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PubMed2001

Conflict and healing in family experience of second-generation emigrants from India living in North America.

In this article, I describe a study that generates a substantive theory of healing from the conflict experienced by second-generation emigrants from India living in North America. Qualitative methodology, specifically, the Grounded Theory method of data analysis and theory building, was used. Literature elucidating the differences between North American and Indian cultural values was used as a basis for exploration. Results suggest that cultural conflict stems from areas such as education and success, pressure from parents to maintain traditional cultural values, family bonds and lack of boundaries, parental control and abuse, and dating and marriage. The results of the conflict are discussed by participants in terms of loneliness and pain, lying, rebellion, or acceptance of cultural values. The factors that mediate the conflict and that determine the degree to which participants rebel or accept the cultural values seem to be linked to the approval and acceptance individuals received from their family or community and their level of self-esteem. Finally, I discuss how individuals can heal from the conflict. Methods of healing include communication with and education for parents, therapy in the areas of anger, resentment, and self-esteem, and developing an alternative support system, which may include other second-generation individuals.

Adult↗
PubMed2002

Dosimetry and mechanical accuracy of the first rotating gamma system installed in North America.

The purpose of this paper is to present the dosimetry and mechanical accuracy of the first rotating gamma system (RGS) installed in North America for stereotactic radiosurgery. The data were obtained during the installation, acceptance test procedure, and commissioning of the unit. The RGS unit installed at UC Davis Cancer Center (RGSu) has modifications on the source and collimator bodies from the earlier version of the Chinese RGS (RGSc). The differences between these two RGSs are presented. The absolute dose at the focal point was measured in a 16-cm-diam acrylic phantom using a small volume chamber, which was calibrated at the University of Wisconsin Accredited Dosimetry Calibration Laboratory (UW-ADCL). The dose in acrylic was then converted to a dose in water. A collimator output factor from each of the four different collimator sizes ranging from 4, 8, 14, and 18 mm was measured with (1) a smaller volume chamber and (2) approximately 3.0 mm x 3.0 mm x 1.0 mm TLD chips in the same acrylic phantom. The Gafchromic films were used for the dose profile, collimator output factor, and mechanical/radiation field isocentricity measurements. The TLD chips were processed in-house whereas Gafchromic films were processed both at the UW-ADCL and in-house. The timer error, timer accuracy, and timer linearity were also determined. The dose profiles were found to be similar between RGSc and RGSu. The 4 mm collimator output factor of the RGSu was approximately 0.6, similar to that from RGSc, in comparison to 0.8 in the report for a Leksell Model U Gamma-Knife. The mechanical/radiation field isocentricity for RGSc and RGSu is found to be similar and is within 0.3 mm in both X and Y directions. In the Z direction, the beam center of the RGSu is shifted toward the sources by 0.75 mm from the mechanical isocenter whereas no data are available for RGSc. Little dosimetric difference is found between RGSu and RGSc. It is reported that RGSc has the same dosimetric and mechanical characteristics as the Model U Gamma-Knife. Therefore, RGSu should be capable of achieving stereotactic radiosurgery with the same degree of dosimetric and mechanical accuracy as with the Gamma-Knife.

California↗
PubMed2000

Phellinus Weirii and Other Native Root Pathogens as Determinants of Forest Structure and Process in Western North America.

The population structure and ecological roles of the indigenous pathogen Phellinus weirii, cause of laminated root rot in conifer forests of western North America, are examined. This pathogen kills trees in slowly expanding mortality centers, creating gaps in the forest canopy. It is widespread, locally abundant, and very long-lived. It is among the most important disturbance agents in the long intervals between stand-replacing events such as wildfire or harvest in these ecosystems and shapes the structure and composition of both wild and managed forests. Trees are infected and killed regardless of individual vigor. Management of public lands is changing dramatically, with renewed emphasis on natural forest structures and processes but pathogens, especially root rot fungi, remain a significant challenge to "ecosystem management."

Douglas-fir↗
PubMed2005

[Differentiation of Dolly Varden char Salvelinus malma from Asia and North America inferred from PCR-RFLP analysis of mitochondrial DNA].

Genetic differentiation of Dolly Varden char Salvelinus malma Walbaum from the Asian and North American Pacific coasts was studied. We examined restriction fragment length polymorphism of three mitochondrial DNA (mtDNA) fragments amplified in polymerase chain reaction, which encoded four NADH dehydrogenase subunits, the cytochrome b gene, and a D-loop segment. The mtDNA haplotypes were shown to form three phylogenetic groups, whose geographic distribution corresponded to three Dolly Varden subspecies: S. malma malma, S. malma krascheninnikovi, and S. malma lordi. The nucleotide sequence divergence between S. malma malma and S. malma krascheninnikovi was 3.8%; between S. malma malma and S. malma lordi, 3.1%; and between S. malma krascheninnikovi and S. malma lordi, 2.5%. The northern Dolly Varden S. malma malma from Asia was shown to be genetically identical to that from North America.

Animals↗
PubMed2006

Emergence of Clostridium difficile-associated disease in North America and Europe.

The clinical spectrum of Clostridium difficile-associated disease (CDAD) ranges from diarrhoea to severe life-threatening pseudomembranous colitis. Although not always associated with previous antibiotic exposure, it is in the majority of cases. CDAD is recognised increasingly in a variety of animal species and in individuals previously not considered to be predisposed. C. difficile can be transmitted via personal contact or environmentally. The role of patients and healthcare workers who are symptom-free but colonised with C. difficile in the intestinal tract is unclear. C. difficile, with more than 150 PCR ribotypes and 24 toxinotypes, has a pathogenicity locus (PaLoc) with genes encoding enterotoxin A (tcdA) and cytotoxin B (tcdB). Genes for the binary toxin are located outside the PaLoc, but the role of this toxin is unclear. The recently completed genome sequence of C. difficile 630 revealed a large proportion of 11% of mobile genetic elements, mainly in the form of conjugative transposons. Diagnostic assays include tests for the detection of C. difficile products or genes and culture methods for isolation of a toxin-producing bacterium. Enzyme immunoassays to detect toxin in faeces are widely available, with varying sensitivities and specificities. Despite practical drawbacks and sensitivity less than 100%, the cell cytototoxicity assay is still considered to be the standard. Rapid diagnostic assays are available on a limited scale and require much improvement. Molecular tests enable the detection of carriers of toxigenic and non-toxigenic strains, as does culture. It is highly recommended to culture C. difficile from toxin-positive faeces samples and to store isolates for future characterisation and typing. The financial impact of CDAD on the healthcare system is substantial (5-15,000 euro/case in England and $1.1 billion/year in the USA). Assuming a European Union population of 457 million, the potential cost of CDAD can be estimated to be 3000 million euro/year, and is expected to almost double over the next four decades. In North America, increasing rates of CDAD have been reported in Canada and the USA since March 2003, involving a more severe course, higher mortality, increased risk of relapse and more complications. This increased virulence is presumably associated with higher levels of toxin production by fluoroquinolone-resistant strains belonging to PCR ribotype 027, pulsed-field gel electrophoresis (PFGE) type NAP1, REA (restriction endonuclease analysis) type BI and toxinotype III. In Europe, outbreaks of CDAD due to the new, highly virulent strain of C. difficile PCR ribotype 027, toxinotype III have been recognised in 75 hospitals in England, 16 hospitals in The Netherlands, 13 healthcare facilities in Belgium and nine healthcare facilities in France. These outbreaks are very difficult to control, and preliminary results from case-control studies indicate a correlation with fluoroquinolones and cephalosporins. Information concerning community-acquired cases of ribotype 027 is lacking, and data concerning its incidence in nursing homes are limited. European countries should first develop early-warning and response capabilities at a national level. Depending on the nature of the notifications received, countries should implement laboratory-based or patient-based surveillance systems in specific, targeted populations.

Animals↗
PubMed1987

The earliest ether anaesthetic in British North America--a first for Saint John, New Brunswick?

Literature relating the early history of ether anaesthesia in New Brunswick which, as part of British North America was a British colony until 1867, is reviewed. There is documentary evidence that the first ether anaesthetic for dental surgery in what is now Canada, was administered in 1844 in St. John, New Brunswick. There is also documentary evidence that the first ether anaesthetic for general surgery was administered in St. John on Monday, January 18, 1847, rather than in Montreal in March, 1847.

Anesthesia, Inhalation↗
PubMed1999

Two Theileria cervi SSU RRNA gene sequence types found in isolates from white-tailed deer and elk in North America.

Two Theileria cervi SSU rRNA gene sequence Types, F and G, from white-tailed deer (Odocoileus virginianus) and elk (Cervus elaphus canadensis) isolates in North America were confirmed. Previously, nucleotide sequencing through a single variable (V4) region showed the presence of SSU rRNA gene Types F and G in T. cervi isolates from white-tailed deer and an elk. In this study, both sequence types were found in four T. cervi isolates (two from deer and two from elk). Microheterogeneity only appeared in the Type G gene, resulting in Subtypes G1, G2 and G3. Subtype G1 was found in two elk and one white-tailed deer T. cervi isolate; Subtypes G2 and G3 were found in a white-tailed deer T. cervi isolate. The Type F SSU rRNA genes were identical in nucleotide sequence in both elk and white-tailed deer T. cervi isolates. The high degree of conservation in the Type F variable regions may be exploited to design specific oligonucleotide primers for parasite detection by the polymerase chain reaction in cervine or tick hosts.

Animals↗
PubMed1980

Kawasaki disease, or mucocutaneous lymph node syndrome: report of seven cases in North America.

The clinical and laboratory findings in seven children with Kawasaki disease are reviewed. Four of the patients had the more complicated course that has characterized the cases diagnosed in North America. This suggests that the benign forms are often mistaken for other febrile illnesses. The patients were two girls and five boys ranging in age from 4 months to 7 years; six were Caucasian and one was a North American Indian. Fever, redness of the oral mucosa, an erythematous or scarlatiniform rash and cervical adenopathy were seen in all; six patients had the characteristic fingertip desquamation and nonexudative conjunctivitis. Cardiac involvement occurred in four patients, two of whom had coronary artery aneurysm or thrombosis. Arthritis or arthralgia was seen in six patients, and aseptic meningitis occurred in four. Of the three patients with jaundice two underwent laparotomy and excision of a hydropic gallbladder; one of them died from Klebsiella pneumoniae sepsis and disseminated intravascular coagulopathy.

Aspirin↗
PubMed1994

Seroprotective groups of Lyme borreliosis spirochetes from North America and Europe.

Five distinct seroprotective groups among North American and European isolates of Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii have been identified using the in vitro borreliacidal assay. The predominant North American seroprotective group comprised isolate 297 and B. burgdorferi isolates from California, Illinois, Wisconsin, New York, and Texas. A second group was represented by isolate C-1-11. The majority of European isolates belonged to a seroprotective group composed of B. garinii. Another European group contained isolates classified genetically as genospecies group VS461 (B. afzelii). A fifth group, represented by isolate LV5, could kill both North American and European isolates of B. burgdorferi sensu lato. These results suggest that combinations of immunogenic protective proteins of spirochetes will be necessary to provide a comprehensive vaccine.

Animals↗
PubMed2000

Juvenile gambling in North America: an analysis of long term trends and future prospects.

Long term trends, based on findings from twenty independent prevalence studies surveying middle and high school youth in North America, suggest that within the past year two out of three legally underage youth have gambled for money. In the United States and Canada as many as 15.3 million 12-17 year olds have been gambling with or without adult awareness or approval, and 2.2 million of these are experiencing serious gambling-related problems. Lottery play dominates legalized forms of gambling among juveniles in both the United States and Canada. Trends between 1984-1999 indicate a substantial increase in the proportion of juveniles who report gambling within the past year, and a parallel increase in the proportion of juveniles reporting serious gambling-related problems. Yet, there continues to be little public awareness or concern about the extent, or the potential hazards associated with juvenile gambling. A composite profile of juveniles reporting numerous gambling problems is contrasted with their peers who reported few or none. Future prospects concerning this growing problem are offered.

Journal Article↗
PubMed2004

Disease susceptibility to ST11 complex meningococci bearing serogroup C or W135 polysaccharide capsules, North America.

Clusters of meningococcal disease caused by a hyperinvasive lineage of Neisseria meningitidis, the ST11 complex, bearing a serogroup C polysaccharide capsule, have been prominent in Europe and North America since the early 1990s. This situation has led to expensive public health measures for outbreak control and, finally, to the introduction of a serogroup C glyconjugate vaccine into the primary immunization schedule in the United Kingdom and elsewhere. ST11 complex meningococci may also express serogroup W135 polysaccharide capsules. We investigated the level of population immunity to this hyperinvasive clone in association with the appearance of outbreaks of meningococcal disease in southern British Columbia. We found that most adults and almost all children were apparently susceptible to infection with ST11 complex meningococci bearing both C and W135 polysaccharide capsules, which suggests that a vaccine program directed against only serogroup C meningococci may be insufficient to prevent hyperinvasive ST11 disease.

Adolescent↗
PubMed1999

ERRATUM: new body mass estimates for omomys carteri, a middle eocene primate from north america. Am J phys anthropol 109:41-52

Payseur BA, Covert HA, Vinyard CJ, Dagosto M. 1999. New Body Mass Estimates for Omomys carteri, a Middle Eocene Primate From North America. Am J Phys Anthropol 109:41-52. This article included an incomplete Table 2. The final two columns, showing "Intercept" and "SEE" data were omitted. The complete Table 2, with these two columns included, is provided below.

Journal Article↗
PubMedDate not supplied

The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America.

The goal of orthopaedic interventions is to improve the functional health of patients, particularly physical function. The American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America (POSNA) commissioned a work group to construct functional health outcomes scales for children and adolescents, focusing on musculoskeletal health. The work group developed scales assessing upper extremity function, transfers and mobility, physical function and sports, comfort (pain free), happiness and satisfaction, and expectations for treatment. Parent and adolescent self-report forms were developed and tested on 470 subjects aged 2-18 years. The POSNA scales demonstrated good reliability, construct validity, sensitivity to change over a 9-month period, and ability to outperform a standard instrument, the Child Health Questionnaire physical functioning scale. They were useful for a wide variety of ages and diagnoses. They appear to be ideally suited for orthopaedic surgeons to assess the functional health and efficacy of treatment of their patients at baseline and follow-up.

Activities of Daily Living↗
PubMed1996

Pallidotomy: a survey of current practice in North America.

Twenty-eight centers completed a survey about their current practice of pallidotomy. This sample represents a non-exhaustive survey of the current practice of pallidotomy in North America and is not a study of outcomes. 1015 patients underwent 1219 pallidotomies: 811 (80%) unilateral, 72 (7%) staged bilateral, and 132 (13%) simultaneous bilateral. Pallidotomy has long been an accepted procedure and the indications for this surgery, in the opinion of the responding centers, were rated on a scale of 1 (poor) to 4 (excellent) and demonstrated dyskinesia as the best indication (median = 4); on-off fluctuations, dystonia, rigidity, and bradykinesia as good indications (median = 3); and freezing, tremor and gait disturbance as fair indications (median = 2). Most centers used MRI alone (50%) or in combination with CT scan (n = 6) or ventriculopathy (n = 5) to localize the target. The median values of pallidal coordinates were: 2 mm anterior to the midcommissural point 21 mm lateral to the midsagittal plane and 5 mm below the intercommissural line. Microrecording was performed by half of the centers (n = 14) and half of the remaining centers were considering starting it (n = 7). Main criteria used to define the target included the firing pattern of spontaneous neuronal discharges (n = 13) and the response to joint movement (n = 10). Most centers performed motor (n = 26) and visual (n = 23) macrostimulation. Twenty four centers performed test lesions using median values of 55 degrees C temperatures for 30 s. Final lesions consisted of 3 permanent lesions placed 2 mm apart, each lesion created with median values of 75 degrees C temperatures for 1 minute. Median hospital stay was 2 days.

Brain Mapping↗
PubMed2006

Are the Health of the Nation Outcome Scales a valid and practical instrument to measure outcomes in North America? A three-site evaluation across Nova Scotia.

We tested the usability, sensitivity and validity of the Health of the Nation Outcome Scales (HoNOS) in routine clinical practice in North America. Three pilot sites provided ratings on all inpatient and outpatient referrals over 4 months using versions covering children and adolescents (HoNOSCA), working-age adults and the over-65s. Data were entered using the routine administrative data system. Sixty-one percent of eligible patients had at least one HoNOS rating (n = 485). Following the initial rating, subsequent completion rates reached 80%. Ratings were sensitive to time and setting, with significantly higher scores in inpatients than outpatients. Individual diagnoses had different patterns of scores, further supporting validity.

Adolescent↗
PubMed1989

The current status of scoliosis screening in North America, 1986. Results of a survey by mailed questionnaire.

In May, 1986, 374 questionnaires on the multiple aspects of school screening for scoliosis were mailed to health care professionals throughout North America. An overall response rate of 73% provided objective information about screening efforts. Results showed that although there is great variability among the programs, at least some screening is done in each of the 50 United States and the District of Columbia. Previously widespread in Canada, only two Provinces currently are officially engaged in screening, Alberta (research projects only) and Prince Edward Island. The most common target population seems to be grades five through nine for both boys and girls. Lack of funding appears to be the largest factor hampering data collection. Although many varied comments and suggestions were received, most called for: 1) new recommendations for screening boys and girls at different grade levels; 2) quantitative referral criteria; 3) improved data gathering: 4) statewide uniformity within programs; and 5) improved understanding within the medical community about indications for referral and the principles of scoliosis treatment.

Adolescent↗
PubMed1998

The RSNA-AUR-ARRS introduction to research program for 2nd year radiology residents: effect on career choice and early academic performance. Radiological Society of North America. Association of University Radiologists. American Roentgen Ray Society.

PURPOSE: To evaluate graduates of the first 5 years of the Introduction to Research program, sponsored by the Radiological Society of North America, Association of University Radiologists, and American Roentgen Ray Society, to determine if they more frequently entered and demonstrated early success in academic careers than did nonparticipants. MATERIALS AND METHODS: In 1997, the authors surveyed all 396 program participants for the 1990-1995 period and 2,047 nonparticipants who were in the same residencies as the participants during that period. Career plans, research participation, and academic achievements were compared. RESULTS: The survey was completed by 321 participants (81%) and 1,153 nonparticipants (56%). More than a third of participants thought the program had a strong effect on their initial career decision. Forty-one percent of participants who completed training (n = 192) were currently in academia versus 26% of nonparticipants (n = 676; P = .001). Of the 321 participants, 35% believed they would spend most of their careers in academia and 15% thought research would be their major focus versus 19% and 8% for the 1,153 nonparticipants (P < .001). Participants had higher levels of academic achievement earlier in their careers than did nonparticipants. CONCLUSION: The Introduction to Research program is encouraging the development of successful research careers. However, the results may be influenced by the self- or departmental selection of participants who were oriented toward research independent of program participation.

Achievement↗