Treatment of intractable hemicrania continua by occipital nerve stimulation

Hemicrania continua (HC) is characterised by a strictly unilateral continuous headache with ipsilateral autonomic features and migrainous symptoms that is exquisitely sensitive to indomethacin.1 As more than 30% of patients report side effects with indomethacin, there is need for an effective and safe alternative. Although several drugs have been used in open-label studies, none offer the same magnitude of response. Occipital nerve stimulation (ONS) has been performed in headache conditions such as chronic migraine and chronic cluster headache, both conditions with clinical similarities to HC and appears to be a safe, potentially efficacious treatment even in those failing all available medical treatments.2 We report the long-term follow-up of a new cohort of 16 patients with HC treated with ONS

Polychlorinated Biphenyls and Metabolic Diseases on St. Lawrence Island, Alaska

Polychlorinated Biphenyls (PCBs) are industrial chemicals that were used from 1929 until 1979 as a plasticizer in paints, plastics, and rubber products. However, PCBs continue to persist in the Arctic. They enter the Arctic environment through air and ocean currents. Sunlight and weathering help break down chemicals, so the Arctic’s lack of sunlight and precipitation during the winter allows PCBs to more readily accumulate. These chemicals settle either on organic films or water and are consequently absorbed by the Arctic food web. PCBs then bioaccumulatep in fatty tissues like omega-3 fatty acids. The higher the animal is in the food web, the greater the accumulation of PCBs in its fatty tissue. The Yupik people of St. Lawrence Island, Alaska rely on a diet that largely consists of bowhead whales, walruses, and seals, all of which are high in omega-3 fatty acids and are near the top of the Arctic food web. Humans occupy the top of the food web and so therefore accumulate the highest concentration of PCBs in their omega-3 fatty acids. Research has shown that high intake of omega-3 fatty acids should promote a healthy endocrine system, therefore protecting against metabolic diseases. However, in recent years, St. Lawrence Island residents have seen a predominate increase in metabolic diseases. A great number of recent scientific evidence suggests a link between exposure to PCBs and endocrine disruption. We hypothesize that consumption of subsistence foods contaminated with PCBs puts these residents at an uncommonly high risk for metabolic diseases

Book Review: The Ophthalmic Laser Handbook

Book Review: Freisberg L, Lighthizer N, Skorin, Jr. L, Stonecipher K, and Zimmerman A. The Ophthalmic Laser Handbook. First Edition. Wolters Kluwer Health; 2021. $102.00, 350 pages, Paperback ISBN: 978-1975170172, e-book ISBN: 978-197517021

Clients\u27 Expectations of Public Health Nurses\u27 Home Visits

Although there is considerable research on the relationship between client expectations and outcomes of care in acute care settings, less is known about clients\u27 expectations for public health nurses\u27 home visits. The aim of this study was to understand clients\u27 expectations of public health nurses\u27 home visits as a first step in making explicit how expectations affect client responses to, and ultimately, outcomes of public health nurses\u27 care. Interviews were conducted with a convenience sample of 19 primary caretakers of high-risk infants admitted to a Neonatal Intensive Care Unit (NICU) and voluntarily enrolled in a High-Risk Infant (HRI) Program in Southern California. All but one of the participants were the mothers of the high-risk infants. The findings of this study elucidated a process of forming expectations , which consisted of two stages, expectation formation and expectation reformation. Contrary to psychological theories of expectations, participants had not formed expectations of public health nurses\u27 home visits. Most had no knowledge of public health nurses work or their infant\u27s referral to the program. However, with prompts from the researcher, participants used guesswork to predict what the nurse might do or say or to state their ideal expectations. The interaction with the public health nurse was a pivotal influence in confirming positive expectations and disconfirming negative expectations. Participants were surprised when the nurse addressed other health care issues of the family

Modelling Online Advertising Design Quality Influences on Millennial Consumer Attitudes in South Africa

Millennials’ advanced knowledge and exposure to product experiences, and irrelevant placement of online advertising has led to an increase of online advertising avoidance. However, effective online advertising design may assist in establishing more positive sentiments towards digital forms of marketing communication. The study used the visual rhetoric theory as the theoretical basis to examine millennial consumer attitudes. The main research aims were to propose an online advertising design quality model, and to ascertain the influence of online advertising design quality on millennial consumer attitudes. The study employed a quantitative research design via an empirical online survey. Online advertising design quality has resulted in a positive effect on relevant information, value, disruptive online placement and timing, personalization and price consciousness, a negative influence on privacy concern and distrust, and ad irritation across various online platforms. This study heightens the importance of design elements and the visual aesthetics of online advertising

Eigenlogic: a Quantum View for Multiple-Valued and Fuzzy Systems

We propose a matrix model for two- and many-valued logic using families of observables in Hilbert space, the eigenvalues give the truth values of logical propositions where the atomic input proposition cases are represented by the respective eigenvectors. For binary logic using the truth values {0,1} logical observables are pairwise commuting projectors. For the truth values {+1,-1} the operator system is formally equivalent to that of a composite spin 1/2 system, the logical observables being isometries belonging to the Pauli group. Also in this approach fuzzy logic arises naturally when considering non-eigenvectors. The fuzzy membership function is obtained by the quantum mean value of the logical projector observable and turns out to be a probability measure in agreement with recent quantum cognition models. The analogy of many-valued logic with quantum angular momentum is then established. Logical observables for three-value logic are formulated as functions of the Lz observable of the orbital angular momentum l=1. The representative 3-valued 2-argument logical observables for the Min and Max connectives are explicitly obtained.Comment: 11 pages, 2 table

A Formative Evaluation of the Family Strengthening Program in the Treasure Valley

Family Advocates, a nonprofit organization serving families in the Treasure Valley in Idaho, offers the Family Strengthening Program. This is a 20-week program providing weekly meetings for families who need to develop strong family cohesion, resilience, and parenting skills to maintain healthy families. The program uses the Strengthening Families’ approach with an emphasis on the protective factors framework and provides incentives to participants for participation. A third-party evaluation team from a local university conducted a formative evaluation of the program to help improve its quality. The evaluation team used both goal-based and goal-free, needs-based evaluation approaches, and analyzed quantitative and qualitative data. This included survey data from past weekly sessions, Facebook alumni group communications, and group interviews and surveys with participants, graduates, volunteers, and staff. The triangulated data indicated that program participants were highly satisfied with the program and felt the program helped improve their protective factors. The data also revealed the parents’ perceptions regarding program incentives as well as their preference for learning in socialized contexts. Based on the formative evaluation results and considering the participants’ perceptions and experiences, the program amended their curriculum and incentive plans to better accommodate the participants’ needs

Human immunodeficiency virus rebound after suppression to < 400 copies/mL during initial highly active antiretroviral therapy regimens, according to prior nucleoside experience and duration of suppression

This study evaluated 1433 human immunodeficiency virus (HIV)-infected patients starting highly active antiretroviral therapy (HAART), 409 (28%) of whom had prior nucleoside experience and achieved an HIV load of <400 copies/mL by 24 weeks of therapy. Three hundred seven patients experienced virus rebound during a total of 2773.3 person-years of follow-up. There was a higher rate of virus rebound among the patients with pre-HAART nucleoside experience (relative hazard [RH], 2.86; 95% confidence interval, 2.22-3.84; P < .0001) and a decreasing rate of virus rebound with increasing duration of virus suppression (i.e., time since achieving a virus load of <400 HIV RNA copies/mL) among both the nucleoside-experienced and naive patients (P < .0001), but the difference between the groups persisted into the third year of follow-up (P = .0007). Even patients who had experienced <2 months of nucleoside therapy before beginning HAART had an increased risk of virus rebound (RH, 1.95; P = .009). It appears that only a small period of pre-HAART nucleoside therapy is sufficient to confer a disadvantage, in terms of risk of virus rebound, that persists for several years