Configurable NOR gate arrays from Belousov-Zhabotinsky micro-droplets.

We investigate the Belousov-Zhabotinsky (BZ) reaction in an attempt to establish a basis for computation using chemical oscillators coupled via inhibition. The system consists of BZ droplets suspended in oil. Interdrop coupling is governed by the non-polar communicator of inhibition, Br2. We consider a linear arrangement of three droplets to be a NOR gate, where the center droplet is the output and the other two are inputs. Oxidation spikes in the inputs, which we define to be TRUE, cause a delay in the next spike of the output, which we read to be FALSE. Conversely, when the inputs do not spike (FALSE) there is no delay in the output (TRUE), thus producing the behavior of a NOR gate. We are able to reliably produce NOR gates with this behavior in microfluidic experiment.

Effect of boiling water carcass immersion on aerobic bacteria counts of poultry skin and processed ground poultry meat.

This study was conducted to determine the relationship between bacteria destruction on poultry carcass skin and bacteria in raw ground poultry meat from the same carcasses. Immersion time in boiling water of broiler chicken whole carcasses required for maximum reduction of naturally occurring aerobic bacterial count on skin was measured. Treatments for chicken carcasses consisted of immersion in boiling water (approximately 95 degrees C) for 0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, and 4 min. Four skin samples taken following treatment and three taken from subsequently ground carcass meat were analyzed for total aerobic plate counts (APC). Analysis of the data indicated a linear increase in bacterial destruction on skin with increased boiling water immersion time from 0 to 4 min. Reduction of skin bacteria to less than 1 log10 occurred at 3 min carcass immersion or longer. The analysis also indicated that treatment with boiling water and removal of skin was effective in reducing bacterial counts in ground meat to similar levels at all treatment times from 0.5 to 4.0 min. Findings from this study indicated that a boiling water immersion intervention and removal of skin could reduce subsequent bacteria contamination of ground meat. This intervention could minimize the risk of pathogen-contaminated primary processed poultry carcasses used in further processing.

Amoxicillin/clavulanate-associated hepatic failure with progression to Stevens-Johnson syndrome.

OBJECTIVE: To describe a patient who developed hepatic failure, Stevens-Johnson syndrome (SJS), and died after receiving amoxicillin/clavulanate therapy. CASE SUMMARY: A 37-year-old white man without significant past medical history received a 10-day course of amoxicillin/clavulanate for treatment of pneumonia. Thirty-two days after starting amoxicillin/clavulanate, he developed jaundice, rash, pruritus, and increasing fatigue. On further evaluation, with the exclusion of toxicity from other drugs or diseases, the time course to development of cholestatic jaundice correlated with the use of amoxicillin/clavulanate. The patient consequently died with progressive hepatic failure, renal failure, and SJS. DISCUSSION: Hepatic injury has been reported with amoxicillin/clavulanate. Signs and symptoms of jaundice and pruritus may appear up to to six weeks after stopping therapy. Most cases of liver injury have been benign and reversible on discontinuation of the amoxicillin/clavulanate. Reported hepatic reactions have been mainly cholestatic, with some mixed cholestatic/hepatocellular liver function test abnormalities. CONCLUSIONS: Clinicians should be aware of amoxicillin/clavulanate as a drug capable of causing hepatitis with eventual systemic dysfunction. While recovery is usually complete following withdrawal of the drug, in patients with rash associated with hepatic dysfunction, renal insufficiency, or other unusual symptoms, earlier consideration of initiating systemic steroids or liver transplantation referral, in hopes of avoiding progressive systemic response, might be worthwhile.

A collaborative partnership to enhance school-based tobacco control policies in West Virginia. Center for Disease Control and Prevention.

INTRODUCTION: The Centers for Disease Control and Prevention's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction were developed, in part, to help state and local education agencies implement effective school-based tobacco control programs. This paper: (1) reports on school tobacco policies, one facet of a larger investigation conducted to examine the consistency between WV's school-based tobacco control policies and programs and the CDC Tobacco Guidelines and (2) describes the impact this investigation had on state policy in WV. METHODS: A content analysis was conducted on all (n = 55) county tobacco policies using a coding protocol developed by the authors. This protocol was designed to enable judgment about whether the county policies addressed particular elements specified in the CDC Tobacco Guidelines. Additionally, data about school-level policies, collected from a telephone survey of a sample of school principals (n = 421), are presented. Since the purpose of the needs assessment was to describe current practice, frequencies were computed for both the county and school-level analyses. RESULTS: Both county- and school-level tobacco policies were found lacking in many of the elements recommended in CDC's Tobacco Guidelines, particularly in the areas of enforcement procedures and access to cessation programs. CONCLUSIONS: Two major outcomes resulted from this needs assessment: (1) the WV State Board of Education's Tobacco Control Policy was revised to be more consistent with CDC's Tobacco Guidelines and (2) increased attention is now being focused on providing cessation options for WV schools.

Diffusion of CDC's Guidelines to Prevent Tobacco Use and Addiction.

The Center for Disease Control and Prevention's School Guidelines to Prevent Tobacco Use and Addiction were developed, in part, to assist state and local education agencies in adopting and implementing effective school-based tobacco prevention and cessation programs. This project assessed state education agency awareness of and reaction to the Guidelines, and documented efforts to disseminate the Guidelines to local schools. Key informants in 15 state education agencies were interviewed. Respondents reported a fairly high level of receptivity to the Guidelines, numerous benefits and few barriers, and high commitment. Levels of use for the Guidelines varied. Dissemination strategies such as mass mailing or teleconferences are not sufficient to influence the use and integration of Guidelines for school health. The diffusion process requires planned change over time through numerous communication channels and should be monitored at the national, state, and local levels to assess effectiveness and impact.

Diffusion of an effective tobacco prevention program. Part I: Evaluation of the dissemination phase.

As health promotion methods are proven effective, the diffusion and widespread implementation of successful programs can significantly reduce behaviors that pose risks to health within a targeted population. The Smart Choices Diffusion Project developed and evaluated a dissemination intervention program that targeted 128 school districts in east Texas. The project employed a theory-based model to disseminate information about a proven tobacco prevention program to opinion leaders in each district. These opinion leaders were asked to personally communicate the program information within their district using a videotape and printed materials, and advocate for program adoption. In addition to personal communication, a newsletter linked school districts. Opinion leaders in 52% of the districts showed the videotape, which modeled program adoption. A quasi-experimental design was used to evaluate the impact of the dissemination phase on teachers' and administrators' readiness to adopt a tobacco prevention program. Evaluation of the dissemination phase revealed no differences between the intervention and comparison districts in a district's readiness to adopt a tobacco prevention program. However, in intervention districts where school administrators viewed the videotape, the administrators were more likely to perceive the innovative program as having a relative advantage and to perceive their district's organizational and social environment as supportive of adopting the program.

Diffusion of an effective tobacco prevention program. Part II: Evaluation of the adoption phase.

This paper presents the results of theory-based intervention strategies to increase the adoption of a tobacco prevention program. The adoption intervention followed a series of dissemination intervention strategies targeted at 128 school districts in Texas. Informed by Social Cognitive Theory, the intervention provided opportunities for districts to learn about and model themselves after 'successful' school districts that had adopted the program, and to see the potential for social reinforcement through the knowledge that the program had the potential to have an important influence on students' lives. The proportion of districts in the Intervention condition that adopted the program was significantly greater than in the Comparison condition (P < 0.001). Stepwise logistic regression indicated that the variables most closely related to adoption among intervention districts were teacher attitudes toward the innovation and organizational considerations of administrators. Recommendations for the development of effective strategies for the diffusion of innovations are presented.

Measurement of self-efficacy for diet-related behaviors among elementary school children.

Health promotion interventions intended to improve dietary behavior frequently incorporate self-efficacy as a construct to enhance behavior change. This paper presents results from a study to establish psychometric properties of a scale to measure children's self-efficacy for selecting healthful food. As part of a series of pilot studies to develop instrumentation for the Child and Adolescent Trial for Cardiovascular Health (CATCH), data were collected on third and fourth grade students (n = 1,127). Data analyses were conducted to estimate internal consistency, test-retest reliability, factorial validity, and criterion related validity. Results revealed acceptable estimates of internal consistency for the dietary self-efficacy scale (coefficient alpha = .84). Self-efficacy was strong associated with the children's usual food choices, accounting for about 34% of variance (Multiple R = .58). Findings support using such an instrument for evaluating intervention programs addressing nutrition behavior and for studies to determine the association of self-efficacy to dietary behavior or related constructs.

The effect of two types of teacher training on implementation of Smart Choices: a tobacco prevention curriculum.

This study examined the implementation phase of a four-year research project to test the effectiveness of strategies to increase diffusion of Smart Choices, a school-based tobacco prevention program. The impact on curriculum implementation of two approaches to teacher training are compared. School districts were randomly assigned to a live workshop training or video training condition. The outcome of the evaluation was teachers' implementation of Smart Choices. Results show a lower proportion of video-trained teachers implemented the curriculum, but overall completeness and fidelity of implementation for those teachers who did teach the curriculum were comparable for the two groups. Video-trained teachers, however, were less likely to use brainstorming and student presentations/role plays, two of the methods prescribed by the curriculum. Implications of the results for teacher training are discussed.

Around-the-clock medical coverage.

Marrying workers' compensation and health insurance plans to reduce administrative workloads and get a firm grip on expenses. Can it work?