Graduate students' perspectives on the role of faculty advisors in helping students with mental health problems.

Objective: Graduate students are more likely to experience mental illness than their peers in the general population. One potential source of support for personal issues and/or mental illness is a graduate student's faculty advisor. Although the relationship between faculty advisors and graduate students can positively influence the success and overall well-being of graduate students, graduate students may be reluctant to disclose mental health issues to their advisors. This study explores graduate students' perspectives on factors that influence their decision to disclose, or not to disclose, personal mental health information to their faculty advisor. Participants: The participants for this study were 28 graduate students from three universities in the southern United States. Methods: Four semi-structured focus groups were conducted over Zoom. Results: Thematic analysis of a series of focus groups with graduate students identified several consistent themes related to this disclosure decision-making process. Conclusions: Results have implications for mental health literacy and interpersonal communication interventions for those charged with mentoring graduate students.

Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement.

INTRODUCTION: Hyperbaric oxygen therapy (HBO2) has been utilized for many years for a multitude of disease entities. One commonly encountered side-effect is otic barotrauma. OBJECTIVE: To determine if patients with specific disease processes are at increased risk of requiring tympanostomy tubes during HBO2. METHODS: Data was obtained from Jan. 2000 to Dec. 2004, retrospectively. The requirement for tympanostomy tubes during a course of HBO2 was established. RESULTS: 325 met inclusion criteria. Fifteen percent of patients overall (95% CI= 11-19%) required tympanostomy tubes. Tubes were required in: 5% necrotizing soft tissue infection (p=0.33); 10% failed/threatened graft (p=0.39); 15% problem wounds; 17% chronic refractory osteomyelitis (CRO) (p=0.64); 22% soft tissue radionecrosis (STRN)/osteoradionecrosis (ORN) (p=0.02); 33% of crush injuries (p=0.10). Twenty-nine percent of nasopharyngeal radiation injury patients (p=0.001) and 10% of the non-nasopharyngeal radiation patients (p=0.36) received tympanostomy tubes. CONCLUSION: A significant increase in tympanostomy tubes were required in nasopharyngeal radiation injury patients.

Suppression of Rotylenchulus reniformis on Cotton by the Nematophagous Fungus ARF.

The reniform nematode, Rotylenchulus reniformis Linford &Oliveira, has become a serious threat to cotton (Gossypium hirsutum L.) production in the United States during the past decade. The objective of this study is to isolate fungi from eggs of R. reniformis and select potential biological control agents for R. reniformis on cotton. Soil samples were collected from cotton fields located in Jefferson County, Arkansas. Eight genera of fungi were included in the 128 fungal isolates obtained, and among them were five strains of the nematophagous fungus ARF. The mtDNA RFLP pattern, colony growth characteristics, and pathogenicity indicate the five ARF isolates represent one described strain and one new strain. Light and electron microscopic observations suggest ARF is an active parasite of R. reniformis, with parasitism ranging from 48% to 79% in in vitro tests. Three greenhouse experiments demonstrated ARF successfully suppressed the number of reniform nematodes during the first and second generation of the nematode. Reductions in numbers of R. reniformis on the roots for the seven application rates of 0.01%, 0.05%, 0.1%, 0.2%, 0.3%, 0.4%, and 0.5% ARF were 87%, 92%, 94%, 96%, 97%, 98%, and and 98%, respectively.

Decomposition of Plant Debris by the Nematophagous Fungus ARF.

In the study of the biological control of plant-parasitic nematodes, knowledge of the saprophytic ability of a nematophagous fungus is necessary to understand its establishment and survival in the soil. The objectives of this study were (i) to determine if the nematophagous fungus ARF (Arkansas Fungus) shows differential use of plant residues; and (ii) to determine if ARF still existed in the soil of a field in which ARF was found originally and in which the population level of Heterodera glycines had remained very low, despite 15 years of continuous, susceptible soybean. Laboratory studies of the decomposition of wheat straw or soybean root by ARF were conducted in two separate experiments, using a CO collection apparatus, where CO-free air was passed through sterilized cotton to remove the microorganisms in the air and then was passed over the samples, and evolved CO was trapped by KOH. Milligrams of C as CO was used to calculate the percentage decomposition of the plant debris by ARF. Data indicated ARF decomposed 11.7% of total organic carbon of the wheat straw and 20.1% of the soybean roots in 6 weeks. In the field soil study, 21 soil samples were taken randomly from the field. Only 3 months after the infestation of the soil with H. glycines, the percentage of parasitized eggs of H. glycines reached 64 +/- 19%, and ARF was isolated from most parasitized eggs of H. glycines. Research results indicated ARF could use plant residues to survive.

Reducing major identification errors within a deployed phlebotomy process.

To achieve a patient-focused care environment, many hospitals are moving phlebotomy from the laboratory to the nursing units. Although this move has benefits, it also can bring an increase in error rates. The Valley Hospital in Ridgewood, New Jersey, implemented the BD Dx System patient identification system (Becton Dickinson, Franklin Lakes, New Jersey) in an effort to reduce the incidence of phlebotomy errors. This article discusses how to identify key factors in deploying phlebotomy, to analyze the specimen collection process, to set baselines for identification of errors, to identify critical steps in the blood collection process for error reduction, and to reduce errors by using the new hand-held computer technology for patient and specimen identification.

How helpful are drug abuse helplines?

Raters called a convenience sample of 30 helplines and claimed to be alcohol, cocaine, heroin, marijuana or tobacco dependent persons seeking treatment. Responses were categorized as helpful, neutral or unhelpful. The median Kappa for agreement between pairs of raters rating a single call was 0.91. Between 36 and 78% of the helplines gave inconsistent responses to two calls giving the same scenario. Across the 346 calls, 43, 40 and 40% of responses to alcohol, cocaine and heroin scenarios were helpful and 28 and 25% of responses to tobacco and marijuana calls were helpful. These preliminary results indicate that much of the time responses to calls to national helplines are not consistent and not helpful.

Positive outcomes in traumatic brain injury-vegetative state: patients treated with bromocriptine.

OBJECTIVE: To assess the effects of multidisciplinary rehabilitation interventions and use of bromocriptine on outcome in patients with traumatic brain injury-vegetative state (TBI-VS). DESIGN: Retrospective review of clinical cases. SETTING: Free-standing rehabilitation hospital; Acute and extended rehabilitation hospital. PARTICIPANTS: Five consecutive TBI-VS patients, as well as 33 TBI-VS patients and 37 traumatic brain injury-minimally conscious state (TBI-MCS) patients reported in the literature. INTERVENTIONS: Bromocriptine administration, systematic neuropsychologic testing, sensory stimulation, and traditional comprehensive rehabilitation with physical therapy, occupational therapy, and speech therapy. MAIN OUTCOME MEASURES: Disability Rating Scale (DRS) at 1, 3, 6, and 12 months postinjury and FIM instrument scores at 1 month and 12 months postinjury, Coma Recovery Scale, and Barry Rehabilitation Inpatient Screening of Cognition. RESULTS: The 5 TBI-VS patients emerged from a VS into a MCS and regained functional status. Their recovery of physical and cognitive functioning, as rated by the DRS, was greater than previously reported in the literature for patients in a VS or MCS at 3, 6, and 12 months postinjury. CONCLUSION: Bromocriptine administration, systematic neuropsychologic testing, sensory stimulation, a comprehensive rehabilitation program, or a combination of these treatments may enhance functional recovery in this TBI-VS patient group. Further systematic study to quantify the contribution of these variables and to reproduce this data in a larger patient population should be performed.

Two behavioral treatments for smoking reduction: a pilot study.

This study compared two behavioral treatments on their efficacy and acceptability in reducing smoking, using a crossover design with interposed return to baseline, 2 weeks/condition. 20 US cigarette smokers reporting an interest in reducing, but not quitting, their smoking either increased the inter-cigarette interval or selected easy cigarettes to eliminate, with a goal of 50% reduction. Nicotine gum accompanied both treatments. Measurements taken were self-reported cigarettes per day, carbon monoxide, cotinine, and thiocyanate; self-rated acceptability of the treatments; adverse events. Both treatments decreased self-reported cigarettes per day (-45% and -38%) and carbon monoxide (-20% and -19%), but not cotinine or thiocyanate. Increasing the inter-cigarette interval produced slightly more reduction in cigarettes per day than cigarette selection, but no other differences were found. Both treatments were acceptable and safe. Although our sample size was small and the duration of reduction documented short, both treatments appear to be acceptable and efficacious behavioral treatments for reduction.

Overwinter Population Dynamics of Heterodera glycines.

The purpose of this research was to compare the overwinter survival of populations of Heterodera glycines at different latitudes in the United States and the effect of changing latitudes before and after the initiation of dormancy. Soil samples infested with H. glycines were collected in August or October in 1992 to 1994 from soybean fields in two to four states (combinations of Arkansas, Florida, Minnesota, Missouri, and Wisconsin). The samples were mixed thoroughly, divided into subsamples, shipped to an overwinter location, and buried until time for processing. To determine survival, cysts, eggs, and second-stage juveniles were extracted from replicated subsamples and counted each month from December to May. Survival generally was between 50% and 100%, and often was best in the state of origin. In Florida, survival was at the 50 to 100% level in soil from most locations, and in Wisconsin was near 100%. Survival of H. glycines in Arkansas and Missouri varied more than at the other locations. In a separate test, survival in microplots in Arkansas, in a more natural environment than that of buried samples, was 70 to 94% for field isolates from Arkansas, Minnesota, and Missouri and 100% for isolates of races 1, 3, and 14 that had been maintained in a greenhouse for several years. Survival appears to be better than previous tests had indicated. High survival rates require cultivars with high levels of resistance and long-term rotations for management.

Planting Date and Soybean Cultivar Maturity Group Affect Population Dynamics of Heterodera glycines, and All Affect Yield of Soybean.

Five soybean cultivars, one each from Maturity Groups (MG) III, IV, V, VI, and VII, all susceptible to Heterodera glycines, were planted in H. glycines-infested soil in April, May, June, and July at multiple locations in Arkansas and Missouri. The purpose of the study was to determine whether planting early reduces yield losses due to H. glycines. The population levels of cysts, eggs, and secondstage juveniles of H. glycines were determined from soil samples collected at planting and harvest. Yields were measured from the two middle rows of 4.9 or 6.1-m four-row plots. The population dynamics of the nematode varied with planting date, cultivar, MG, and initial nematode population. Generally, the lowest reproductive factor (Rf = final population/initial population) for any year was on the MG III cultivar, regardless of planting date or field location. Also, the Rf was generally lower on each cultivar planted in April than in June or July. The highest Rf values were on cultivars in MG VI or VII planted in June or July. Yields were not consistently correlated with initial nematode population level. Early planting of late-maturing soybean cultivars may be profitable, but early planting of MG III cultivars, though supporting little if any increase in nematode numbers, did not result in high yields.

Control of soybean cyst nematode by chitinolytic bacteria with chitin substrate.

Sixty-four chitinolytic bacterial isolates from soybean fields in Arkansas were tested for suppression of soybean cyst nematode (Heterodera glycines) in a heat-treated silt loam soil amended with 0.6% (w/w) chitin in a greenhouse. Five isolates consistently reduced numbers of H. glycines compared to controls receiving neither chitin nor bacteria, or only chitin. Four of the five isolates interacted with the chitin substrate to enhance its effectiveness in reducing numbers of the nematode. The size of the clear-zone produced by some of the isolates in colloidal chitin medium, an indication of chitinolytic activity in vitro, was not related to suppression of nematode numbers in soil.

Effects of Rhizobacteria on Soybean Cyst Nematode, Heterodera glycines.

Rhizobacteria were isolated from the rhizoplane and rhizosphere of soybean plants from fields in Arkansas and tested for their effect on numbers of soybean cyst nematode (Heterodera glycines). In initial greenhouse tests in heat-treated silt loam soil, 138 of the 201 bacterial isolates tested had no influence on numbers of cysts and eggs + second-stage juveniles (J2) of H. glycines, 36 reduced (suppressive isolates) and 27 increased (enhancing isolates) numbers of cysts and (or) eggs + J2 when compared to the controls (P

Rapid-sequence intubation at an emergency medicine residency: success rate and adverse events during a two-year period.

OBJECTIVES: Rapid-sequence intubation (RSI) is an active airway intervention used frequently in emergency medicine (EM). The authors hypothesized that RSI can be performed safely in the setting of an EM training program at a tertiary care center. METHODS: Observational study of RSI at an urban ED/Level 1 trauma center with annual census of 100,000 patients. Consecutive patients who underwent RSI during a two-year period were studied. Data included age, gender, type of patient (medical/trauma), indication for intubation, number of intubation attempts (laryngoscope passes), training level of operator, and major immediate adverse events (clinical deterioration within 10 minutes of RSI). RESULTS: RSI was used in 417 of 596 (70%) critically ill patients requiring emergent intubation. The patient demographic distribution was the following: adults 89.7%, male 58%, and trauma 44%. Primary indications for intubation among RSI patients were as follows: mechanical ventilation 57.4%, airway protection 41.3%, and cardiac arrest 1.3%. Distribution of intubations by level of EM training was PGY1, 5%; PGY2, 52%; PGY3, 40%; and attendings, 3%. Intubations were successfully completed within two attempts in 97% of the patients. Major immediate adverse events were encountered in six patients (1.4%) (hypotention=2, hypoxemia=1, dysrhythmia=3). There was no death attributable to RSI. The rate of intubations requiring two or fewer attempts and without major immediate adverse events was 96%. Three patients required cricothyrotomy. CONCLUSION: In the setting of an EM residency at a tertiary care ED, RSI can be performed successfully with few major immediate adverse events.

Y-site stability of fosphenytoin and sodium phenobarbital.

Fosphenytoin and sodium phenobarbital in 0.9% sodium chloride injection were analyzed in a simulated Y-site admixture. Each drug was analyzed for stability by high-pressure liquid chromatography (HPLC) from three simulated Y-site samples over an eight-hour period. The HPLC assay results indicate that both fosphenytoin and sodium phenobarbital are stable together at a Y site over an eight-hour period. In addition, there was no change in sample clarity or pH over the same period. The results indicate that, when medically necessary, fosphenytoin and sodium phenobarbital in 0.9% sodium chloride injection can be administered via the same intravenous line.

Fosphenytoin y-site stability studies with Lorazepam and midazolam hydrochloride.

The treatment of status epilepticus may require in certain situations the concurrent administration of lorazepam or midazolam with fosphenytoin. Simulated Y-site fosphenytoin/lorazepam and fosphenytoin/midazolam hydrochloride admixtures, respectively, in 0.9% sodium chloride injection were analyzed using a stability-indicating high-performance liquid chromatography (HPLC) method. Each drug was analyzed for stability by HPLC from three simulated Y-site samples over an eight-hour period. The HPLC assay results indicate that both fosphenytoin and lorazepam are stable together at a Y site over an eight-hour period. In addition, there was neither a change in sample clarity nor a change in pH over the same period. The results indicate that, when medically necessary, fosphenytoin and lorazepam in 0.9% sodium chloride injection can be administered via the same intravenous (IV) line. Midazolam free base was precipitated upon admixture of midazolam hydrochloride and fosphenytoin solutions. Therefore, midazolam hydrochloride and fosphenytoin should not be given via the same IV line.

Stability of Dobutamine Hydrochloride 4mg/mL in 5% Dextrose Injection at 5 and 23 deg C.

The stability of dobutamine hydrochloride 4 mg/mL in 5% dextrose injection has been studied using a stability-indicating, high-performance liquid chromatography assay method. The admixture injections were stable for 30 days at 5 and 23 deg C. Concentrations ranged between 98.5% and 102.6% for the room-temperature samples, and 99.6% and 101.8% for the refrigerated samples, of the initial mean concentrations. The standard curves demonstrated linearity (r2>.999). Variations within and between days were less than 3%. None of the samples appeared to form a visible precipitate or changed in color or clarity and the pH of the samples remained between 3.5 and 3.7.

Variations in Host Preference among and within Populations of Heterodera trifolii and Related Species.

Seven populations of Heterodera trifolii from Arkansas, Kentucky, Pennsylvania, and Australia plus 3 or 4 single-cyst isolates (SCI) from each population were tested for reproduction on seven species of plants to compare the host preferences among and within populations. Common lespedeza, Kummerowia striata cv. Kobe, was a good host for all populations and isolates. Therefore, a plant was considered to be a host if the number of females produced on it was 10% or more of the number on Kobe. All seven populations reproduced on Trifolium repens and T. pratense. None reproduced on Beta vulgaris or Glycine max. One single-cyst isolate from the Australian population produced a few females on T. pratense. The Australian population maintained on carnation, Dianthus caryophyllus, produced females on carnation but not on curly dock, Rumex crispus. However, its subpopulation maintained on T. repens produced females on R. crispus but not on carnation. Four of the other six populations produced females on R. crispus, and four produced females on carnation. Differences in host range were observed among seven of the mother populations and their SCI, and among isolates within each population. Five host range patterns were found in populations and SCI of H. trifolii. Significant quantitative differences occurred among populations in the numbers of females on most hosts, between isolates and their original populations, and among isolates from the same population. SCI selected from white clover produced fewer females on a series of test hosts and had host ranges the same as or narrower than those of the original populations. However, SCI selected from Kobe lespedeza had more females on some hosts and had host ranges the same as or wider than those of the original populations. The host ranges of all populations and SCI of H. trifolii were different from those of populations and SCI of race 3 of H. glycines and H. lespedezae.

Parasitism of Sedentary Stages of Heterodera glycines by Isolates of a Sterile Nematophagous Fungus.

ABSTRACT Isolates of a sterile fungus designated ARF (Arkansas fungus) can be separated into two groups, ARF-C and ARF-L, that differ morphologically and in their ability to suppress numbers of Heterodera glycines on soybean. Our objectives were to determine if the two ARF groups differed in their ability to parasitize juveniles, females, and eggs in the rhizo-sphere of soybean and to proliferate in soil. The experiments were conducted in a greenhouse using soil infested with homogenized ARF mycelium. The ARF-L isolates parasitized more juveniles and young females than did the ARF-C isolates. Suppression of these stages was 67% for ARF-L and 12% for ARF-C isolates 14 days after nematode inoculation. When soybean plants containing gravid females were transplanted into fungus-infested soil, ARF-L isolates parasitized 55 to 98% of nematode eggs, whereas ARF-C isolates parasitized 0 to 22%. In both heat-treated and nonheated soil, the biomass of mycelial mats, a measure of relative proliferation, tended to be greater for ARF-L than for ARF-C isolates. The ability of ARF-L isolates to parasitize a large percentage of both pre-reproductive stages and eggs of H. glycines may contribute to its effectiveness as a biological control agent.

The effectiveness of a tobacco prevention program with adolescents living in a tobacco-producing region.

OBJECTIVES: This study investigated the efficacy of a social-influences tobacco prevention program conducted with adolescents living in a high tobacco production area. METHODS: Students in 10 experimental schools completed the tobacco prevention program and a booster intervention. Control students received health education as usual. RESULTS: After 2 years of treatment, smoking rates in the treatment group (vs the control group) were lower for 30-day, 7-day, and 24-hour smoking. The intervention had more of an impact on those who were involved in raising tobacco than it did on those not involved in raising tobacco. CONCLUSIONS: Although modest, effects were achieved with minimal intervention time in a high-risk group, indicating that social-influences prevention programs may be effective in such groups.