Otoacoustic emissions as a screening test for hearing impairment in children

Transient evoked otoacoustic emissions (TEOAEs) are low amplitude sound waves produced by the healthy cochlea. They can be recorded with a microphone in the external ear. TEOAEs are abolished by hearing losses of 30 dB or more. The feasibility of using TEOAEs as a screening test for hearing loss in children was studied. TEOAE recordings were attempted in 56 children attending an audiology clinic. Recordings were possible from both ears in 52 children; of these 104 ears, 32 had hearing deficits of 30 dB or more. Hearing status was compared with the results of six TEOAE screening criteria. All criteria had a sensitivity of 1.00. Four standard TEOAE criteria yielded specificities of 0.46-0.58. Two new criteria derived from analysis of limited frequencies from the TEOAE waveform gave specificities of 0.76 and 0.82. It can be concluded that, when appropriate pass/fail criteria are employed, TEOAEs are a feasible screening test in children.     

Religion and Spirituality in the Lives of People with Serious Mental Illness

Although there is a fair sized literature documenting the relationship of religiousness and spirituality with health and well-being, far fewer studies have examined this phenomenon for people with serious mental illness. In this research, religiousness is defined as participation in an institutionalized doctrine while spirituality is framed as an individual pursuit of meaning outside the world of immediate experience. In this study, 1,824 people with serious mental illness completed self-report measures of religiousness and spirituality. They also completed measures of three health outcome domains: self-perceived well-being, psychiatric symptoms, and life goal achievement. Results showed that both religiousness and spirituality were significantly associated with proxies of well being and symptoms, but not of goal achievement. Implications of these findings for enhancing the lives of people with psychiatric disability are discussed.     

Open vs Laparoscopic Vertical Banded Gastroplasty: A case control study with 1-year follow-up

Background: Vertical Banded Gastroplasty (VBG) is one of the most common bariatric operations. It can be performed by open or laparoscopic methods. The purpose of this study was to analyze and compare the 1-year results of 40 patients who underwent laparoscopic (20) and open (20). Methods: The initial 20 patients undergoing LaparoscopicVBG and the initial 20 patients in whom an Open VBG were performed in our Institution were comparatively evaluated. Demography, surgical details, complications, and 1-year weight loss were analyzed. Results: Both groups were highly comparable in terms of age, sex and body mass index. Laparoscopic VBG was a more prolonged procedure (median 4 hr) than the open VBG (median 3 hr). On the other hand, hospital stay was significantly shorter in the laparoscopic procedure (median 10 days for the open and 6 days for the laparoscopic). One year weight loss and complications were similar in both groups. Conclusions: Laparoscopic VBG is a safe procedure for the treatment of morbid obesity. This initial series shows comparable results.     

Effects of orbital spaceflight on human osteoblastic cell physiology and gene expression

During long-term spaceflight, astronauts lose bone, in part due to a reduction in bone formation. It is not clear, however, whether the force imparted by gravity has direct effects on bone cells. To examine the response of bone forming cells to weightlessness, human fetal osteoblastic (hFOB) cells were cultured during the 17 day STS-80 space shuttle mission. Fractions of conditioned media were collected during flight and shortly after landing for analyses of glucose utilization and accumulation of type I collagen and prostaglandin E(2) (PGE(2)). Total cellular RNA was isolated from flight and ground control cultures after landing. Measurement of glucose levels in conditioned media indicated that glucose utilization occurred at a similar rate in flight and ground control cultures. Furthermore, the levels of type I collagen and PGE(2) accumulation in the flight and control conditioned media were indistinguishable. The steady-state levels of osteonectin, alkaline phosphatase, and osteocalcin messenger RNA (mRNA) were not significantly changed following spaceflight. Gene-specific reductions in mRNA levels for cytokines and skeletal growth factors were detected in the flight cultures using RNase protection assays. Steady-state mRNA levels for interleukin (IL)-1alpha and IL-6 were decreased 8 h following the flight and returned to control levels at 24 h postflight. Also, transforming growth factor (TGF)-beta(2) and TGF-beta(1) message levels were modestly reduced at 8 h and 24 h postflight, although the change was not statistically significant at 8 h. These data suggest that spaceflight did not significantly affect hFOB cell proliferation, expression of type I collagen, or PGE(2) production, further suggesting that the removal of osteoblastic cells from the context of the bone tissue results in a reduced ability to respond to weightlessness. However, spaceflight followed by return to earth significantly impacted the expression of cytokines and skeletal growth factors, which have been implicated as mediators of the bone remodeling cycle. It is not yet clear whether these latter changes were due to weightlessness or to the transient increase in loading resulting from reentry.     

A BPA survey of recently appointed consultants

A postal survey of recently appointed consultant paediatricians was undertaken to determine whether they perceived their training had adequately equipped them for their current job. The response rate was 69% (207/299). After excluding replies from consultants trained outside the UK the analysis was carried out on 167 replies. Trainees held a mean 5.2 posts during general and higher professional training, necessitating a mean 1.8 house moves. Altogether 82% felt moves were beneficial to training but 46% found moves 'very disruptive' to family life. Only 12% of district general hospital and 22% of teaching hospital senior registrars took two research sessions a week. Supervision and training in research was absent or poor for more than 60%; 24% felt major changes and 55% moderate changes were needed to current training. Training in non-clinical skills was particularly in demand and a curriculum for both trainers and trainees with regular appraisals is required. Research at senior registrar level needs review and educational methods improved to achieve better training in a shorter period.     

Helping and achieving: Compatible or competing goals for men and women in medical school?

This study investigates the attitudes of medical students toward oncology and examines the help- and achievement-orientations of males and females to ascertain whether these orientations are gender-related. Ninety freshmen, 125 sophomores, 83 juniors, and 87 senior medical students responded to questionnaires assessing their attitudes. Female students were both more help- and achievement-oriented than were the male students. Helping and achieving were compatible goals for these women. Both male and female students were significantly more help-oriented by their senior year but they also felt significantly less effective in helping than did students in the first 3 years.     

Factors associated with positive HIV serostatus among women who use drugs: continued evidence for expanding factors of influence

OBJECTIVE: To identify risk factors associated with positive HIV serostatus among African American women who smoke crack and/or inject drugs and who are not enrolled in drug treatment or another institutional setting. METHODS: Baseline interviews were conducted from June 1998 to June 2000 with 379 heterosexually active women (ages 18 to 59) who had been recruited for potential enrollment into an HIV intervention trial. RESULTS: Adjusted for age and drug using status, women who expressed more difficulty saying no to sex with male partners were more likely to be HIV-positive (adjusted odds ratio [aOR]=3.08, 95% confidence interval [CI] 2.02, 4.83). Similarly, those who indicated greater communication with casual sex partner(s) were less likely to test positive (aOR=0.29, 95% CI 0.10, 0.89). Lower HIV internal control and a history of cuts or burns on lips due to crack smoking were also associated with positive serostatus, and were important confounders in the final multivariate model. A higher level of internal control was associated with a decreased likelihood of positive serostatus, while a history of cuts or burns on the lips was associated with an increased likelihood of HIV antibodies, even after controlling for the amount of oral sex. CONCLUSIONS: A broad array of factors may promote or avert infection with HIV. The degree to which personal attributes and beliefs, and relationship characteristics contribute to the likelihood of infection must continue to be addressed. The importance of oral sex and presence of oral sores and their potential role in transmission was suggested.     

OP-1 Augments Glucocorticoid-inhibited Fracture Healing in a Rat Fracture Model

Glucocorticoids inhibit bone remodeling and fracture healing. We sought to determine whether osteogenic protein 1 (OP-1) can overcome this inhibition in a closed fracture model in the rat. Time-released prednisolone or placebo pellets were implanted subcutaneously; closed femoral fractures were created 2 weeks later in rats. Fractures received sham, OP-1 and collagen, or collagen-only implants. Femurs were harvested at 3, 10, 21, 28, and 42 days postfracture. Fractures were examined radiographically for amount of hard callus; mechanically for torque and stiffness (also expressed as a percentage of the contralateral intact femur); and histomorphometrically for amount of cartilaginous and noncartilaginous soft callus, hard callus, and total callus. Glucocorticoid administration inhibited fracture healing. The application of a devitalized Type I collagen matrix mitigated the inhibitory effects of prednisolone on fracture healing However, further increases in indices of fracture healing were observed when OP-1 was added to the collagen matrix compared with collagen alone. OP-1 and collagen was more effective than collagen alone.