Acute transverse myelitis in the emergency department: A case report and review of the literature

Acute transverse myelitis (ATM) is a neurologic condition that presents with bilateral lower extremity weakness and sensory loss associated with bowel and bladder dysfunction. Whereas the time of onset may be hours to days, the time to either partial or complete recovery may require months. The etiology is varied and may be idiopathic. Laboratory and radiographic evaluation may be nonrevealing. Corticosteriods have been used for treatment, but their efficacy is controversial. As illustrated by this case report, the essential aspect of the initial management of ATM is the elimination of potentially treatable causes.     

Eight year study of viral isolates from cot deaths in Glasgow

Over an eight year period 21 different viral strains excluding polioviruses were isolated in 44 (19%) of 237 cot deaths. The percentage of viral positive cases was significantly greater in over 16 week age groups and in cultures obtained less than 24 hours after death.     

Assessing Health Disparities in Rural Hawaii Using the Hoshin Facilitation Method

CONTEXT: Health disparities between rural and urban communities are well documented. There are many suggested causes and many proposed solutions but no one-size-fits-all answer. The most successful community interventions have been introduced by communities themselves. However, before communities invest in such interventions, each group must identify and prioritize their needs. PURPOSE: This article describes the Hoshin facilitation method as a practical option assisting communities in assessing their needs and gaining consensus for future steps. METHODS: Thirty-four meetings were held in 11 rural communities in Hawaii using the Hoshin process to identify factors that impact rural health. Themes were identified by constant comparative analysis and thematic frequency described. Commonality of responses between communities was examined. Informal feedback was collected from meeting participants. FINDINGS: There was a great deal of commonality between community responses, with economic factors, drug use, lack of community leadership, lack of health care services and access to services, lack of healthy activities for youth, and poor public education being the most common issues noted. Group involvement in the meetings was high, and the facilitation method received positive feedback from participants. CONCLUSIONS: The Hoshin facilitation method is a very useful tool to help communities rapidly identify and prioritize areas for programmatic attention.     

Attitudes towards mental illness: testing the contact hypothesis among Chinese student nurses in Hong Kong

This study investigated whether previous contact with mental illness affected the attitudes to mental illness (AMI) of general student nurses in Hong Kong — the contact hypothesis. We employed a quasi-experimental design. We compared the attitudes to mental illness of students who had previous contact with mental illness through having taken a psychiatric secondment with those who had not taken a psychiatric secondment. Also, we compared the AMI of: students who had taken other courses related to mental illness with those who had not; those who had a family history of mental illness with those who had not; and those who lived with a mentally ill relative with those who did not. We found that previous contact with mental illness had no significant effect on the attitudes to mental illness of the students. In other words our findings do not support the contact hypothesis. Our sample expressed positive general attitudes to mental illness when presented with general issues about mental illness. However, their attitudes were less positive when presented with specific issues about mental illness that might impinge upon their daily lives. We discuss the implications of these findings for mental health nursing practice, education and research.     

Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient.

OBJECTIVE: This article examines the success of mini-dental implants (MDI'S) by assessing four subjective measures of patient satisfaction for MDI's in the edentulous maxilla and mandible: comfort, retention, chewing ability and speaking ability. Success rates, surgical techniques, and financial advantages of the MDI's are reviewed. STUDY DESIGN: Thirty consecutive patients received four MDI's between the mental foramen of the mandible from 9/18/2003 to 10/22/2004. Questionnaires were sent to all thirty patients an average of 5 months postoperatively. The patients ranked comfort, retention, chewing ability, and speaking ability from 1 to 10 (1=poor and 10=excellent). RESULTS: A total of 116 MDI's were placed in 13 months and 113 remain stable for a 97.4% implant success rate. Pre-operatively patients rated their retention at 1.7+/-0.42 and post-operatively at 9.6+/-0.37, for a difference of 7.9 (p=3.6-19). Comfort was the next greatest improvement, with a pre-operative rating of 2.2+/-0.63 and a post-operative rating of 9.4+/-0.45, for a difference of 7.2 (p=3.5-15). Chewing ability also improved, with a difference of 7.0 (p=2.9e-16). In the final category of speaking ability, the pre-operative to post-operative difference was 3.2 (p=1.1e-5). CONCLUSION: MDI's are a highly successful implant option for patients with poor tolerance to maxillary and mandibular prosthesis. The implants are relatively affordable and overall patient satisfaction is excellent.