Dermatoglyphic features in Prader-Willi syndrome with respect to chromosomal findings

Dermatoglyphic findings were compared in 38 Prader-Willi syndrome (PWS) patients and 270 normal controls. Twenty-one of the PWS patients had an interstitial deletion of the proximal long arm of chromosome 15 and seventeen PWS cases had normal chromosomes. Findings in PWS are not diagnostic but do show some consistent deviations that can be used in the clinical evaluation of PWS patients. These include a displacement of the axial triradius away from the normal proximal position, an excess of whorls primarily on the thumbs, radial termination of the palmar A mainline, and lack of arches on the big toe. Deletion PWS patients were much more homogeneous than non-deletion cases with respect to plantar patterns. The previously reported deficit of plantar pattern intensity was restricted only to deletion PWS and was characterized by a lack of plantar interdigital II-IV patterns with almost exclusively hallucal distal loops

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Aims: The study investigated the attitudes of intravenous drug users (IDUs) towards the provision of drug consumption rooms (DCRs) in the UK and their willingness to use DCRs. Methods: Participants were 90 methadone-maintained outpatients recruited from a London clinic. A questionnaire asked about their willingness to use a DCR, their views on various rules commonly-implemented by DCRs, and how they believed DCRs might impact on the drug-taking behaviours of drug users and their peers. Findings: A large majority (89%) expressed willingness to use a DCR and accepted the need for rules such as no drug sharing (84.3%), no assistance with injecting (81.8%), compulsory supervision (76.7%) and compulsory hand washing (92.1%). However, the IDUs were split over whether injection in the neck or groin should be disallowed and whether certain categories of IDUs (e.g. juveniles, pregnant women) should be excluded from DCRs. Majorities thought it unlikely that DCRs would encourage users to try risker drug preparations (76.6%), or encourage non injectors to inject for the first time (74.5%). Conclusions: In a country where DCRs are not available, the study highlights the willingness of IDUs to use a DCR and accept its rules, even for a sample most of whom were not homeless

Slaying the demon. The dementia challenge: Progress and achievements

There can be no doubt that the delivery of high quality care and support for patients and families living with dementia is a major challenge for health and social care services. As a nation we are living longer and we are seeing more people living with co-morbidities including dementia. Whilst our effort must remain on improving diagnostic and therapeutic interventions to treat and manage dementia, we must also be focused on supporting patients, families and carers who are living and coping with dementia on a daily basis. They need co-ordinated support and high quality services now, not the promise of improvements in the future. It was within this context that the NHS South Strategic Health Authority invested and commissioned work to advance innovation and identification of best practice across provider services in the South of England. We recognised that there was much to be proud of, but our challenge was to highlight best practice and innovation and share that with wider audiences and encourage adoption of excellence.This important report provides a valuable window on the work that is currently being developed across the South of England and in a wide range of services. The projects and programmes are extremely diverse, and are at different stages of development. We are continuing to learn about what works and what doesn’t. Many of the projects are multi-agency and all are actively engaged in partnership working across disciplines and - importantly - are working closely with patients and carers. The work is not easy, and unfortunately structural re-organisations and reform of the NHS and Social Care, and continuing funding challenges, have caused some delays in progressing the projects. However, the commissioners and authors of the report believe it is of vital importance to share the findings thus far, whilst recognising that many of the projects are still on-going and will continue to develop. Our aim is simple – we want to encourage dialogue and sharing in a field of research and practice that is engaging with one of the greatest health and social care challenges of our time. We believe that further investment and research is clearly needed but we also recognise that by adopting best practice now across all organisations we can also help those patients, families and carers who need high quality services and support today and tomorrow. We must continue to invest, research and advance our knowledge and understanding in the dementia field, but as we do we must apply our findings to our daily practice and not ignore the small interventions that can improve the lives of so many on a daily basis. This report is designed to support practitioners, commissioners, delivery agents, patients and carers by shining a light on the best practice and innovations we have found today. Please engage with it, share it, and adopt the best

When veiled silences speak: reflexivity, trouble and repair as methodological tools for interpreting the unspoken in discourse-based data

Researchers who have attempted to make sense of silence in data have generally considered literal silences or such things as laughter. We consider the analysis of veiled silences where participants speak, but their speaking serves as ‘noise’ that ‘veils’, or masks, their inability or unwillingness to talk about a (potentially sensitive) topic. Extending Lisa Mazzei’s ‘problematic of silence’ by using our performativity-performance analytical method, we propose the purposeful use of ‘unusual conversational moves’, the deployment of researcher reflexivity, and the analysis of trouble and repair as methods to expose taken-for-granted normative frameworks in veiled silences. We illustrate the potential of these research practices through reference to our study on men’s involvement in reproductive decision-making, in which participants demonstrated an inability to engage with the topic. The veiled silence that this produced, together with what was said, pointed to the operation of procreative heteronormativity

Detection and Quantification of Antiviral Drug Tenofovir Using Silver Nanoparticles and Surface Enhanced Raman Spectroscopy (SERS) With Spatially Resolved Hotspot Selection

This study introduces a convenient and ultra-sensitive method of detection and quantification of the antiviral drug, tenofovir (TFV), by surface-enhanced Raman spectroscopy (SERS). Novel spatially resolved instrumentation for spectral acquisition and subsequent statistical analysis for hot spot selection was developed for convenient quantification of TFV in an aqueous matrix. Methods of statistical analysis include the use of partial least squares (PLS) regression vector analysis and spectral ranking by quality indices computed using CHAOS theory. Hydroxylamine-reduced Ag colloidal nanoparticles evaporated to dryness on an aluminum well-plate were used as the SERS substrate. To our knowledge, quantification of TFV down to 25 ng/mL by SERS, comprising clinically relevant concentrations, has not been previously reported. Furthermore, in this work we propose a novel method of quantification of aqueous TFV standards by SERS using statistical treatment of data by PLS and CHAOS theory. Based on these data, we propose future studies to develop a method of TFV detection and quantification in biological samples, beneficial to clinicians for rapid assessment of drug adherence during the treatment and prevention of viral diseases

Factors Predicting the Mental Health of Adolescents Attending a Faith-based Australian School System: A Multi-group Structural Equation Analysis

Background: Adolescents attending Seventh-day Adventist schools (Adventist) in Australia tend to experience good health and exhibit better health behaviors than national norms, however few studies have investigated factors predicting their mental health. Aims: The aim of this study was to explore the complex network of factors that predict the mental health status (MHS) of adolescents attending Adventist schools in Australia. Methods: A survey instrument was used to collect data from 1527 secondary school students attending Adventist schools across Australia. Structural equation modeling was employed to examine concomitantly the direct and indirect effects of childhood experiences, present attitudes and selected health behaviors on MHS. Results: Childhood family dynamics had the strongest association with MHS (βtotal = 0.33) followed by a sense of meaning and purpose (βtotal = 0.27), perceived social misfit status (βtotal = –0.19), and school academic performance (βtotal = 0.18). Multi-group analysis found significant pathway differences in the model for gender with regards to the association of meaning and purpose, physical activity and sleep quantity with MHS. Conclusions: The outcomes of the study highlight the importance of early positive childhood family dynamics and the discovery of meaning and purpose during adolescence to promote positive mental health among adolescents

A Nation-Wide Survey of High School Baseball Coaches’ Perceptions Indicates Their Arm Care Programs Play a Role in Injury Prevention

Background Arm care programs consisting of upper extremity strengthening and stretching have been recommended for injury prevention for pitchers of all ages. There has been no investigation into high school baseball coaches’ usage and perceptions of arm care programs to mitigate physical impairments associated with injuries in baseball players. Hypothesis/Purpose The purpose of this study was to investigate the current usage of arm care programs by high school baseball coaches. The primary objective was to determine if coaches use group-based or individualized arm care programs. The secondary objective sought to determine if the use of arm care programs is influenced by coaches’ age, education, and experience level. Finally, this study explored the potential barriers to arm care implementation and high school baseball coaches’ current awareness and beliefs of injury prevention. Study Design Descriptive cross-sectional survey Methods A 29-item online survey was emailed to 18,500 high school baseball coaches throughout the United States. Data were collected for three months, and the response rate was 3.7%. Results A total of 87.3% (n=571/654) of responding coaches use arm care programs with their players. Of coaches performing arm care, only 18.5% of 571 individualize their arm care exercises based on specific player needs. However, older and more experienced coaches are more likely to individualize their programs. Among the 12.7% (n=83/654) of coaches who do not use arm care programs, the two most commonly cited reasons for not implementing arm care were lack of observed benefit (41%) and insufficient staff (31%). Although 42% of 654 coaches recognized reduced shoulder mobility as a major contributor to injury, risk factors such as throwing with a fatigued arm, previous injury history, and throwing \u3e 8 months per year were not consistently identified as primary risk factors. Conclusion The results of this study suggest that the majority high school baseball coaches implement group-based arm care exercise programs to prevent injury. Lack of confidence in the effectiveness and staffing limitations were major barriers to implementation of arm care programming. However, the responding coaches exhibited inconsistent risk factor awareness and dated injury prevention beliefs. Therefore, better educational collaboration between rehabilitation professionals and high school coaches regarding injury risk factors and preventative strategies is warranted. Level of Evidence Level