Prenatal Care and Infant Mortality in Nevada

The U.S. outspends all other industrial countries on health care, and yet Americans hardly enjoy better health (Gorman 2010). An American baby born in 2006 can expect to live 78 years – two years less than a baby born across the Canadian border. The U.S. ranks 28th in infant mortality out of the 30 major industrial countries (Gorman 2010). A large part of the gap in infant mortality can be traced to high infant death rates in certain populations, particularly African-Americans who make up about 13% of the total population. In 2005, infant mortality for non-Hispanic blacks in the U.S. ran to 13.6 deaths per 1,000 live births compared with 5.76 deaths per 1,000 live births for non-Hispanic whites. Such disparities reflect differences in education, environment, and socioeconomic status – factors notoriously difficult to mitigate (Gorman, 2010, p. 34)

Health Care Access and Insurance Availability in Nevada

The U.S. Department of Health and Human Services (2012) defines healthcare access as “the timely use of health services to achieve the best health outcomes.” The Department specifies that efficient health care access is contingent on several steps, including (1) entry into the healthcare system, (2) availability of needed services, and (3) accessibility of providers with whom individuals can establish relationships founded on mutual communication and trust

Treatment of abdominal aortic anastomotic pseudoaneurysm with percutaneous coil embolization

AbstractIntraabdominal anastomotic pseudoaneurysms continue to be a late complication of aortic reconstructive procedures. Early surgical repair is critical but is associated with high operative mortality rates. We present a patient who was diagnosed with a distal anastomotic pseudoaneurysm 13 months after transabdominal repair of a symptomatic abdominal aortic aneurysm. Because of the poor operative risk, the patient was considered for a less invasive approach and underwent coil embolization of the abdominal aortic anastomotic pseudoaneurysm. The patient remains without recurrence of pseudoaneurysm 3.5 years later. (J Vasc Surg 2002;35:811-4.

Understanding the contribution of metabolism to Mycobacterium tuberculosis drug tolerance

Treatment o

Avaliação do desempenho de fungos entomopatogênicos sobre fêmeas de Dactylopius opuntiae (Hemiptera: dactylopiidae) em condições de laboratório.

O OBJETIVO DESTE TRABALHO FOI INVESTIGAR O POTENCIAL DOS FUNGOS ENTOMOPATOGÊNICOS NO CONTROLE DE D. OPUNTIAE.Resumo 1669-1

Lumped Parameter Models of the Central Nervous System for VIIP Research

INTRODUCTION: Current long-duration missions to the International Space Station and future exploration-class missions beyond low-Earth orbit, such as to Mars and asteroids, expose astronauts to increased risk of Visual Impairment and Intracranial Pressure (VIIP) syndrome [1]. It has been hypothesized that the headward shift of cerebral spinal fluid (CSF) and blood in microgravity may cause significant elevation of intracranial pressure (ICP), which in turn induces VIIP syndrome through biomechanical pathways [1, 2]. However, there is insufficient evidence to confirm this hypothesis. In this light, we are developing lumped-parameter models of fluid transport in the central nervous system (CNS) as a means to simulate the influence of microgravity on ICP. The CNS models will also be used in concert with the lumped parameter and finite element models of the eye described in the realted IWS abstracts submitted by Nelson et al., Feola et al. and Ethier et al. METHODS: We have developed a nine compartment CNS model (Figure 1) capable of both time-dependent and steady state fluid transport simulations, based on the works of Stevens et al. [3]. The breakdown of compartments within the model includes: vascular (3), CSF (2), brain (1) and extracranial (3). The boundary pressure in the Central Arteries [A] node is prescribed using an oscillating pressure function PA(t) simulating the carotid pulsatile pressure wave as developed by Linninger et al. [4]. For each time step, pressures are integrated through time using an adaptive-timestep 4th and 5th order Runga-Kutta solver. Once pressures are found, constitutive equations are used to solve for flowrates (Q) between each compartment. In addition to fluid flow between the different compartments, compliance (C) interactions between neighboring compartments are represented. We are also developing a second CNS model based on the works of Linninger et al. [4] which takes a more granular approach to represent the interactions of the intracranial and spinal compartments with the inclusion of arteries, arterioles, capillaries, venules, veins, venous sinus, and ventricles. The flow through the arteries, veins and CSF compartments are governed by continuity, momentum and distensibility balance equations. Furthermore, unlike the Stevens et al. approach, the Monro-Kellie doctrine of constant cranial volume and the bi-phasic nature of the brain parenchyma are implemented. These features appear to be more consistent with the physiologic and anatomical behavior of the CNS, and follow a modeling philosophy similar to the lumped parameter eye model that is intended to be integrated with the CNS model. However, Linningers approach has never been implemented to include hydrostatic gradient and microgravity simulation capabilities. Therefore, we aim at implement this modeling approach for spaceflight simulations and assess its overall applicability to VIIP research. OBJECTIVES: We will present verification and validation test results for both models, as well as head-to-head comparison to explore their strengths and limitations with respect to mathematical implementation and physiological significance for VIIP research. In doing so, we hope to provide some guidance to the HRP research community on how to appropriately leverage lumped parameter models for space biomedical research

On waiting for something to happen

This paper seeks to examine two particular and peculiar practices in which the mediation of apparently direct encounters is made explicit and is systematically theorized: that of the psychoanalytic dialogue with its inward focus and private secluded setting, and that of theatre and live performance, with its public focus. Both these practices are concerned with ways in which “live encounters” impact on their participants, and hence with the conditions under which, and the processes whereby, the coming-together of human subjects results in recognizable personal or social change. Through the rudimentary analysis of two anecdotes, we aim to think these encounters together in a way that explores what each borrows from the other, the psychoanalytic in the theatrical, the theatrical in the psychoanalytic, figuring each practice as differently committed to what we call the “publication of liveness”. We argue that these “redundant” forms of human contact continue to provide respite from group acceptance of narcissistic failure in the post-democratic era through their offer of a practice of waiting

Respect for the journey: a survivor-led investigation of undergoing psychotherapy assessment.

PURPOSE: Psychotherapy assessments are key decision points for both clients and services, carrying considerable weight on both sides. Limited research indicates that assessments have immediate and long-term impacts on clients, particularly where trauma has been experienced, affecting engagement with therapy. Understanding assessments from clients' perspectives can inform service development and improve client experience. METHODS: This is a survivor-led exploration of clients' experiences of undergoing assessment for talking therapies. Interviews were conducted with seven people who had undergone assessment for psychological therapies in third sector and NHS services. Interviews were recorded, transcribed and analysed thematically. RESULTS: The core theme was 'respect for the journey' reflecting the need expressed by participants for their life experiences prior to the assessment to be given full respect and consideration. Six sub-themes were identified: trauma and desperation, fear of judgement, search for trust and safety, sharing and withholding (a balancing act), feeling deconstructed, and finding hope. CONCLUSIONS: The findings highlight the heightened emotional power surrounding psychotherapy assessments, reflecting the journey participants had undertaken to reach this point. The dilemma facing clients at the heart of an assessment-how much to share and how much to withhold-demonstrates the importance for services and assessors of treating the journey a client has made to the assessment with care and respect. Findings indicate the value of services and practitioners undertaking a trauma-informed approach to assessment encounters