Genetic analyses of the parasitic nematode, Parelaphostrongylus tenuis, in Missouri and Kentucky reveal unexpected levels of diversity and population differentiation.

Wildlife translocations, which involve the introduction of naive hosts into new environments with novel pathogens, invariably pose an increased risk of disease. The meningeal worm Parelaphostrongylus tenuis is a nematode parasite of the white-tailed deer (Odocoileus virginianus), which serves as its primary host and rarely suffers adverse effects from infection. Attempts to restore elk (Cervus canadensis) to the eastern US have been hampered by disease caused by this parasite. Using DNA sequence data from mitochondrial and nuclear genes, we examined the hypothesis that elk translocated within the eastern US could be exposed to novel genetic variants of P. tenuis by detailing the genetic structure among P. tenuis taken from white-tailed deer and elk at a source (Kentucky) and a release site (Missouri). We found high levels of diversity at both mitochondrial and nuclear DNA in Missouri and Kentucky and a high level of differentiation between states. Our results highlight the importance of considering the potential for increased disease risk from exposure to novel strains of parasites in the decision-making process of a reintroduction or restoration.

Increased detection of mastitis pathogens by real-time PCR compared to bacterial culture.

Rapid and accurate identification of mastitis pathogens is important for disease control. Bacterial culture and isolate identification is considered the gold standard in mastitis diagnosis but is time consuming and results in many culture-negative samples. Identification of mastitis pathogens by PCR has been proposed as a fast and sensitive alternative to bacterial culture. The results of bacterial culture and PCR for the identification of the aetiological agent of clinical mastitis were compared. The pathogen identified by traditional culture methods was also detected by PCR in 98 per cent of cases indicating good agreement between the positive results of bacterial culture and PCR. A mastitis pathogen could not be recovered from approximately 30 per cent of samples by bacterial culture, however, an aetiological agent was identified by PCR in 79 per cent of these samples. Therefore, a mastitis pathogen was detected in significantly more milk samples by PCR than by bacterial culture (92 per cent and 70 per cent, respectively) although the clinical relevance of PCR-positive culture-negative results remains controversial. A mixed infection of two or more mastitis pathogens was also detected more commonly by PCR. Culture-negative samples due to undetected Staphylococcus aureus infections were rare. The use of PCR technology may assist in rapid mastitis diagnosis, however, accurate interpretation of PCR results in the absence of bacterial culture remains problematic.

Pathogen profile of clinical mastitis in Irish milk-recording herds reveals a complex aetiology.

Effective mastitis control requires knowledge of the predominant pathogen challenges on the farm. In order to quantify this challenge, the aetiological agents associated with clinical mastitis in 30 milk-recording dairy herds in Ireland over a complete lactation were investigated. Standard bacteriology was performed on 630 pretreatment quarter milk samples, of which 56 per cent were culture-positive, 42 per cent culture-negative and 2 per cent contaminated. Two micro-organisms were isolated from almost 5 per cent of the culture-positive samples. The bacteria isolated were Staphylococcus aureus (23 per cent), Streptococcus uberis (17 per cent), Escherichia coli (9 per cent), Streptococcus species (6 per cent), coagulase-negative Staphylococci (4 per cent) and other species (1 per cent). A wide variety of bacterial species were associated with clinical mastitis, with S aureus the most prevalent pathogen overall, followed by S uberis. However, the bacterial challenges varied widely from farm to farm. In comparison with previous reports, in the present study, the contagious pathogens S aureus and Streptococcus agalactiae were less commonly associated with clinical mastitis, whereas, the environmental pathogens S uberis and E coli were found more commonly associated with clinical mastitis. While S aureus remains the pathogen most commonly associated with intramammary infection in these herds, environmental pathogens, such as S uberis and E coli also present a considerable challenge.

Assessing parenting competence in child protection cases: a clinical practice model.

Evaluating parents in the context of possible abuse or neglect involves unique challenges. This paper describes a practice model for conducting clinical evaluations of parents' ability to care for young children (under age 8). Core features of the model include (a) a focus on parenting qualities and the parent-child relationship, (b) a functional approach emphasizing behaviors and skills in everyday performance, and (c) application of a minimal parenting standard. Several factors complicate the assessment task, namely, the absence of universally accepted standards of minimal parenting adequacy, the coercive context of the assessment, the scarcity of appropriate measures, difficulties predicting future behavior, and the likely use of the evaluation in legal proceedings. In the proposed model, the evaluator (a) clarifies specific referral questions in advance; (b) uses a multimethod, multisource, multisession approach; (c) organizes findings in terms of parent-child fit; (d) prepares an objective, behaviorally descriptive report that articulates the logic for the evaluator's clinical opinions regarding the referral questions; and (e) refrains from offering opinions regarding ultimate legal issues. The paper describes requisite skills needed to conduct parental fitness evaluations, sample methods, and a protocol for writing the evaluation report.

Clinical assessment of parents in child protection cases: an empirical analysis.

We investigated the content and legal relevance of clinical evaluations of parents conducted in child abuse and neglect cases. The sample consisted of 190 mental health evaluation reports, randomly selected from major providers, that had been completed on parents involved in a large, urban juvenile court system. We coded evaluations on 170 objective and qualitative characteristics in order to assess for criteria recommended in the forensic literature. We compared evaluations across groups categorized by type (e.g., psychological, psychiatric, bonding/parenting, substance abuse) and where the assessments were performed (outside or inside the court). We found numerous substantive failures to meet those criteria for forensic relevance. Evaluations of parents typically were completed in a single session, rarely included a home visit, used few if any sources of information other than the parent, often cited no previous written reports, rarely used behavioral methods, stated purposes in general rather than specific terms, emphasized weaknesses over strengths in reporting results, and often neglected to describe the parent's caregiving qualities or the child's relationship with the parent. Some relevant differences were evident across assessment groups, pointing to examples of more thorough, parenting-specific evaluation practices. We recommend ways to improve current practices in forensic parenting assessment.

Psychosocial correlates of child abuse potential in multiply disadvantaged adolescent mothers.

OBJECTIVE: This study had two aims: First to examine psychosocial correlates of child maltreatment risk, and second to assess the validity of the CAP Inventory (Milner, 1986) with multiply disadvantaged teenage mothers. METHOD: Participants were 75 adolescent mothers who were wards of the Illinois child protection system. Mothers (aged 14-18) and infants participated in home-based psychosocial assessment of personal and parenting functioning. Group comparisons examined differences for mothers with elevated versus normal versus invalid CAP scores due to faking good. RESULTS: Findings indicated that abuse risk groups differed on emotional distress, social support satisfaction, reading achievement, and years of education, but not on parenting beliefs or quality of child stimulation. Differences favored the normal over the elevated risk group in all significant comparisons, whereas mothers with elevated faking good differed from normals only in lower reading achievement. Multiple regression analysis highlighted emotional distress, support dissatisfaction, and low achievement as significant predictors of greater abuse risk. CONCLUSIONS: Despite sharing multiple disadvantages, adolescent wards are a heterogeneous group who show different levels of psychosocial functioning corresponding to levels of child maltreatment risk. The findings provide support for the concurrent validity and clinical applicability of the CAP Inventory with disadvantaged teenage mothers.

Effect of tricyclic antidepressants on taste responses in humans and gerbils.

One of the side effects of antidepressant pharmacotherapy reported clinically is impairment of the sense of taste. In this study, the taste effects of four tricyclic antidepressant compounds (clomipramine HCl, desipramine HCl, doxepin HCl, and imipramine HCl) were evaluated experimentally by topical application of the drugs to the tongue. Taste detection threshold concentrations for all four medications ranged from 0.1 mM to 0.2 mM in young persons but were elevated by as much as 7.71 times that in elderly individuals who were taking no concurrent medications. Each compound had a predominantly bitter taste with other qualities including metallic, sour, and sharp-pungent. In addition, each tricyclic antidepressant at concentrations from 1 mM to 5 mM blocked responses to a wide range of taste stimuli in both humans and gerbils. The differential suppression of other tastes by tricyclic antidepressants at the level of the taste receptors may contribute to the clinical reports of dysgeusia and hypogeusia.

Two prenatal alcohol use screening instruments compared with a physiologic measure.

OBJECTIVE: To compare two prenatal alcohol use screening instruments with a physiologic measure of prenatal alcohol use. DESIGN: Retrospective comparison of the Prenatal Alcohol Use Interview (PAUI) and the ACOG Antepartum Record with CDTect. SETTING: An inner-city, high-volume, prenatal clinic. PARTICIPANTS: Fifty-six women selected and enrolled at their first prenatal visits. MAIN OUTCOME MEASURE: An assessment of relative sensitivity and specificity of two prenatal alcohol use screening instruments. RESULTS: Women identified as Drinkers by the CDTect were more likely to be identified as Drinkers by the PAUI (59%) than by the ACOG Antepartum Record (19%). Also, the PAUI had a lower false negative rate (41%) than the ACOG record (80%). That is, the PAUI was less likely to identify as Quitters women the CDTect identified as Drinkers than was the ACOG record. CONCLUSION: The PAUI is a more sensitive screen than the ACOG record and should be the instrument preferred for screening prenatal alcohol use.

The economics of electronic journals.

High print journal subscription costs, access to desktop publishing software, and awareness of Internet capability are among several reasons that interest in the electronic publishing of scholarly journals is increasing rapidly. The economic considerations of electronic publishing are not as familiar, however, although the fingertip accessibility of electronic journals, and in some cases, the lack of subscription charges gives the impression that electronic journal publishing is a much less costly means of publishing. Such an impression receives qualified confirmation in this article as an overview of the costs of scholarly publishing is provided, and the costs of print and electronic journals are compared. Also addressed are ways to recover costs of publishing electronic journals, and predictions for the future of such journals.

Psychometric analysis of the self-coherence survey.

Self-coherence, as measured by the Self-Coherence Survey, is an important determinant of psychosocial health in a variety of life circumstances. This report presents a psychometric analysis of the Self-Coherence Survey that resulted in three scales labelled Appraisal, Holism, and Introspection. The factorial structure, reliability, and validity of Self-Coherence was evaluated and replicated in two samples from the same community population (Phase I n = 433; Phase II n = 421). The three dimensions identified in the theoretical discussion of self-coherence published in this journal in 1993, were identified and replicated. Implications for further research and nursing practice are discussed.

Medical student attrition: a 10-year survey in one medical school.

Medical student wastage leads to adverse emotional and social consequences for individual students and financial difficulties and morale problems for medical schools. This study retrospectively assessed the records of all students at Leeds School of Medicine who left the course prematurely between 1983 and 1992. The demographic data of the leavers were compared with those of all students entering the school during the 10 years studied. A-level examination choices and results of the leavers were compared with those of a control group of all students who entered the school in 1990. The attrition rate over the 10 years was 14% (283 students), with more males than females leaving. Fewer mature students than expected left the course. More leavers had A-level physics and lacked A-level biology compared with the control group. The leavers were academically less able than the controls. Fifty-three per cent of leavers were asked to withdraw from the course for academic reasons; the rest left voluntarily. Thirty per cent had personal problems, 9% had a combination of academic and personal problems and 8% had health problems (psychological difficulties were the commonest). Seventy-one per cent of leavers entered another degree course; science degrees were the most popular. Reasons for medical student wastage and possible solutions are discussed.

Perinatal substance use: promoting abstinence in acute care settings.

All health-care providers need to understand the effects of alcohol, nicotine, and other drugs on the mother and developing fetus and the ways to promote abstinence or at least a decrease in use. The use of these substances may produce chronic and/or catastrophic effects that force the pregnant woman into contact with the health-care system. Such contact can produce a healthier outcome for both the mother and fetus if it includes identification of substance use and intervention to promote abstinence. In this article, the author describes the consequences of prenatal substance use for the mother and fetus, identifies techniques used to screen and assess prenatal substance use, and explains strategies used to intervene in prenatal substance use.

The Children's Headache Assessment Scale (CHAS): factor structure and psychometric properties.

This study investigated the content validity, factor structure, and psychometric properties of the Children's Headache Assessment Scale (CHAS), a parent rating scale for identifying environmental variables associated with pediatric headache. In Study 1, input from physicians and psychologists was obtained to develop a revised set of 44 items receiving high endorsement. In Study 2, the questionnaire was administered to parents of 92 child headache sufferers, ages 6-16, and readministered 2 weeks later. An exploratory factor analysis revealed five factors (Disruptive Impact, Social Consequences, Stress Antecedents, Physical Antecedents and Quiet Coping, and Prescription Medication Use) that reflect distinct environmental concomitants of childhood headache. Scale reliabilities (alpha, .64-.82) indicate acceptable internal consistency, and test-retest reliabilities indicate relatively stable factors and items. High scores on the Disruptive Impact factor were associated with more severe, lengthy, and infrequent headache occurrence, lending initial support for the validity of this factor. Overall, the findings support the clinical and research utility of the CHAS in behavioral treatment of childhood headache.

Chronic pain--challenge and response.

Tramadol is effective in treating both acute and chronic pain, exhibiting a potency equivalent to that of pethidine, and it has an acceptable adverse event profile. Whilst the most common adverse events are nausea, vomiting, drowsiness and dizziness, as would be expected from an opioid, there is a noticeable lack of respiratory depression. This latter property, together with its low potential for the development of tolerance and dependence, make tramadol a most interesting agent for clinical use. The studies reported in this article illustrate the beneficial and adverse effects of tramadol to enable the clinician to judge the value of this agent.