An update on the diagnosis and treatment of early Lyme Disease: Focusing on the bull\u27s eye, you may miss the mark

To confidently diagnose and treat Lyme disease, the clinician must first understand the natural history of this disease, especially its protean early manifestations. Emergency physicians, primary care physicians, and other providers need to be vigilant in terms of the timely recognition of erythema migrans (EM), the unique marker of early localized stage 1 disease. The classic EM, originally described as a slowly expanding bull\u27s eye lesion, is now recognized to be present in only the minority of cases (9%); the dominant morphologic lesion of EM is now recognized to be the diffusely homogenous red plaque or patch, which occurs in over 50% of cases. This update will define the current morphologic features of early Lyme disease, the indication for serologic studies, and the most recent treatment guidelines, including therapeutic pitfalls

An Overview on Urban Education: A Brief History and Contemporary Issues

This paper is designed to provide insights into both the ever-shifting nature-as well as the trajectory of-urban education in the United States. We provide a brief historical synopsis, a contextualization of how education in urban settings is commonly constructed through popular discourses, and a discussion of how the definitions and perceptions of urban schools influence research and policy measures. Lastly, this paper offers a brief exploration of recent movements and complications concerning urban education reform.Educatio

Open Learning Resources for Water Data Analysis

Presented as part of the Open for Climate Justice: Lightning Talks event

Reefs In Crisis: A Look At The Chronic Destruction Caused By Ships

Within the world\u27s oceans, the greatest diversity of life is found on coral reefs. Often called the rainforests of the sea, these amazing living structures play a crucial role in sustaining a thriving ocean habitat, particularly in tropical areas. Although coral reefs comprise less than one percent of the ocean floor, nearly twenty-five percent of all marine life are dependent upon coral reefs for their survival. The many benefits which the reefs offer include food production, coastal protection and immense biodiversity. Unfortunately, it is believed that ten percent of the world\u27s coral reefs have sustained irreversible damage. Over the past two decades, the coral reefs around the world have experienced dramatic change, especially those in the Florida Keys and the Caribbean. In an effort to raise the world\u27s awareness of the threats to coral reefs, more than one hundred governments, nongovernmental organizations, multilateral lending institutions, regional organizations, and United Nations affiliates declared 1997 the Year of the Coral Reef. Coral reefs continue to degrade in response to natural disturbances such as hurricanes, coral bleaching and disease, and human activity, including: reef-destructive fishing, sedimentation from deforestation and development, raw sewage, nutrients and pesticides from agricultural practices, oil from ships and landbased sources, and direct damage from tourism activities, boat anchors, and ship groundings. Ship groundings are one of the most destructive anthropogenic factors, causing substantial localized damage to coral reefs. Throughout the 500- year history of mariners in the New World, thousands of shipwrecks have been documented, including many groundings on coral reefs. In the 1850s, the United States government was concerned about the number of ships running aground on coral reefs off the coast of Florida, so a famous Harvard biologist, L. Agassiz, was given the task of determining what, if anything, the government could do in order to get rid of the reefs. Wisely, Agassiz concluded that the reefs were in fact permanent structures and recommended that lighthouses be built to protect shipping activities. One of the most avoidable disturbances is the cumulative damage caused by ships. In U.S. waters alone, millions of gallons of oil have been spilled by ships since 1989. Immediate cleanups typically yield recovery rates that range from ten percent to fifteen percent. Residual oil and the cleanup techniques themselves effect hundreds of miles of shoreline and damage an inestimable amount of natural resources. The spills and subsequent damage to the marine environment that result during the transportation of oil offer impetus and insight to our monetary valuation of nature. To address the degradation of the Nation\u27s natural resources, Congress and the President have enacted a suite of environmental laws. Explicit statutory authority to restore injured resources commenced with the Clean Water Act (CWA) amendments of 1977 and continued with the enactment of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the National Marine Sanctuaries Act (NMSA), and the Oil Pollution Act of 1990 (OPA). As the primary federal trustee for coastal and marine resources, the National Oceanic and Atmospheric Association (NOAA) is responsible for ensuring the restoration of resources injured by releases of hazardous materials and of national marine sanctuary resources injured by physical impacts. The CWA, CERCLA and OPA mandate that parties who release, destroy, cause the loss of, or injure sanctuary resources are responsible for their restoration. The NMSA mandates that parties who spill hazardous materials or oil into the marine environment are responsible for both cleanup and restoration costs. The valuation of natural resources allows the courts to assess damages for environmental harm, resulting in the use of economic models to protect the environment. The natural resource damage provisions of current relevant statutes reflect a novel hybrid of economic theory, tort, trust, and administrative law elements. Because the valuation methods of claims brought under the public trust doctrine are essentially similar to the statutory damage provisions, the discussion of common law theories is limited to the public trust doctrine, though several other common law theories have been asserted in a post-spill claim. This Comment will consider the evolving role of nonuse and contingent valuation, and the progression away from an economic pricing theory of the valuation of Nature toward a recognition of the intrinsic value of Nature. The Fifth Circuit\u27s 1970 decision in United States v. Ray recognized the Government\u27s vital interest ... in preserving the reefs for public use and enjoyment, and declared that protective action by the Government to prevent despoliation of these unique natural resources is of tantamount importance. The U.S. government\u27s current position toward reefs and marine ecology is evident in the designation of the several National Marine Sanctuaries, and the participation in the International Coral Reefs Initiative. In Agenda 21 of the International Coral Reef Initiative (ICRI), marine ecosystems, including coral reefs, were accorded prominent status. Increasing public and political recognition of the need to protect coral reefs has been the major impetus for nations to preserve reefs. The IRCI objectives call for a strengthened commitment to and implementation of programs to conserve, restore and promote sustainable use of coral reefs, as well as an increased capacity for development and implementation of policies, management, research, and monitoring of reefs

Reefs In Crisis: A Look At The Chronic Destruction Caused By Ships

Within the world\u27s oceans, the greatest diversity of life is found on coral reefs. Often called the rainforests of the sea, these amazing living structures play a crucial role in sustaining a thriving ocean habitat, particularly in tropical areas. Although coral reefs comprise less than one percent of the ocean floor, nearly twenty-five percent of all marine life are dependent upon coral reefs for their survival. The many benefits which the reefs offer include food production, coastal protection and immense biodiversity. Unfortunately, it is believed that ten percent of the world\u27s coral reefs have sustained irreversible damage. Over the past two decades, the coral reefs around the world have experienced dramatic change, especially those in the Florida Keys and the Caribbean. In an effort to raise the world\u27s awareness of the threats to coral reefs, more than one hundred governments, nongovernmental organizations, multilateral lending institutions, regional organizations, and United Nations affiliates declared 1997 the Year of the Coral Reef. Coral reefs continue to degrade in response to natural disturbances such as hurricanes, coral bleaching and disease, and human activity, including: reef-destructive fishing, sedimentation from deforestation and development, raw sewage, nutrients and pesticides from agricultural practices, oil from ships and landbased sources, and direct damage from tourism activities, boat anchors, and ship groundings. Ship groundings are one of the most destructive anthropogenic factors, causing substantial localized damage to coral reefs. Throughout the 500- year history of mariners in the New World, thousands of shipwrecks have been documented, including many groundings on coral reefs. In the 1850s, the United States government was concerned about the number of ships running aground on coral reefs off the coast of Florida, so a famous Harvard biologist, L. Agassiz, was given the task of determining what, if anything, the government could do in order to get rid of the reefs. Wisely, Agassiz concluded that the reefs were in fact permanent structures and recommended that lighthouses be built to protect shipping activities. One of the most avoidable disturbances is the cumulative damage caused by ships. In U.S. waters alone, millions of gallons of oil have been spilled by ships since 1989. Immediate cleanups typically yield recovery rates that range from ten percent to fifteen percent. Residual oil and the cleanup techniques themselves effect hundreds of miles of shoreline and damage an inestimable amount of natural resources. The spills and subsequent damage to the marine environment that result during the transportation of oil offer impetus and insight to our monetary valuation of nature. To address the degradation of the Nation\u27s natural resources, Congress and the President have enacted a suite of environmental laws. Explicit statutory authority to restore injured resources commenced with the Clean Water Act (CWA) amendments of 1977 and continued with the enactment of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the National Marine Sanctuaries Act (NMSA), and the Oil Pollution Act of 1990 (OPA). As the primary federal trustee for coastal and marine resources, the National Oceanic and Atmospheric Association (NOAA) is responsible for ensuring the restoration of resources injured by releases of hazardous materials and of national marine sanctuary resources injured by physical impacts. The CWA, CERCLA and OPA mandate that parties who release, destroy, cause the loss of, or injure sanctuary resources are responsible for their restoration. The NMSA mandates that parties who spill hazardous materials or oil into the marine environment are responsible for both cleanup and restoration costs. The valuation of natural resources allows the courts to assess damages for environmental harm, resulting in the use of economic models to protect the environment. The natural resource damage provisions of current relevant statutes reflect a novel hybrid of economic theory, tort, trust, and administrative law elements. Because the valuation methods of claims brought under the public trust doctrine are essentially similar to the statutory damage provisions, the discussion of common law theories is limited to the public trust doctrine, though several other common law theories have been asserted in a post-spill claim. This Comment will consider the evolving role of nonuse and contingent valuation, and the progression away from an economic pricing theory of the valuation of Nature toward a recognition of the intrinsic value of Nature. The Fifth Circuit\u27s 1970 decision in United States v. Ray recognized the Government\u27s vital interest ... in preserving the reefs for public use and enjoyment, and declared that protective action by the Government to prevent despoliation of these unique natural resources is of tantamount importance. The U.S. government\u27s current position toward reefs and marine ecology is evident in the designation of the several National Marine Sanctuaries, and the participation in the International Coral Reefs Initiative. In Agenda 21 of the International Coral Reef Initiative (ICRI), marine ecosystems, including coral reefs, were accorded prominent status. Increasing public and political recognition of the need to protect coral reefs has been the major impetus for nations to preserve reefs. The IRCI objectives call for a strengthened commitment to and implementation of programs to conserve, restore and promote sustainable use of coral reefs, as well as an increased capacity for development and implementation of policies, management, research, and monitoring of reefs

International nurse recruitment and NHS vacancies: a cross-sectional analysis

BACKGROUND: Foreign-trained nurse recruits exceeded the number of new British-trained recruits on the UK nurse register for the first time in 2001. As the nursing shortage continues, health care service providers rely increasingly on overseas nurses to fill the void. Which areas benefit the most? And where would the NHS be without them? METHODS: Using cross-sectional data from the 2004 Nursing and Midwifery Council register, nurse resident postcodes are mapped to Strategic Health Authorities to see where foreign recruits locate and how they affect nurse shortages throughout the UK. RESULTS: Areas with the highest vacancy rates also have the highest representation of foreign recruits, with 24% of foreign-trained nurses in the UK residing in the London area and another 16% in the SouthEast (comparable numbers for British-trained nurses are 11% and 13%, respectively). Without foreign recruitment, vacancy rates could be up to five times higher (three times higher if only Filipino recruits remained). CONCLUSION: The UK heavily relies on foreign recruitment to fill vacancies, without which the staffing crisis would be far worse, particularly in high vacancy areas

Men Feel it too: An Examination of Body Image and Disordered Eating among Older Males

This quantitative study examined body image and disordered eating in older males. Using a series of questionnaires and demographic questions, two research questions were explored: a) What are the characteristics of older males in terms of eating and body image? and b) Are disordered eating behaviors among older males related to dissatisfaction with body image, specifically physical appearance or physical functioning? Paired samples t-tests revealed that older males rated their ideal body figure as significantly smaller than their current figure, t(35) = -5.53, p \u3c .01, which indicates the presence of body dissatisfaction. Twenty percent of participants were found to be at risk for disordered eating attitudes and behaviors. Furthermore, a correlation was found between disordered eating attitudes and body dissatisfaction particularly as it relates to physical appearance, (r(33) = -.486, p \u3c .01)

Exercise Beliefs During Pregnancy in a Predominantly Low-Income, Urban Minority Population

In 2002, and reaffirmed in 2009, The American College of Obstetricians and Gynecologists recommended that healthy pregnant women exercise for at least thirty minutes most days of the week. Exercise during a healthy pregnancy is safe and has many maternal and fetal benefits. Identified benefits include management of weight gain, improvement in mood, and preparation for labor. Previous research has evaluated women’s beliefs and practices of exercise in pregnancy, but it has focused on affluent, ethnic majority populations. This survey study was performed to assess beliefs about exercise in pregnancy in a predominantly low-income, urban minority population.https://jdc.jefferson.edu/cwicposters/1031/thumbnail.jp