Learning chronobiology by improving Wikipedia.

Although chronobiology is of growing interest to scientists, physicians, and the general public, access to recent discoveries and historical perspectives is limited. Wikipedia is an online, user-written encyclopedia that could enhance public access to current understanding in chronobiology. However, Wikipedia is lacking important information and is not universally trusted. Here, 46 students in a university course edited Wikipedia to enhance public access to important discoveries in chronobiology. Students worked for an average of 9 h each to evaluate the primary literature and available Wikipedia information, nominated sites for editing, and, after voting, edited the 15 Wikipedia pages they determined to be highest priorities. This assignment (http://www.nslc.wustl.edu/courses/Bio4030/wikipedia_project.html) was easy to implement, required relatively short time commitments from the professor and students, and had measurable impacts on Wikipedia and the students. Students created 3 new Wikipedia sites, edited 12 additional sites, and cited 347 peer-reviewed articles. The targeted sites all became top hits in online search engines. Because their writing was and will be read by a worldwide audience, students found the experience rewarding. Students reported significantly increased comfort with reading, critiquing, and summarizing primary literature and benefited from seeing their work edited by other scientists and editors of Wikipedia. We conclude that, in a short project, students can assist in making chronobiology widely accessible and learn from the editorial process.

Further neurochemical and behavioural investigation of Brattleboro rats as a putative model of schizophrenia.

Brattleboro (BRAT) rats are a mutant variant of the Long-Evans (LE) strain deficient in the neurohormone vasopressin. BRAT rats show behavioural alterations relevant to schizophrenia. In particular, BRAT rats show deficits in prepulse inhibition (PPI) and alterations in various measures of cognition. The aim of this study was to replicate the reported PPI deficits in BRAT rats and its reversal by antipsychotic drugs and to investigate other behavioural and neurochemical characteristics. Acoustic startle reactivity, PPI, spontaneous and amphetamine-induced locomotor activity (LMA) and ex-vivo steady state neurochemistry were measured in male homozygous BRAT rats and LE rats. The effects of antipsychotics on PPI deficits were also determined. Relative to LE, BRAT rats showed enhanced startle reactivity, hyperactivity to a novel environment, PPI deficits and decreased levels of dopamine and DOPAC (dihydroxyphenylacetic acid) in the frontal cortex. BRAT and LE rats showed similar levels of hyperactivity following amphetamine (0.26 mg/kg s.c.). PPI deficits were attenuated by acute clozapine (5-10 mg/kg s.c.), risperidone (0.1-1 mg/kg i.p.), haloperidol (0.1-0.5 mg/kg p.o.) and less robustly by olanzapine (0.3-3 mg/kg s.c.). Chronic administration of clozapine (5 mg/kg s.c., once daily) attenuated baseline hyperactivity and elevated PPI of both strains. Clozapine concentrations were higher in BRAT brains compared with LE rats. These data confirm the reported PPI deficit in BRAT rats and its reversal by antipsychotic drugs, suggesting BRAT rats may represent a potential model for identifying novel antipsychotic drugs.

Treatment protocol for the management of a sodium hypochlorite accident during endodontic therapy.

During routine endodontic therapy, sodium hypochlorite inadvertently was forced out the apex of tooth No. 12. The patient experienced immediate severe pain, swelling, and hemorrhage from the canal access. Treatment was palliative, including patient education and reassurance, narcotic analgesics, cold and hot compresses, and multiple follow-up visits.

Attitudes toward self-care: a consumer study.

Although self-care is emerging as a growing movement wherein lay persons are assuming more responsibility for prvention, detection and treatment of health problems, we have almost no basic descriptive studies of attitudes toward self-care of professionals and consumers. The present study explored the reliability and validity of an attitude instrument designed to assess consumer's attitudes toward self-care and also its sensitivity to group differences in attitudes. A scale constructed for use with a provider population was revised and administered by telephone interview to 245 families in central California. Attitudes were found to be favorable. The scale's internal consistency reliability was calculated and found to be .65 (Cronbach's alpha); mean attitudes of three treatment groups were found to differ significantly. In view of the scale's moderate reliability, it is suggested that the scale be revised to provide a more sensitive discrimination of favorable attitudes.

Effect of a self-care book on physician visits. A randomized trial.

A self-care book that guides patients in seeking home care or physician care for 63 medical problems was assessed in three randomly selected groups of families to determine the book's effect on the number of visits to physicians. The first group was given the book and an optional seminar on its use; the second group was identical to the first but each family was promised $50 if their visits to physicians dropped by one third; the third group was a control group (total, 699 families). The book had no significant effect on the number of physician's visits during six- and 12-month study periods even though one half of the families read most or all of the book, and more than one third used it for a specific medical problem. Large-scale distribution of this self-care book therefore did not result in significantly less dependence on physicians for treatment of acute medical problems.

Cost containment through risk-sharing by primary care physicians: a history of the development of United Healthcare.

A new type of independent practice association has been organized to encourage primary care physicians in private practice to become coordinators and financial managers for their patients' medical care. Each patient chooses one internist, family or general physician, or pediatrician and must be referred by that physician for all specialized care. The primary care physician authorizes payment from his/her own account for hospital and referral care provided to patients. He or she shares any deficit or surplus remaining at the end of the year. This is a background paper detailing the history of development and specific features contained in this new concept of putting the physician in charge and "at risk" for the costs of medical care to his/her patients. The plan has been operating in northern California, Washington, and Utah and has 40,000 members and 750 participating physicians. This historical background paper is part of a large project--State Employees' Insurance Benefits Utilization Study (SEIBUS) being done by the University of Washington School of Public Health to evaluate use and costs of medical care under this innovative plan.

Tennessee: using a statewide data system for family planning.

PIP: In 1970, the Tennessee state health department established a statewide system for collecting family planning data which are used by service providers and planners to manage the statewide program and evaluate ongoing program efforts. Teach-ins were held explaining the reasons for instituting the system, the potential use for clinic staff, and extensive directions on completing the data forms. The first form is a medical visit record, used principally for admission, medical followup, and annual return visits. The second form is a record for non-medical transactions as recruitment, resupply, or counseling. The forms are to be filled out by clerical, paramedical or nursing staff. Through the system, monthly reports of delinquent patients may be utilized for followup and each county can be ranked according to the proportion of estimated numbers in need of family planning services who have been served. 6 reports are sent to each county monthly, including: 1) a due list of those due to return for services over the next 6 weeks; 2) a missed list of patients who missed their scheduled return for service during the preceeding 2 months; 3) a dropped list of patients 2 or more months overdue; 4) a monthly listing of county rankings by the proportion of local target population currently receiving services; 5) a report on patient activity status by method of contraception; 6) a monthly report on number of visits showing which members of each county's clinic staff are delivering which types of services. A major reason for initiating a centralized record system was to stimulate interest in family planning at the county level, while giving each county a tool to evaluate its own performance and compare its program to other counties. County continuation rates vary from 40.1% to 77.6%. For the state as a whole 54.6% of the 46,950 pill patients were still active 1 year after their initial clinic visit.^ieng