The Spokane Study: High School Football Injuries

Until a uniform classification system is adopted, it will be hard to compare studies of football injuries. This author believes that the picture is not as grim as often reported.     

Ethiopia: An Emerging Family Planning Success Story

From 1990 to 2011, contraceptive use in Ethiopia increased ninefold and the total fertility rate fell from 7.0 to 4.8. These are two dramatic illustrations of a family planning success story that has emerged over the last two decades and is still emerging. What are the main elements of this success? We posit that the four most significant factors are: political will, generous donor support, nongovernmental and public–private partnerships, and the government's establishment of a network of health extension workers. In this study, we look at these factors and how their interaction increased the proportion of women having both the desire to use and ability to access contraceptives. Also highlighted are some of the key lessons learned in Ethiopia that are relevant to other African countries interested in emulating the country's success.     

Screening in the Prenatal Period for Intimate Partner Violence and History of Abuse: A Survey of Edmonton Obstetrician/Gynaecologists

Objective

This study sought to understand how obstetrician gynaecologists (OB/GYNs) in Edmonton, Alberta screen prenatal patients for intimate partner violence (IPV). It also aimed to explore attitudes, beliefs, and perceptions regarding IPV and identify barriers to screening for IPV. Institutional protocols, resources, and support available to clinicians and patients were also reviewed.

Developing cultural competence through self-reflection in interprofessional education: Findings from an Australian university

Interprofessional education and cultural competence are both necessary for health professionals working in interprofessional teams serving diverse populations. Using a pre–post-survey case series design, this study evaluates a novel learning activity designed to encourage self-reflection and cultural competence in an Australian interprofessional education context. Undergraduate health professional students in a large subject viewed three 7–15 minute videos featuring interviews with persons of a minority cultural, linguistic, or sexual group who were living with a disability or managing a health condition. Immediately afterwards, students in interprofessional groups completed a structured activity designed to promote interprofessional and cultural reflection. A localised version of a validated scale measured cultural competence before and after the learning activity. Results suggest the value of video-based learning activities based on real-life examples for improving cultural competence. Despite initially rating themselves highly, 64% of students (n = 273) improved their overall cultural competence, though only by M = 0.13, SD = 0.08, of a 5-point rating-scale interval. A nuanced approach to interpreting results is warranted; even slight increases may indicate improved cultural competence. Suggestions for improving the effectiveness of video-based cultural competence learning activities, based on qualitative findings, are provided. Overall the findings attest to the merit of group discussion in cultural competence learning activities in interprofessional education settings. However, the inclusion of group discussions within such learning activities should hinge on group dynamics.     

Combustion-related organic species in temporally resolved urban airborne particulate matter

Accurate characterization of the chemical composition of particulate matter (PM) is essential for improved understanding of source attribution and resultant health impacts. To explore this, we conducted ambient monitoring of a suite of 15 combustion-related organic species in temporally resolved PM_2.5 samples during an ongoing animal exposure study in a near source environment in Detroit, MI. All of the 15 species detected were above the method detection limit in 8 h samples. This study focused on two molecular classes: polycyclic aromatic hydrocarbons (PAHs) and hopanes measured in samples. Of the 12 PAHs studied, benzo[b]fluoranthene (169 pg m^?3), benzo[g,h,i]perylene (124 pg m^?3), and benzo[e]pyrene (118 pg m^?3) exhibited the three highest mean concentrations while 17α(H),21β(H)-hopane (189 pg m^?3) and 17α(H),21β(H)-30-norhopane (145 pg m^?3) had the highest mean concentrations of the three hopanes analyzed in samples. Ratios of individual compound concentrations to total compound concentrations (∑15 compounds) showed the greatest daily variation for 17α(H),21β(H)-hopane (11–28%) and 17α(H),21β(H)-30-norhopane (8–20%). Diagnostic PAH concentration ratios ([IP]/[IP + BP] (range 0.30–0.45), [BaP]/[BaP + BeP] (range 0.26–0.44), [BaP]/[BP] (range 0.41–0.82), [Bb]/[Bk] (range 2.07–2.66)) in samples reflected impacts from a mixture of combustion sources consistent with greater prevalence of petroleum combustion source emissions (gasoline, diesel, kerosene, and crude oil) compared to coal or wood combustion emissions impacts at this urban site. Results from this study demonstrate that short-duration sampling for organic speciation provides temporally relevant exposure information.     

Successful use of cryocrit for monitoring response to therapeutic plasma exchange in type 1 cryoglobulinemia

Waldenstrom macroglobulinemia (WM) is a clinical syndrome that is defined as lymphoplasmacytic lymphoma with bone marrow involvement and IgM monoclonal gammopathy of any level. In some instances WM can result in a type I cryoglobulinemia with very high cryocrits, which is unusual in type II and III cryoglobulinemia. We describe a case of an 80 year old male with WM, severe type I cryoglobulinemia, and an extremely elevated cryocrit (69%). Over the course of five weeks we performed nine therapeutic plasma exchanges (TPE), and after seven treatments his cryocrit had decreased to 6% with improvement in his symptoms. By monitoring his cryocrit throughout his TPE sessions, we were able to assess his response to treatment, determine the ideal length of treatment in addition to his symptomatic improvement. J. Clin. Apheresis 31:403–404, 2016. © 2015 Wiley Periodicals, Inc.