Management of bite injuries

Most mammalian bites are caused by dogs, cats or humans. Cat and human bites often become infected, so antibiotic prophylaxis should be considered in addition to wound management. Early referral for surgical assessment of human bites to the hand may be required. Amoxycillin with clavulanate is suitable for prophylaxis in most cases. Prophylaxis is usually continued for 5–7 days. Depending on their immunisation status, patients may need vaccination against tetanu

More like him, me, or us: the impact of trait similarity on adolescent women’s sexual risk behaviors in relationships

Ideal partner traits and how they relate to a young woman’s current partner and relationship is a knowledge gap in the literature. The objectives of this study were 1) to assess any differences in interpersonal characteristics between a young woman or her partner and relationship and 2) to examine the impact of this difference on sexual monogamy, condom use and frequency of vaginal sex. Study participants (n=387, 14–17 years at enrollment, 90% African American) were recruited from three primary care adolescent health clinics serving areas with high rates of unintended pregnancy and sexually transmitted infection (STI); data were drawn from a longitudinal cohort study of sexual relationships and behaviors among young women. Nineteen interpersonal characteristics, including physical, financial, communication and personal characteristic variables, were found to have varying influences on relationships and sexual behaviors with ‘like him’ and ‘like us’ as referents. Monogamy increased as a male partner wanted to get somewhere in life [OR 5.41, (1.25, 23.52, p<0.05)], was intelligent [OR 3.42, (1.09, 10.76, p<0.05)] and had money [OR 1.55, (0.272, 0.595, p<0.001)] in a partnership; monogamy similarly increased when a partner wanted to get somewhere in life [OR 6.77, (1.51, 30.36, p<0.01)], was intelligent [OR 4.02, (1.23, 13.23, p<0.05)], and had money [OR 2.41, (1.51, 3.84, p<0.001)] compared to the young woman. The likelihood of using a condom at last sex increased when the male partner had a nice body [OR 1.42, (1.02, 1.99, p<0.05)], was popular [OR 1.60, (1.12, 2.29, p<0.01)], cared for others [OR 3.43, (1.32, 8.98, p<0.01)], was good at sports [OR 1.35, (1.06, 1.73, p<0.05)] and expressed his feelings [OR 2.03, (1.14, 3.60, p<0.01)]. The condom use ratio increased when the male partner was able to take care of himself [OR 0.076, (0.017, 0.136, p<0.01)], was cute [OR 0.190, (0.082, 0.30, p<0.001)], and had a nice body [OR 0.044, (0.001, 0.09, p<0.05)] in a dyad; the condom use ratio also increased when a male partner could take care of himself [OR 0.091, (0.014, 0.168, p<0.05)], was cute [OR 0.194, (0.077, 0.311, p<0.001)] compared to the young woman. Coital frequency increased when the male partner was described as being able to take care of himself [OR 3.33, (0.138, 6.52, p<0.05)]. Such influences are important in discussions with young women regarding personal and partner choices in sexual health as partners, behaviors and motivations for choice frequently change

Medical student self-efficacy, knowledge and communication in adolescent medicine

Objectives To evaluate student self-efficacy, knowledge and communication with teen issues and learning activities. Methods Data were collected during the 8-week pediatric rotation for third–year medical students at a local children’s hospital. Students completed a self-efficacy instrument at the beginning and end of the rotation; knowledge and communication skills were evaluated during standardized patient cases as part of the objective structured clinical examination. Self-efficacy, knowledge and communication frequencies were described with descriptive statistics; differences between groups were also evaluated utilizing two-sample t-tests. Results Self-efficacy levels of both groups increased by the end of the pediatric rotation, but students in the two-lecture group displayed significantly higher self-efficacy in confidentiality with adolescents (t(35)=-2.543, p=0.02); interviewing adolescents, assessing risk, sexually transmitted infection risk and prevention counseling, contraception counseling were higher with marginal significance. No significant differences were found between groups for communication; assessing sexually transmitted infection risk was marginally significant for knowledge application during the clinical exam. Conclusions Medical student self-efficacy appears to change over time with effects from different learning methods; this higher self-efficacy may increase future comfort and willingness to work with this high-risk, high-needs group throughout a medical career

TB191: Conservation and Management of Native Bees in Cranberry

Threats to agriculturally important pollinators have serious implications for human beings. A loss of bees translates to less successful crop pollination, thus reduced yield and poorer quality fruits. Native bees have the potential to serve as commercial pollinators. A diverse pollinator complex comprised of both honey bees and native bees should result in stable pollination levels and should be resistant to threats such as disease, fluctuating honey and crop prices, and honey bee transportation costs. Adding the goal of native bee conservation to land management increases the ecological integrity of an ecosystem by conserving a unique biological interaction that is the basis for most native wild plant reproduction. This report describes pollination in the cranberry agroecosystem and outlines steps to take to manage native bees in cranberry.https://digitalcommons.library.umaine.edu/aes_techbulletin/1017/thumbnail.jp

Using Fidelity Measures to Support the Training of Graduate Students Working in School Settings

This paper presents a case example of a school-based social development program supported by counselors, yet implemented by graduate student facilitators in a mid-sized urban public school in New England. The authors describe a process for developing and validating fidelity instruments and the use of these assessments to train lay facilitators or graduate students enrolled in counseling or counselor education programs. Guidelines are presented for school counselors interested in using customized fidelity instruments to formatively assess training needs of graduate students

Using Fidelity Measures to Support the Training of Graduate Students Working in School Settings

This paper presents a case example of a school-based social development program supported by counselors, yet implemented by graduate student facilitators in a mid-sized urban public school in New England. The authors describe a process for developing and validating fidelity instruments and the use of these assessments to train lay facilitators or graduate students enrolled in counseling or counselor education programs. Guidelines are presented for school counselors interested in using customized fidelity instruments to formatively assess training needs of graduate students

The experience of family carers attending a joint reminiscence group with people with dementia: A thematic analysis

Reminiscence therapy has the potential to improve quality of life for people with dementia. In recent years reminiscence groups have extended to include family members, but carers' experience of attending joint sessions is undocumented. This qualitative study explored the experience of 18 family carers attending 'Remembering Yesterday Caring Today' groups. Semi-structured interviews were transcribed and subjected to thematic analysis. Five themes were identified: experiencing carer support; shared experience; expectations (met and unmet), carer perspectives of the person with dementia's experience; and learning and comparing. Family carers' experiences varied, with some experiencing the intervention as entirely positive whereas others had more mixed feelings. Negative aspects included the lack of respite from their relative, the lack of emphasis on their own needs, and experiencing additional stress and guilt through not being able to implement newly acquired skills. These findings may explain the failure of a recent trial of joint reminiscence groups to replicate previous findings of positive benefit. More targeted research within subgroups of carers is required to justify the continued use of joint reminiscence groups in dementia care

Apathy Is Not Associated With a Panel of Biomarkers in Older Adults With HIV Disease

OBJECTIVE: Apathy is prevalent in HIV disease and can significantly impact personal well-being; however, little is known about its neurobiological substrates in persons with HIV (PWH) disease. METHODS: This cross-sectional, correlational study examined the association between apathy and several plasma biomarkers (tumor necrosis factor alpha, kynurenine, tryptophan, quinolinic acid, brain-derived neurotrophic factor, glial fibrillary acidic protein, neurofilament light chain, and phosphorylated tau at position threonine 181) in 109 PWH and 30 seronegative participants ages 50 and older. Apathy was measured with a composite score derived from subscales of the Frontal Systems Behavior Scale and the Profile of Mood States. RESULTS: Multiple regressions showed that PWH had significantly greater severity of apathy symptoms, independent of both data-driven and conceptually-based covariates. Pairwise correlations in the PWH sample indicated that apathy was not significantly associated with any of the measured biomarkers and all of the effect sizes were small. CONCLUSION: Findings suggest that apathy is not strongly associated with peripheral biomarkers of inflammation, neurotrophic support, or neurodegeneration in older PWH. Limitations of this study include the cross-sectional design, the use of self-report measures of apathy, and low rates of viremia. Longitudinal studies in more representative samples of PWH that include a more comprehensive panel of fluid biomarkers, informant and behavioral indicators of apathy, and relevant psychosocial factors might help to further clarify the neurobiological substrates of this complex neuropsychiatric phenomenon

Patterns of hepatitis B prevalence and seroconversion in hemodialysis units from three continents: The DOPPS

Patterns of hepatitis B prevalence and seroconversion in hemodialysis units from three continents: The DOPPS.BackgroundHepatitis B (HBV) historically has been a public health issue within hemodialysis units. This study estimates HBV prevalence and seroconversion rates across seven countries and investigates associations with facility level practice patterns.MethodsThe study sample was from the Dialysis Outcomes and Practice Patterns Study (DOPPS), a cross-sectional, prospective, observational study of adult hemodialysis patients randomly selected from 308 dialysis facilities in France, Germany, Italy, Spain, the United Kingdom, Japan, and the United States. Logistic regression was used to model the odds ratio (OR) of HBV prevalence, and Cox regression was used to model time from entry into the study to HBV seroconversion.ResultsIn this sample, mean HBV facility prevalence was 3.0% with a median of 1.9%. The percentage of facilities with an HBV prevalence 0% to 5% was 78.5%. Adjusted HBV prevalence was higher in France, Germany, and Italy and lower in Japan and the United Kingdom. The majority of facilities (78.1%) had a seroconversion rate of 0 conversions per 100 patient-years. Presence of a protocol for HBV-infected patients was significantly associated with HBV seroconversion in the separate practice pattern model [risk ratio (RR) = 0.52, P = 0.03] and in the combined practice pattern model (RR = 0.44, P = 0.01).ConclusionThere are differences in HBV prevalence and rate of seroconversion both at the country and the hemodialysis facility level. Presence of a protocol for HBV-infected patients was strongly and significantly associated with decreased risk for seroconversion. The observed variation suggests opportunities for improved HBV outcomes with further definition of optimal practice patterns at the facility level