Intravenous fat emulsion therapy for intentional sustained-release verapamil overdose

We report the first case of sustained-release verapamil toxicity treated with Intralipid fat emulsion (IFE). Toxicity was confirmed by elevated serial serum verapamil and metabolite, norverapamil, levels. Most previously reported cases of IFE therapy involve local anaesthetic toxicity and cardiac arrest. Our patient was in shock despite standard therapy. No adverse events were noted and the patient fully recovered.     

The Ethics of Nursing Student International Clinical Experiences

This article explores the motivations for offering international nursing student experiences and the reasons students choose to participate. Students should prepare by learning cultural humility rather than cultural competency, and they should be oriented to the ethical responsibility implicit in caring for those in developing countries. Programs that provide these experiences need to be developed with an eye to sustainability so the lives of those receiving care will be enriched after the students go home.     

Community Influences on Married Men’s Uptake of HIV Testing in Eight African Countries

Despite efforts to increase HIV testing in the African region, the proportion of men who report ever having been tested for HIV remains low. Research has focused on individual level determinants of women’s testing however little is known about factors associated with men’s testing behavior. This analysis investigates community influences on HIV testing among men ages 15–54, using Demographic and Health Survey (DHS) data from Chad, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia, and Zimbabwe. Multilevel models were fitted in each country for the outcome of ever receiving an HIV test. After controlling for individual and household level factors, community level factors of demographics, economics, and behavior and knowledge remain significantly associated with HIV testing among men. The results of this analysis highlight the need to recognize the impact of community influences on men’s HIV test seeking behavior, and to harness these community factors in the design of programs aimed at encouraging the uptake of HIV testing among men in Africa.     

Discourse in healthy old-elderly adults: A longitudinal study

Abstract

This longitudinal study investigated discourse abilities in 16 normal adults in their 80s and 90s at two separate testing times. The discourse tasks evaluated macro-level processing of narratives as manifested on retells, summaries, gists, and morals, and in explanations of proverbs. The group results showed preservation with increased age on those discourse tasks that required global levels of processing. No significant decreases in performance were found in applying strategies of reduction, generalization, and interpretation, factors associated with preserved discourse function in normal advanced ageing are discussed. The findings have implications for differential diagnosis of dementia and aphasia.     

Fostering hand washing before lunch by students attending a special needs young adult program

A multiple baseline across groups design was used to investigate the effects of a treatment package on hand washing before lunch by five students with disabilities who attended a young adult educational program. To evaluate hand washing, a lotion called Glo Germ was applied to participants’ hands. Glo Germ is visible under a black light, which allowed the quality of hand washing to be assessed by comparing the amount visible before and after hand washing using a 3-point scale. Following a baseline period in which hand washing was assessed, participants were exposed to a hand washing training procedure, which improved one participant's hand washing. Next, a lottery system was imposed in which the number of lottery tickets earned each day depended on the quality of hand washing, specifically, on the rating assigned (0, 1, or 2). This condition was associated with improved hand washing by the other four participants. Finally, a condition adding feedback to the lottery system resulted in further improvements in the quality of hand washing for all participants. Follow up data indicated modest maintenance of hand washing after lunch. These results suggest that treatment packages similar to that used in the present study merit further investigation and that Glo Germ is of value in ascertaining the quality of hand washing.     

Bone Density in Peripubertal Boys with Autism Spectrum Disorders

We determined whether bone mineral density (BMD) is lower in boys with autism spectrum disorders (ASD) than controls, and also assessed variables that may affect BMD in ASD. BMD was measured using dual energy X-ray absorptiometry (DXA) in 18 boys with ASD and 19 controls 8–14 years old. Boys with ASD had lower BMD Z-scores at the spine, hip and femoral neck, and differences at the hip and femoral neck persisted after controlling for maturity and BMI. Vitamin D intake from food and in serum were lower in ASD subjects, as was exercise activity. We conclude that BMD is lower in peripubertal boys with ASD and may be associated with impaired vitamin D status and lower exercise activity.     

Arousal,Working Memory Capacity,and Sexual Decision-Making in Men

This study investigated whether working memory capacity (WMC) moderated the relationship between physiological arousal and sexual decision making. A total of 59 men viewed 20 consensual and 20 non-consensual images of heterosexual interaction while their physiological arousal levels were recorded using skin conductance response. Participants also completed an assessment of WMC and a date-rape analogue task for which they had to identify the point at which an average Australian male would cease all sexual advances in response to verbal and/or physical resistance from a female partner. Participants who were more physiologically aroused by and spent more time viewing the non-consensual sexual imagery nominated significantly later stopping points on the date-rape analogue task. Consistent with our predictions, the relationship between physiological arousal and nominated stopping point was strongest for participants with lower levels of WMC. For participants with high WMC, physiological arousal was unrelated to nominated stopping point. Thus, executive functioning ability (and WMC in particular) appears to play an important role in moderating men’s decision making with regard to sexually aggressive behavior.