Influenza and its treatment

The etiology, clinical picture, and treatment of influenza up till the discovery of sulphanilamide has been recounted. Sulphanilamide and its derivatives discussed.A comparison made of the use of sulphanilamide and ordinary drugs in some sixty cases of influenza which occurred in Adelaide this year and a final conclusion arrived at that the treatment of influenza should comprise the following six main points.1. The wearing of a mask of five layers of gauze for all who are in contact with influenza. 2. Gargles and mouth washes,especially of dilute ammon. sulphate to prevent introduction of virus. 3. Adequate rest in bed. 4. Ordinary drugs as required for special symptoms. 5. Prophylactic vaccines of the virus in all its strains as soon as available, given at correct times to have maximum protection when epidemic is due. 6.M & B 693 to deal with the secondary invading organisms

Developing Confidence for Patient Advocacy: Reflections from an International Clinical Experience

In this article, the first author reflects on the process of developing confidence in selected nursing roles, particularly becoming a strong advocate as a new nurse and communicating effectively with patients and their families. The reflections focus on experiences throughout her four years as an undergraduate nursing student, including a final clinical practicum in Ghana in early 2017. The first author describes this reflective process in first person, while the second author assisted to reflect on and describe aspects of this learning trajectory. This clinical experience in a low income country such as Ghana provided the first author an opportunity to build confidence in her practice and refine her skills as a strong patient advocate. These learning opportunities afforded a better understanding of the relationship between global citizenship and her role as a registered nurse. &nbsp

"The Country of the Plague": Anticulture and Autoethnography in Dickens's 1850s

This short paper proposes to consider the transition from Bleak House (1852–53) to Little Dorrit (1856–57) as a phase of particular significance in Dickens's debate with himself over the claims, benefits, and pitfalls of national and wider forms of belonging. I elide Hard Times (1854) because it seems to me that with the composition of Bleak House Dickens had definitively arrived at the conviction that the twenty-number monthly novel was that one of his novelistic forms best suited to sustained exploration and testing of capacious social networks making claims upon individuals' identification and loyalty. In Bleak House – as I have argued in Disorienting Fiction: The Autoethnographic Work of Nineteenth-Century British Novels (2005) – Dickens responds to the false universalism of the Great Exhibition of 1851 by producing his most restrictively “national” of novels, programmatically and demonstratively shutting out a wider world in order to produce an image of Britain that negatively foreshadows the kind of autarkic, autotelic fantasies of single cultures associated with the classic functionalist ethnography of the early twentieth century, as practiced by such luminaries as Bronislaw Malinowski and Franz Boas. “Negatively” is key here, since anticipations of ethnography in nineteenth-century British (autoethnographic) fiction typically involve representation of the nation as “a form of anticulture whose features define by opposition the ideals [later] attributed to genuine cultures” (Buzard, Disorienting 21). Whereas the fast-disappearing genuine culture of ethnographic literature was credited with the integrated totality of “a sturdy plant growth, each remotest leaf and twig of which is organically fed by the sap at the core” (Sapir 90–93), Britain's culture vouchsafed in Bleak House and exemplified in the tentacular Court of Chancery presents “a state of disastrous and inescapable interconnection,” “a culture-like vision of social totality that is simply marked with a minus sign” (Buzard, Disorienting 21)

Is treatment-resistant schizophrenia categorically distinct from treatment-responsive schizophrenia? A systematic review

Abstract Background Schizophrenia is a highly heterogeneous disorder, and around a third of patients are treatment-resistant. The only evidence-based treatment for these patients is clozapine, an atypical antipsychotic with relatively weak dopamine antagonism. It is plausible that varying degrees of response to antipsychotics reflect categorically distinct illness subtypes, which would have significant implications for research and clinical practice. If these subtypes could be distinguished at illness onset, this could represent a first step towards personalised medicine in psychiatry. This systematic review investigates whether current evidence supports conceptualising treatment-resistant and treatment-responsive schizophrenoa as categorically distinct subtypes. Method A systematic literature search was conducted, using PubMed, EMBASE, PsycInfo, CINAHL and OpenGrey databases, to identify all studies which compared treatment-resistant schizophrenia (defined as either a lack of response to two antipsychotic trials or clozapine prescription) to treatment-responsive schizophrenia (defined as known response to non-clozapine antipsychotics). Results Nineteen studies of moderate quality met inclusion criteria. The most robust findings indicate that treatment-resistant patients show glutamatergic abnormalities, a lack of dopaminergic abnormalities, and significant decreases in grey matter compared to treatment-responsive patients. Treatment-resistant patients were also reported to have higher familial loading; however, no individual gene-association study reported their findings surviving correction for multiple comparisons. Conclusions Tentative evidence supports conceptualising treatment-resistant schizophrenia as a categorically different illness subtype to treatment-responsive schizophrenia. However, research is limited and confirmation will require replication and rigorously controlled studies with large sample sizes and prospective study designs

Elementos de economía política

Obra traducida de la 1ª ed inglesa de 1821 a través de una traducción posterior al francés (ver nota p. 246

A new classification and linear sequence of extant gymnosperms

A new classification and linear sequence of the gymnosperms based on previous molecular and morphological phylogenetic and other studies is presented. Currently accepted genera are listed for each family and arranged according to their (probable) phylogenetic position. A full synonymy is provided, and types are listed for accepted genera. An index to genera assists in easy access to synonymy and family placement of genera.Peer reviewe

From Harm to Robustness: A Principled Approach to Vice Regulation

John Stuart Mill’s harm principle maintains that adult behavior cannot justifiably be subject to social coercion unless the behavior involves harm or a significant risk of harm to non-consenting others. The absence of harms to others, however, is one of the distinguishing features of many manifestations of “vices” such as the consumption of alcohol, nicotine, recreational drugs, prostitution, pornography, and gambling. It is with respect to vice policy, then, that the harm principle tends to be most constraining, and some current vice controls, such as prohibitions on drug possession and prostitution, violate Mill’s precept. In the vice arena, we seem to be willing to accept social interference with what Mill termed “self-regarding” behavior. But does that willingness then imply that any social intervention into private affairs is justifiable, that the government has just as much right to outlaw Protestantism, or shag carpets, or spicy foods, as it does to outlaw drugs? In this paper I argue that advances in neuroscience and behavioral economics offer strong evidence that vices and other potentially addictive goods or activities frequently involve less-than-rational choices, and hence are exempt from the full force of the harm principle. As an alternative guide to vice policy, and following some guidance from Mill, I propose the “robustness principle”: public policy towards addictive or vicious activities engaged in by adults should be robust with respect to departures from full rationality. That is, policies should work pretty well if everyone is completely rational, and policies should work pretty well even if many people are occasionally (or frequently) irrational in their vice-related choices. The harm and robustness principles cohere in many ways, but the robustness principle offers more scope for policies that try to direct people “for their own good,” without opening the door to tyrannical inroads upon self-regarding behavior

Morally Respectful Listening and its Epistemic Consequences

What does it mean to listen to someone respectfully, that is, insofar as they are due recognition respect? This paper addresses that question and gives the following answer: it is to listen in such a way that you are open to being surprised. A specific interpretation of this openness to surprise is then defended

Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings: Longitudinal analysis of results from the MAL-ED cohort study

Background: Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings.Methods: We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained length in 3 month intervals, at age 2 and 5 years, and used a longitudinal model to account for temporality and time-dependent confounding. Findings: Among 1469 children who completed 2 year follow-up, 35622 stool samples were tested and yielded valid results. Diarrhoeal episodes attributed to bacteria and parasites, but not viruses, were associated with small decreases in length after 3 months and at age 2 years. Substantial decrements in length at 2 years were associated with subclinical, non-diarrhoeal, infection with Shigella (length-for-age Z score [LAZ] reduction –0·14, 95% CI –0·27 to –0·01), enteroaggregative Escherichia coli (–0·21, –0·37 to –0·05), Campylobacter (–0·17, –0·32 to –0·01), and Giardia (–0·17, –0·30 to –0·05). Norovirus, Cryptosporidium, typical enteropathogenic E coli, and Enterocytozoon bieneusi were also associated with small decrements in LAZ. Shigella and E bieneusi were associated with the largest decreases in LAZ per log increase in quantity per g of stool (–0·13 LAZ, 95% CI –0·22 to –0·03 for Shigella; –0·14, –0·26 to –0·02 for E bieneusi). Based on these models, interventions that successfully decrease exposure to Shigella, enteroaggregative E coli, Campylobacter, and Giardia could increase mean length of children by 0·12–0·37 LAZ (0·4–1·2 cm) at the MAL-ED sites.Interpretation: Subclinical infection and quantity of pathogens, particularly Shigella, enteroaggregative E coli, Campylobacter, and Giardia, had a substantial negative association with linear growth, which was sustained during the first 2 years of life, and in some cases, to 5 years. Successfully reducing exposure to certain pathogens might reduce global stunting