMS community

SJTREM has published an account by Sollid and colleagues of the pre-hospital medical response to the major incidents, which occurred in Oslo and Utøya island on July 22, 2011. Although very similar incidents have occurred in Europe and elsewhere, this terrible day saw the greatest loss of life recorded in this type of incident in recent times. Internationally EMS providers looked on with the certain knowledge that this type of incident is sadly one that we all have to prepare for. It is unrelated to national foreign policy, religious extremism or the existence of known terrorist activity. In short this type of incident is unpredictable and has the potential to happen in any community at any time

A Foot-note to Captain Young’s Itineraries: Letters of Jeremy Robinson

Topographical Memoir on East and West Florida With Itineraries of General Jackson’s Army, by Capt. Hugh Young of that army, appeared in the last three issues of the Quarterly. Another series on the same general subject of roads and travel in Florida in the early nineteenth century will be begun in the October number next: papers relating to the survey and construction of the Pensacola-St. Augustine highway, arranged and with an introduction by Mark F. Boyd to whom we are indebted for the Young memoir

Is baseline aerobic fitness associated with illness and attrition rate in military training?

Background Respiratory illnesses are a leading cause of morbidity and medical discharge in the military. This study aimed to investigate the effects of baseline aerobic fitness on haematological, salivary and mood variables, and simultaneously, in a novel approach, to identify factors precipitating illness and attrition rate in recruits during military training. Methods Thirty-five healthy male recruits from an Army Training Regiment undertaking 12 weeks of training were prospectively investigated. Their 2.4 km run time (RT) was used as a surrogate of baseline aerobic fitness. Saliva and venous blood samples were analysed for secretory IgA, full blood counts and cell cytokine production (interleukin (IL) 6 and IL-8), respectively. Each recruit completed questionnaires on mood profile, and gastrointestinal and upper respiratory tract symptoms (URTS). Results Significant salivary and haematological perturbations were observed and coincided with increased duration of URTS/week and mood disturbance over this military training period. From Start to End: leucocyte count decreased by 28% ( p<0.001); neutrophil percentage (%) decreased by 13% (p<0.01); lymphocyte % increased by 17% (p<0.05); the neutrophil:lymphocyte ratio decreased by 22% (p<0.01); eosinophil% increased by 71% (p<0.01). From Start to Mid to End: monocyte% increased by 68% at Mid (p<0.01) but only by 30% at End (p<0.01); IL-6 increased by 39% at Mid (p<0.01) and a further 61% by End. The 2.4 km RT was significantly associated with URTS duration (p<0.01). In addition, a 1-min increase in 2.4 km RT increased a recruit’s risk 9.8-fold of developing URTS lasting, on average, 3.36 days/week. In recruits ranked with high-URTS duration their RT was 48 s slower (p<0.01) than those with low-URTS, and their attrition rate reached 45%. Conclusions The least fit recruits may have found training more physically demanding as reflected in the higher URTS duration, which may have led to a high attrition rate from the Army. It is worth considering that baseline aerobic fitness might be an important factor in illness development and attrition rate in recruits during this type of military training

Structural and ligand binding investigation of VanS, a protein involved in antibiotic resistance

VanS is an integral membrane protein, and a receptor histidine kinase representing on half of the VanSR two component system. In the presence of vancomycin, as well as certain other antibiotics, VanS undergoes autophosphorylation at a conserved histidine residue and then transfers this phosphoryl group to a conserved aspartate on VanR. The phosphorylated form of VanR binds to the promoter region of the vanHAX operon, inducing expression of these genes, which confer glycopeptide antibiotic resistance to the cell. Although the vancomycin resistance mechanism is mostly well-characterised, questions surrounding the structure and mode of activation of VanS remain unanswered. This thesis describes work towards the structural and ligand-binding characterisation of the extracellular \sensor" domain of VanS. Little is known of the structure of this domain, and while there exists evidence in the literature to support numerous theories surrounding the identity of the VanS ligand, no report has yet been made of a direct observation of a binding event involving any VanS protein and its ligand To identify the ligand to VanS, the catalytically active, full-length VanS proteins of Enterococcus faecium (VanSA) and Streptomyces coelicolor (VanSSC) were heterologously expressed, solubilised and purified and binding studies were carried out by solution-state NMR. We present evidence of interactions between vancomycin and both VanS proteins, indicating that direct binding of vancomycin may be the mechanism by which both proteins are activated. The VanSSC extracellular domain was isolated as a synthetic peptide, its structure characterised, and the binding interface between this domain and vancomycin was investigated. Evidence of binding at the N-terminal end of the extracellular domain, in agreement with the findings of Koteva et al. (2010), is presented here. An interaction between vancomycin and DPC detergent micelles was also observed and characterised, and the biological significance of such an interaction is discusse