Review of Interventional Therapies for Refractory Pediatric Migraine.

This is a review of the latest and seminal evidence in pediatric migraine. It covers the etiology and pathophysiology known today, and then will review treatment options, efficacy and safety, quality of data and indications. Though migraine is usually regarded as an infliction in adults, it is not uncommon in the pediatric population and affects up to 8% of children. Children may experience migraine differently than adults, and present not only with headache but also frequent gastrointestinal symptoms. They are frequently shorter in duration than in adults. Traditional migraine treatment in adults is less effective in children. In this population, adjunct therapies - such as interventional techniques - should be considered when traditional treatment fails, including Botulinum Toxin A (BTA) injections, peripheral nerve and ganglion blocks. BTA injections are FDA approved for migraine prophylaxis in adults, but currently not in children; however, recent evidence shows efficacy and safety in pediatric migraine management. Nerve blocks stop nociceptive afferent fibers through injection of local anesthetics, and it may be associated with the local injection of corticosteroids. Although more common in adults, recent data suggests they are safe and effective in children and adolescents. Blocking the sphenopalatine ganglion can be achieved through nasal approach, and achieves a similar action by blocking the entire ganglion. Interventional techniques may provide a key component in the alleviation of this otherwise debilitating chronic migraine pain. Though most studies have been performed in adults, new studies provide encouraging results for treatment in children

Microbial activities in forest soils exposed to chronic depositions from a lignite power plant

Atmospheric emissions of fly ash and SO2 from lignite-fired power plants strongly affect large forest areas in Germany. The impact of different deposition loads on the microbial biomass and enzyme activities was studied at three forest sites (Picea abies (L.) Karst.) along an emission gradient of 3, 6, and 15 km downwind of a coal-fired power plant (sites Ia, II, and III, respectively), representing high, moderate and low emission rates. An additional site (site Ib) at a distance of 3 km from the power plant was chosen to study the influence of forest type on microbial parameters in coniferous forest soils under fly ash and SO2 emissions. Soil microbial biomass C and N, CO2 evolved and activities of L-asparaginase, L-glutaminase, beta-glucosidase, acid phosphatase and arylsulfatase (expressed on dry soil and organic C basis) were determined in the forest floor (L, Of and Oh horizon) and mineral top soil (0-10 cm). The emission-induced increases in ferromagnetic susceptibility, soil pH, concentrations of mobile (NH4NO3 extractable) Cd, Cr, and Ni, effective cation exchange capacity and base saturation in the humus layer along the 15 km long transect significantly (P<0.05) reflected the effect of past depositions of alkaline fly ash. Soil microbial and biochemical parameters were significantly (P<0.05) affected by chronic fly ash depositions. The effect of forest type (i.e. comparison of sites la and Ib) on the studied parameters was generally dominated by the deposition effect. Alkaline depositions significantly (P<0.05) decreased the microbial biomass C and N, microbial biomass C-to-N ratios and microbial biomass C-to-organic C ratios. Microbial respiration, metabolic quotient (qCO(2)) and the activities of L-asparaginase, L-glutaminase, beta-glucosidase, acid phosphatase and arylsulfatase were increased by long-term depositions from the power plants. Acid phosphatase had the highest specific (enzyme activities expressed per unit organic C) activity values among the enzymes studied and arylsulfatase the lowest. The responses of the microbial biomass and soil respiration data to different atmospheric deposition loads were mainly controlled by the content of organic C and cation exchange capacity, while those of enzyme activities were governed by the soil pH and concentrations of mobile heavy metals. We concluded that chronic fly ash depositions decrease litter decomposition by influencing specific microbial and enzymatic processes in forest soils. (C) 2004 Elsevier Ltd. All rights reserved

Healing By The Sea: An Empirical Study Into Biophilic Design

This thesis will explore the question, to what extent can biomimicry benefit occupants of a tropical biophilic design? The typology under investigation is a tropical resort with design focus placed on biomimicry, positively benefiting mental wellness of guests. The project is titled "Healing By The Sea: An Empirical Study Into Biophilic Design." The site is 11-acres of coastal property, with roughly 100,000 square feet of built resort. It is located in Salem, Runaway Bay, St. Ann, Jamaica. The Theoretical Premise is that vacations, as well as interaction with nature and water, are believed to increase the health of humans. The Project Justification for a tropical resort is the vast amount of knowledge nature has to offer architecture to promote healthier lifestyles; the environment in which the resort is built has an effect on perceptions of the guests. Biophilic design will promote a healing atmosphere for people visiting the resort, benefiting from the natural properties of the coastal area. Two positive elements that are incorporated into this project are the employment of residents, as well as the tourism boost of the economy and local businesses

Les partenariats public-privé contractuels face au droit administratif

Master [120] en droit, Université catholique de Louvain, 201

What do individuals experiencing homelessness want for their care?: A needs assessment survey

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.The homeless population is growing across the United States, particularly in urban areas. Homelessness has a detrimental impact on health and quality of life, especially among the unsheltered homeless population. Oftentimes, there is a disconnect between existing community services and actual needs of individuals experiencing homelessness. The purpose of this study was to identify prioritized needs in an urban unsheltered homeless population and measure associations with self-reported health. We conducted a needs assessment from April-June 2018 of 144 unsheltered homeless individuals in metro Phoenix, Arizona. The 16-question survey investigated perceptions of priority needs, sources of medical care, health literacy, and health status. Survey results were analyzed using Wilcoxon Rank Sum Test, Chi-squared analysis, and multivariable logistic regression. Most respondents (91.6%) identified food as a top need. The majority (64.1%) utilized emergency departments (EDs) as their primary source of care, and 40.1% reported suboptimal health. Suboptimal health was more likely to be reported in those who expressed transportation (OR 3.03, 95% CI: 1.30-7.07) or medical care (OR 2.47, 95% CI: 0.99-6.14) as a top priority need. Health illiteracy (OR 3.68, 95% CI: 0.76-17.9) was associated with suboptimal health, as was obtaining care at an ED (OR 2.05, 95% CI: 0.81-5.25). The data demonstrate that food security was the top priority need of this urban unsheltered population. Interventions improving accessibility to transportation, high-quality medical care, and health education should be implemented to improve the health of this population. Such interventions may also decrease care sought in ED settings. These conclusions are likely generalizable to other unsheltered homeless populations in large urban cities; however, regional and cultural differences exist. Our needs assessment may serve as a template for future needs assessments of other urban unsheltered homeless populations.This item is part of the College of Medicine - Phoenix Scholarly Projects 2021 collection. For more information, contact the Phoenix Biomedical Campus Library at [email protected]

Water Resource Experiment Station

Students in this studio were asked to design a Water Resource Experiment Station at a site on the bank of the Missouri River west of Linton and South of Bismarck, North Dakota. The students were given presentations by studio collaborators from the Biology Department and the Department of Civil Engineering concerning the use of constructed wetlands to clean waste water from the laboratory and rain water harvesting from the building’s exterior to add fresh water to the clean waste water for the use of the laboratory. Each design is approximately 20,000 square feet in area, has public parking and public toilets accessible from the exterior and is intended to be open to the public for their use after hours and on the weekends. My project was inspired by the structure of a dandelion. The flower led me to a folded plate super structure and a hexagonal form throughout. A great deal of focus was placed on the water collection systems