Joint Tenancy—Creditor-Debtor Relations

By Initiative No. 208, adopted and now codified as RCW 64.28, the former prohibition against joint tenancy with the right of survivorship has been repealed and substituted with .... a form of co-ownership of property, real and personal, known as joint tenancy. \u27 The proviso that the transfer shall not derogate from the rights of creditors raises serious questions of meaning and interpretation. If the proviso means that the rights of creditors will not be changed by joint tenancy ownership, then this article will serve little purpose. If the proviso is to be applied only to the creditors existing at the time of the creation of the joint tenancy, then all subsequent creditors must look to the common law for their rights and remedies. If the proviso applies only to the original transfer creating the joint tenancy, an existing creditor may ignore the transfer and treat the debtor as the sole owner, but if the proviso be given a broader interpretation to permit its application to the passage of title occurring at the death of a joint tenant, it will create creditors\u27 rights and incidents of joint tenancy beyond the incidents at common law.8 RCW 64.28.010 further provides, ... a joint tenancy shall have the incidents of survivorship and severability as at common law. The better approach would be to limit the proviso to the original transfer, though the matter will not be laid to rest until the supreme court has passed upon this specific point

Barriers to Pediatric Sickle Cell Disease Guideline Recommendations.

National guidelines recommend that providers counsel all patients with sickle cell anemia about hydroxyurea (HU) therapy and screen children with sickle cell anemia annually for the risk of stroke with transcranial Doppler (TCD). We surveyed a national convenience sample of sickle cell disease clinicians to assess factors associated with low adherence. Adherence was 46% for TCD screening. Low adherence was associated with a lack of outcome expectancy (eg, a belief that there would be poor patient follow-up to TCD testing; P < .05). Adherence was 72% for HU counseling. Practice barriers (eg, lack of support staff or time) and a lack of agreement with HU recommendations were associated with low adherence (P < .05). This study demonstrates that different types of strategies are needed to improve TCD screening (to address follow-up and access to testing) versus HU counseling (to address physician agreement and practice barriers)

Packaging as a marketing tool: Adolescents’ perceptions of branded and plain tobacco packaging

Plain packaging first appeared on the UK policy agenda in the Department of Health’s 2008 ‘Consultation on the Future of Tobacco Control’. Since then, plain (or standardised) packaging has been framed through the potential benefit to young people. Within the period of this thesis, plain packaging has been actively debated and draft plain packaging regulations were published in June 2014. An extended literature review of academic and practitioner marketing literature, internal tobacco company documents and public health packaging research, establishes that the research informing the policy debate, while consistent in its approach and findings, fails to recognise the strategic nature of pack design, the full extent of the influence that branded design can have on consumer responses, and the importance of product design as a marketing tool. This thesis attempts to address these gaps in the plain packaging evidence base. It explores if, and how, adolescents engage with different styles of packaging and product design, whether or not an association between tobacco packaging and adolescent smoking exists, and whether it is possible to observe cognitive, affective and behavioural responses to packaging. The study uses a sequential exploratory mixed methodology design with two stages of research. First, focus groups were conducted with 15 year olds (n=48) to explore adolescent responses to tobacco packaging and product design. The findings show that adolescents are most appreciative of ‘novelty’ pack designs. These ‘novelty’ packs, for instance with innovative structures or distinctive designs and colours, generated positive user imagery and influenced affective feelings among participants. Cigarettes with slim diameters, white tips and decorative designs increased appeal and communicated a weaker tasting and less harmful product. Conversely, a plain pack eliminated positive perceptions and feelings, and exposed tobacco as harmful, dirty and not for young people. The qualitative findings were used to develop measures and hypotheses which were tested in a quantitative survey.The second stage of research utilised a cross-sectional in-home survey (n=1373) with 11 to 16 year olds. Respondents were asked to rate three different pack styles - ‘novelty’, ‘regular’ and ‘plain’ - on 11 pack ratings items and four pack feelings items. The findings show adolescents hold ‘novelty’ packaging in higher regard than ‘regular’ packaging across pack ratings items. There were fewer differences between ‘novelty’ and ‘regular’ packaging for the pack feelings items. Plain packaging was consistently rated most negatively across all survey items. Logistic regressions, controlling for factors known to influence youth smoking, showed that susceptibility to smoke was associated with positive appraisal and also receptivity for ‘novelty’ packaging. There was no association with pack appraisal or receptivity for the plain pack. While susceptibility is not a direct behavioural response it is a reasonable predictor of future tobacco use. Collectively the findings show that ‘novelty’ packaging and product design holds greatest appeal for adolescents. Plain packaging limits the opportunity for tobacco companies to communicate with, mislead and influence consumers. Based upon the role of packaging for consumer goods in general, and tobacco in particular, plain packaging would effectively reduce the promotional role of packaging

ANTIGEN-SPECIFIC SYNERGISM IN THE IMMUNE RESPONSE OF IRRADIATED MICE GIVEN MARROW CELLS AND PERITONEAL CAVITY CELLS OR EXTRACTS

A synergistic immune response to foreign erythrocytes may be induced in heavily irradiated mice injected with a mixture of isologous cells obtained from marrow and from the peritoneal cavity. Under appropriate conditions, homologous or heterologous peritoneal cavity cells, heat-killed cells, or cellfree extracts made from such cells are also effective. The activity of the peritoneal cavity cells or extracts is antigen-specific, in the sense that cells or extracts obtained from animals previously immunized with the test antigen produce much stronger synergistic effects than do cells from animals immunized with some other antigen; however, the peritoneal cavity cells or extracts are not immunogenic when tested in primed animals. The marrow cells, demonstrated to contain precursors of the antibody-forming cells produced during this synergistic immune response, also show a form of antigen-specificity

Fetal Heart Rate Decelerations in Women with Sleep-Disordered Breathing

Emerging literature has shown that women with sleep-disordered breathing (SDB) have increased risk for gestational hypertension/preeclampsia and gestational diabetes. Case reports suggest an association between maternal apnea and fetal heart rate deceleration but data are lacking on how maternal sleep impacts fetal health. Since decelerations may be associated with adverse outcomes, we sought to determine whether fetal heart rate decelerations were associated with SDB. A cohort study of third trimester pregnant women with a singleton fetus was conducted. Participants underwent a home sleep test with continuous portable electronic fetal monitoring. SDB was defined as a respiratory disturbance index (RDI)≥10 events/hour. The temporality between a respiratory event and fetal heart rate decelerations was determined to be present if a deceleration occurred \u3c 30 s after a respiratory event. Forty women were included with mean (±SD) age, BMI, and gestational age of 32.0±5.5 years, 37.1±8.0 kg/m(2), and 34.6±2.4 weeks respectively. Overall, n=23 (57.5%) women had SDB. Thirty-seven late decelerations were observed in 18 women; of these, 84% were temporally associated with a respiratory event. Nine of the 18 women (50%) had SDB. Ten prolonged decelerations were observed in 6 women of which nine (90%) were temporally associated with a respiratory event. Five of the six women (83%) had an RDI≥10. These initial data suggest that, in this population, the majority of both late and prolonged fetal heart rate decelerations occur with a maternal respiratory event. Since respiratory events are characteristic of maternal SDB, this raises the possibility that SDB may influence fetal well-being

Lunar surface engineering properties experiment definition. Volume 1: Mechanics, properties, and stabilization of lunar soils

Lunar soil simulation and stabilization, and impact penetrometer studie

Factors associated with the utilization of community dental services among newly incarcerated adults

Background: Given the high rates of risky behaviors and health conditions among incarcerated individuals and the relationship between oral and general health, receipt of quality dental care is essential to the overall health and well-being of this population. However, few recent studies have focused on access to care and the state of oral health among incarcerated populations in the U.S. For the current study, a secondary data analysis was conducted to: 1) assess factors associated with the use of dental services among a newly incarcerated prison population in Georgia and 2) consider barriers related to utilization of dental services pre- to post-release. Methods: Descriptive statistics were calculated, and bivariate and logistic regression analyses were conducted utilizing SAS 9.2 software. Results: Thirty-one percent (n=250) of survey respondents reported having a dental visit within the past year. Survey respondents who had a regular dentist (OR: 1.9; 95% CI: 1.325, 2.697), private dental insurance (OR: 1.5; 95% CI: 1.022, 2.245), or who reported pain as the reason for their last dental visit (OR: 2.2; 95% CI: 1.556, 3.130) were more likely to have utilized dental services within the past year. Conclusions: The findings highlight the role of social and economic resources and oral health needs on utilization of dental services. Additional practice and policy efforts are needed to address gaps in the dental care continuum that affect currently and formerly incarcerated adults in Georgia

The Influence of Three Types of Speech Production upon Auditory Comprehension in Aphasia

TB

Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial.

BACKGROUND: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions. METHODS: We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437. FINDINGS: Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts. INTERPRETATION: Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer. FUNDING: WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac

Three‐Dimensional Sonographic Measurement of Blood Volume Flow in the Umbilical Cord

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135361/1/jum201231121927.pd