Cherry Hill Research Articles

Medical Evaluation for Child Physical Abuse: What the PNP Needs to Know

InstructionsTo obtain continuing education credit:1.Read the article carefully.2.Read each question and record your answer on the enrollment form.3.Complete the program evaluation questions. Please note that you will not receive credit unless the evaluation questions are completed.4.You must receive 70% correct responses to receive the certificate.5.Tests will be accepted up to 12 months from the date of publication.ObjectivesBased on the content of the article, you will be able to:1.Identify historical indicators of physical abuse.2.Recognize features of bruise injuries that raise concern for physical abuse.3.State when to report a concern of suspected physical abuse to Child Protective Services.4.Describe diagnostic testing recommended for children presenting with specific injuries.5.Identify classic findings of abusive head trauma.6.Describe features of burn injuries that raise concern for physical abuse.Contact hours: 1.0Passing score: 70%This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hours.Two Ways to Earn Your CE Contact HoursEarn FREE CE Contact Hours OnlineContact Hours for this online activity are FREE for NAPNAP Members. Non-Members will be charged a fee of $10 to receive Contact Hours for this online activity through PNPSourCESM. Payment can be made by credit card through PNPSourCESM.1.To take the Post Test for this article and earn contact hours, please go to PNPSourCESM at www.napnapce.org.2.Click on the name of the CE Article.3.If you already have an account with PNPSourCESM, log in using your user name and password. If you are a NAPNAP member, log in with your member ID number and password. If you are a first-time user and NAPNAP non-member, click on “Create New Account.”4.Once you have successfully passed the Post Test and completed the evaluation form, you will be able to print out your certificate immediately.Earn CE Contact Hours By Mail1.Mail your completed form with your check for $10.00 (members) or $15.00 (non-members) to NAPNAP, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2634. If you wish, you may photocopy the form rather than tear the page out of the Journal.2.Answers to the test will be graded and then you will receive a certificate for successful completion within 6 weeks of receipt of answers at NAPNAP.

Supraglottic Jet Ventilation in Difficult Airway Management

BackgroundSupraglottic jet ventilation (SJV) via the “jet endotracheal tube” (JET) designed by Wei (WEI JET; Wei Medical LLC, Cherry Hill, NJ) provides adequate oxygenation and ventilation during direct laryngoscopy and tracheal intubation in animals. It has facilitated intubation in apneic pigs with a simulated difficult airway. ObjectiveTo report on the first clinical study to examine the efficacy of using SJV via the WEI JET, in combination with end-tidal CO2 pressure (PetCO2) monitoring during SJV, in maintaining oxygenation during direct laryngoscopy, and in facilitating placement of the WEI JET, and comparing it to the standard intubation technique using a conventional endotracheal tube. The relative safety of using SJV via the WEI JET in airway management was also addressed to provide the foundation for a larger-scale clinical study using the WEI JET, to be carried out in the future. MethodsPatients in the control group were intubated with a conventional endotracheal tube, and patients in the experimental group were intubated with a WEI JET. The effectiveness of SJV through a WEI JET in maintaining proper oxygenation, and the use of PetCO2 monitoring to facilitate intubation, were studied and compared to the control group. Complications such as sore throat, laryngospasm, and barotrauma were recorded during the study and 24 h after extubation. ResultsIn the WEI JET group, pulse oxygen saturation (SpO2) was 100% in all patients during intubation. No serious complications were detected, and the incidence of minor complications was comparable to the control group. Under PetCO2 guidance, 100% of patients in the WEI JET group were intubated on the first attempt, compared to 30% of Grade III view patients in the control group, who required two attempts. ConclusionUsing the WEI JET with SJV provides adequate oxygenation during tracheal intubation in apneic patients for a prolonged period of time, with no difference in complications compared to the standard intubation technique. PetCO2 monitoring facilitated intubation in patients with a Grade III glottis view.

Philly’s Cheesesteak Is Ubiquitous, But Where’s the Best One?

Back to table of contents Previous article Next article Information about PhiladelphiaFull AccessPhilly’s Cheesesteak Is Ubiquitous, But Where’s the Best One?Leslie SinclairLeslie SinclairSearch for more papers by this authorPublished Online:17 Feb 2012https://doi.org/10.1176/pn.47.4.psychnews_47_4_26-aAbstractIt’s almost Pavlovian the way the name of a city can make you think of—or even imagine that you can taste—that city’s famed cuisine. In Baltimore, it’s the crab cakes. In New Orleans, the beignets, served hot and liberally sprinkled with powdered sugar.The famous Philly cheesesteak offers meaty, cheesy goodness, no matter where you find it in Philadelphia.Susan Stevenson/ShutterstockIn Philadelphia, it’s the cheesesteak, a hearty sandwich on a soft roll, filled with sliced or chopped steak mixed with melted cheese, and served “wit” or “wit’out”—onions, that is. The cheese is your choice, as long as you choose American, provolone, or Cheez Whiz (that’s right, that gooey cheese-in-a-jar). Many locals insist the soft bread on which a cheesesteak sandwich is made must come from the Amoroso’s Baking Company, a long-time, family-owned Philadelphia staple.But if you talk to Philadelphians about anything else related to cheesesteaks, you’ll soon realize there’s no consensus. Everybody has their favorite, and there are so many cheesesteak sources, the task of finding the best can quickly become overwhelming.The two most famous cheesesteaks in Philadelphia come from a pair of eateries located directly across the street from one another, at the corner of 9th and Passyunk (pronounced pass-a-yunk). Located only two miles from the Pennsylvania Convention Center, Geno’s Steaks and Pat’s King of Steaks are considered cultural and culinary landmarks. Ordering a sandwich from each and performing a “taste test” is a popular tourist pastime.Visitors to the Pennsylvania Convention Center also have several cheesesteak options at Reading Terminal Market, located just across the street from the center at the corner of 12th and Arch streets. One of the best is Spataro’s Cheesesteaks, called “One of the 10 Best Cheesesteaks You’ve Never Had” in 2009 by Carolyn Wyman of the Philadelphia City Paper. Wyman, a nationally syndicated newspaper food columnist who wrote the Great Philly Cheesesteak Book and leads food tours at Reading Terminal Market, explains that the Spataro family is related to Tony Della Monica, a co-owner of Chick’s Deli in Cherry Hill, N.J. Chick’s is the out-of-town shop made famous when it won Philadelphia magazine’s 2003 best cheesesteak award.“Tony taught the Spataros how to reproduce his elegant steak, including how to cut up Spanish onions thin enough that they can be cooked to crispy-sweet doneness simultaneous with the highly flavorful but not-at-all-greasy meat,” explained Wyman.Other cheesesteak options in Reading Terminal Market include By George! Pizza, Pasta, and Cheesesteaks and Carmen’s Famous Italian Hoagies.No matter where you find it in Philadelphia, the cheesesteak is sure to add a cheesy, meaty, Philadelphia flavor to your annual meeting experience! ISSUES NewArchived

Editorial introductions

Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. Section Editors Peter C. BelafskyPeter C. BelafskyDr Belafsky grew up in Cherry Hill, New Jersey, USA. He graduated cum laude from Vassar College in Poughkeepsie, New York, USA. After Vassar he completed a joint MD/MPH program from The Tulane University Medical School and the Tulane University School of Public Health and Tropical Medicine in New Orleans, USA. He then completed his otolaryngology residency at Tulane and received a PhD in epidemiology from the Tulane University Graduate School. After his residency, Dr Belafsky attended Wake Forest University, USA, for a fellowship in laryngology and bronchoesophagology. He is now Director of the Center for Voice and Swallowing of the University of California at Davis in Sacramento, USA. Lisa BuckmillerLisa BuckmillerDr Lisa Buckmiller is an Associate Professor in the Department of Otolaryngology at the University of Arkansas for Medical Sciences, USA. She is the Vice-Chief of Pediatric Otolaryngology at Arkansas Children's Hospital, USA. Dr Buckmiller completed her undergraduate training in molecular biology & biochemistry at the University of California, Santa Cruz, USA, and went on to do her medical training at the University of California, Irvine College of Medicine, USA, and her residency in otolaryngology at the University of California, Davis in Sacramento, USA. She then accomplished her fellowship training in pediatric otolaryngology at Arkansas Children's Hospital, and has continued on as faculty there since 2001. Dr Buckmiller is the director of two multidisciplinary teams, including the Cleft Lip & Palate Team as well as the Vascular Anomalies Team at Arkansas Children's Hospital. In 2005, she was awarded the Benjamin & Milton Endowed Chair in Pediatric Facial Plastic & Reconstructive Surgery for her work to better the lives of children with facial deformities. She also is dedicated to serving overseas on medical missions several times a year and performs surgeries for both cleft lip and palate as well as hemangiomas and vascular malformations on these trips. She is board certified and is an active member of the American Academy of Otolaryngology, International Society for the Study of Vascular Anomalies, American Cleft Palate Association, and the American Society of Pediatric Otolaryngology. Dr Buckmiller's research interests are in the areas of vascular anomalies as well as treatment of velopharyngeal insufficiency and primary rhinoplasty for cleft patients.

Kawasaki Disease: A Review

InstructionsTo obtain continuing education credit:1.Read the article carefully.2.Read each question and record your answer on the enrollment form.3.Complete the program evaluation questions. Please note that you will not receive credit unless the evaluation questions are completed.4.You must receive 70% correct responses to receive the certificate.5.Tests will be accepted up to 12 months from the date of publication.ObjectivesBased on the content of the article, you will be able to:1.Understand the pathogenesis behind Kawasaki disease.2.Recognize the characteristic features of the disease and how to diagnosis a child with Kawasaki disease.3.Understand the pharmacologic treatment of both the acute and chronic phases of the disease.4.Realize the long-term clinical implications of the disease.Contact hours: 1.0 (of which 0.5 is pharmacology content)Passing score: 70%This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hours, of which 0.5 is pharmacology content.Two Ways to Earn Your CE Contact HoursEarn FREE CE Contact Hours OnlineContact Hours for this online activity are FREE for NAPNAP Members. Non-Members will be charged a fee of $10 to receive Contact Hours for this online activity through PNPSourCESM. Payment can be made by credit card through PNPSourCESM.1.To take the Post Test for this article and earn contact hours, please go to PNPSourCESM at www.napnapce.org.2.Click on the name of the CE Article.3.If you already have an account with PNPSourCESM, log in using your user name and password. If you are a NAPNAP member, log in with your member ID number and password. If you are a first-time user and NAPNAP non-member, click on “Create New Account.”4.Once you have successfully passed the Post Test and completed the evaluation form, you will be able to print out your certificate immediately.Earn CE Contact Hours By Mail1.Mail your completed form with your check for $10.00 (members) or $15.00 (non-members) to NAPNAP, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2634. If you wish, you may photocopy the form rather than tear the page out of the Journal.2.Answers to the test will be graded and then you will receive a certificate for successful completion within 6 weeks of receipt of answers at NAPNAP.

CE Posttest

InstructionsTo obtain continuing education credit:1.Read the article carefully.2.Read each question and record your answer on the enrollment form.3.Complete the program evaluation questions. Please note that you will not receive credit unless the evaluation questions are completed.4.You must receive 70% correct responses to receive the certificate.5.Tests will be accepted up to 12 months from the date of publication.ObjectivesBased on the content of the article, you will be able to:1.Identify prepubertal female genital anatomy.2.Describe why a normal ano-genital examination does not negate the possibility of sexual abuse.3.State when to report a concern of suspected sexual abuse to child protective services.4.Identify abnormal ano-genital examination findings.5.Recognize sexually transmitted infections that are of concern for sexual abuse and warrant reporting to child protective services.6.Describe three essential components of the medical evaluation for child sexual abuse.Contact hours: 1.0Passing score: 70%This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hour.Two Ways to Earn Your CE Contact HoursEarn FREE CE Contact Hours OnlineContact Hours for this online activity are FREE for NAPNAP Members. Non-Members will be charged a fee of $10 to receive Contact Hours for this online activity through PNPSourCE. Payment can be made by credit card through PNPSourCE.1.To take the Post Test for this article and earn contact hours, please go to PNPSourCESM at www.napnapce.org.2.Under Course Categories, JPHC Post Tests, click the name of the CE Article.3.If you already have an account with PNPSourCESM, log in using your user-name and password. If you are a NAPNAP member, log in with your member ID number and password. If you are a first-time user and NAPNAP non-member, click on “Create New Account.”4.Once you have successfully passed the Post Test and completed the evaluation form, you will be able to print out your certificate immediately.Earn CE Contact Hours by Mail1.Mail your completed form with your check for $10.00 (members) or $15.00 (non-members) to NAPNAP, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2634. If you wish, you may photocopy the form rather than tear the page out of the Journal.2.Answers to the test will be graded and then you will receive a certificate for successful completion within 6 weeks of receipt of answers at NAPNAP.

Beta-blockers: Essential heart failure therapy*

Cooper Health System; Cherry Hill, NJ The author has not disclosed any potential conflicts of interest.

Inhibition of Anti-HIV MicroRNA Expression: A Mechanism for Opioid-Mediated Enhancement of HIV Infection of Monocytes

Inhibition of Anti-HIV MicroRNA Expression: A Mechanism for Opioid-Mediated Enhancement of HIV Infection of Monocytes

Man's inhumanity to children

Man's inhumanity to children

Constipation in the Pediatric Patient: An Overview and Pharmacologic Considerations

InstructionsTo obtain continuing education credit:1.Read the article carefully.2.Read each question and record your answer on the enrollment form.3.Complete the program evaluation questions. Please note that you will not receive credit unless the evaluation questions are completed.4.You must receive 70% correct responses to receive the certificate.5.Tests will be accepted up to 12 months from the date of publication.ObjectivesBased on the content of the article, you will be able to:1.Review the definitions and complications of chronic constipation in the pediatric population.2.Examine the common causes of constipation and assess the evaluation and diagnosis of constipation in children.3.Evaluate the current literature, clinical practice guidelines, and pharmacology that direct therapeutic decisions made in the management of constipation in children.4.Describe the three-step process for managing constipation in the pediatric patient: complete bowel evacuation, maintenance of bowel evacuation, and weaning of medications.5.Appraise novel and alternative pharmacologic agents in the management of constipation in children.Contact hours: 1.0Passing score: 70%This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hours, of which 1.0 is pharmacology content.Two Ways to Earn Your CE Contact HoursEarn FREE CE Contact Hours OnlineContact Hours for this online activity are FREE for NAPNAP Members. Non-members will be charged a fee of $10 to receive Contact Hours for this online activity through PNPSourCESM. Payment can be made by credit card through PNPSourCESM.1.To take the Post Test for this article and earn contact hours, please go to PNPSourCESM at www.napnapce.org.2.Click on the name of the CE Article.3.If you already have an account with PNPSourCESM, log in using your user-name and password. If you are a NAPNAP member, log in with your member ID number and password. If you are a first-time user and NAPNAP non-member, click on “Create New Account.”4.Once you have successfully passed the Post Test and completed the evaluation form, you will be able to print out your certificate immediately.Earn CE Contact Hours By Mail1.Mail your completed form with your check for $10.00 (members) or $15.00 (non-members) to NAPNAP, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2634. If you wish, you may photocopy the form rather than tear the page out of the Journal.2.Answers to the test will be graded and then you will receive a certificate for successful completion within 6 weeks of receipt of answers at NAPNAP.

Cognitive-Behavioral Therapy as an Adjunct to Second-Generation Antipsychotics in the Treatment of Schizophrenia

This study determined whether adding cognitive-behavioral therapy to treatment for outpatients with schizophrenia would be more effective than the use of second-generation antipsychotics alone. Thirty-three patients were randomly assigned to receive either second-generation antipsychotics alone (N=18) or second-generation antipsychotics plus cognitive-behavioral therapy (N=15). All patients received pharmacotherapy from a single provider and in a predetermined standard manner. Psychopathology ratings were done at baseline, at the end of treatment (12 weeks) and three months after completion of treatment (24 weeks). Twenty-five (76%) patients completed baseline and 12-week evaluations, and 17 (68%) patients who finished treatment also completed evaluations at 24 weeks. At the end of treatment persons in the second-generation antipsychotics plus cognitive-behavioral therapy group were rated as having less severe delusions than patients in the group receiving second-generation antipsychotics only, and this difference was maintained three months after treatment ended. Adding cognitive-behavioral therapy may help with reducing the severity of delusions among patients with schizophrenia.

2009 H1N1 Influenza Pandemic

InstructionsTo obtain continuing education credit:1.Read the article carefully.2.Read each question and record your answer on the enrollment form.3.Complete the program evaluation questions. Please note that you will not receive credit unless the evaluation questions are completed.4.You must receive 70% correct responses to receive the certificate.5.Tests will be accepted up to 12 months from the date of publication.ObjectivesBased on the content of the article, you will be able to:1.Describe the evolution of influenza viruses, specifically the 2009 H1N1 influenza virus.2.Describe treatment of children infected with 2009 H1N1 influenza.3.Discuss strategies to prevent the spread of influenza virus.4.Discuss the 2010/2011 seasonal influenza vaccine components.Contact hours: 1.0 of which 0.5 hours is pharmacologyPassing score: 70%This continuing education activity is administered by the National Association of Pediatric Nurse Practitioners (NAPNAP) as an Agency providing continuing education credit. Individuals who complete this program and earn a 70% or higher score on the post test will be awarded 1.0 NAPNAP contact hours, of which 1.0 is pharmacology content.Two Ways to Earn Your CE Contact HoursEarn FREE CE Contact Hours OnlineContact Hours for this online activity are FREE for NAPNAP Members. Non-Members will be charged a fee of $10 to receive Contact Hours for this online activity through PNPSourCE. Payment can be made by credit card through PNPSourCE.1.To take the Post Test for this article and earn contact hours, please go to PNPSourCESM at www.napnapce.org.2.Click on the name of the CE Article.3.If you already have an account with PNPSourCESM, log in using your user-name and password. If you are a NAPNAP member, log in with your member ID number and password. If you are a first-time user and NAPNAP non-member, click on “Create New Account.”4.Once you have successfully passed the Post Test and completed the evaluation form, you will be able to print out your certificate immediately.Earn CE Contact Hours By Mail1.Mail your completed form with your check for $10.00 (members) or $15.00 (non-members) to NAPNAP, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2634. If you wish, you may photocopy the form rather than tear the page out of the Journal.2.Answers to the test will be graded and then you will receive a certificate for successful completion within 6 weeks of receipt of answers at NAPNAP.

Children with Autism Spectrum Disorders: Three Case Studies

Children with Autism Spectrum Disorders: Three Case Studies

Practice Corner

IN THIS EDITION of the Practice Corner, the clinical practice questions were chosen due to their direct relationship to the ASPAN 2008-2010 Standards of Perianesthesia Nursing Practice. 1 American Society of PeriAnesthesia Nurses2008-2010 Standards of Perianesthesia Nursing Practice. ASPAN, Cherry Hill, NJ2008 Google Scholar Theresa Clifford, MSN, RN, CPAN, is ASPAN President 2009-2010.

Veterinary Continuing Education: A Must-do or a Want-to?

When we graduated from veterinary school, we thought homework would finally end. Little did we know that even after we became full-fledged veterinarians, homework would never end. Veterinary medicine is constantly evolving. Because new medical treatments and surgeries are constantly being developed in all fields of veterinary medicine, it is our responsibility, even our obligation, to ourselves, our clients, and our patients to keep abreast of these developments. Making time and resources available to obtain continuing education (CE) can be challenging given the demands of our work and families. In veterinary school, new information was spoon-fed to us in a classroom. But as graduate veterinarians, we have to actively join organizations, spend hard-earned salaries, and often travel long distances to obtain CE. We also must be knowledgeable of CE requirements demanded by the various states in which we practice and by the various specialty colleges to which many of us belong.Veterinarians handle CE in different ways. Some look forward to CE; others dread it. To address this issue, I invited 6 practitioners working in different states to comment on their feelings and approaches to CE. The participants are William Benner, MS, DVM, VCA South Hadley Animal Hospital, South Hadley, MA, USA; Kenneth D. Dazen, VMD, Dipl ABVP (Avian Practice), Animal and Bird Health Care Center, Cherry Hill, NJ, USA; Robert Hess, Jr, DVM, Winter Park Veterinary Hospital, Winter Park, FL, USA; Michael Lutz, DVM, West Meade Veterinary Clinic, LLC, Nashville, TN, USA; Robert Ness, DVM, Ness Exotic Wellness Center, Lisle, IL, USA; and Rhoda Stevenson, DVM, Dipl ABVP (Avian Practice), Exotic Bird Hospital, Jacksonville, FL, USA. I hope this discussion will make you aware not only of how your colleagues approach CE but also of how you think about CE, so that you can stay on top of new developments in veterinary medicine.

Hilliard, Russell E. (2005). Hospice and palliative care music therapy: A guide to program development and clinical care. Cherry Hill, NJ: Jeffrey Books. 128 pages. $20.00

Hilliard, Russell E. (2005). Hospice and palliative care music therapy: A guide to development and clinical care. Cherry Hill, NJ: Jeffrey Books. 128 pages. $20.00 This book is deceiving in appearance. At roughly 1 20 pages, it seems to be a quick read which could be easily used as a reference for the obvious purpose stated in its title. However, it becomes clear early in the first chapter that Hilliard has packed a great deal of information and resources into a compact volume. His extensive background in hospice and palliative care is evident in his knowledge of hospice organizational structures and administrative needs. Its purpose, as Dena Register states in the book's foreword, is to both new and seasoned clinicians with the information required to successfully pursue development of a hospice music therapy program (p. v) with particular emphasis on the oft-ignored business of such a task. Hilliard's relatively brief professional career, only 14 years long, is as packed with experience as his book is with information. His biographical blurb details how he started a brand new hospice straight out of his internship in 1 994 and then continued to initiate over 20 more such programs since. Besides working in end-of-life care, he also practiced in psychiatric and grief/bereavement settings. Additionally, he completed a master's of social work degree and a Ph.D., the latter through Florida State University. Music therapists who have little hospice experience, such as myself, will likely reach for this book for practical advice on hospice music therapy development, especially if they are familiar with Hilliard's writings and frequent conference presentations on the topic. Readers will want to know what it takes, clinically and practically, to initiate and maintain a new music therapy in hospice. Hilliard begins to answer these questions by providing background on the hospice movement in the United States and brief descriptions of how music has been used in these settings, including nonmusic therapy applications such as music thanatology, music counseling, and medical troubadours. He also gives an overview of how the U.S. healthcare system works with and manages funding and organizational structures of hospice care, which is imperative for music therapists to understand before embarking on development. In the second chapter, he then addresses the clinical needs of the hospice population, citing medical research and describing Quality of Life scales which can be useful for music therapists learning about the hospice field's assessment tools. In the third chapter Hilliard addresses the clinical aspects of music therapy in hospice. After reviewing both quantitative and qualitative research with this population, he then gives an overview of his own music therapy orientation in hospice care: Cognitive-Behavioral Music Therapy (which he abbreviates as CbxMT). While Hilliard acknowledges that music therapy training in the United States is diverse, he cites his own 2003 research which seems to support the efficacy of CbxMT in increasing the quality of life for hospice patients. (The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. Journal of Music Therapy. 40(2), 113-137). He goes on to describe relevant music therapy techniques, eventually presenting 22 music therapy Care Plans addressing the varied clinical needs identified in the previous chapter. These plans resemble music therapy activity plans in that they outline the materials needed to provide a specific technique, the procedure in implementing the technique, and a case example. Some of these plans are written by music therapy interns, some by music therapists with master's degrees, and some by Hilliard himself. There is no clear distinction between the skill level of these various practitioners or the level of practice at which the practitioners are operating. …

All Plants are "Exotic Invasives"

www.ethnobotanyjournal.org/vol6/i1547-3465-06-117.pdf Ethnobotany Research & Applications 6:117-119 (2008) Daniel E. Moerman, University of Michigan-Dearborn, 6515 Cherry Hill Rd., Ypsilalanti, MI 48198, U.S.A. dmoerman@umd.umich.edu Why? First, the Hawaiian islands are the remains of massive volcanoes which arose atop a hot spot in the Pacific plate. They were formed of sterile molten rock. My understanding is that the endemic higher plant flora of Hawai`i, preceding human occupation, is descended from approximately 40 original plants, seeds, roots, or whatever, deposited after storms, or from lost birds, or the like. The first of those 40 landed on one of the islands which existed at the time (they come and go in what is apparently something like a 15 million year cycle) and somehow “took root,” so to speak. An omniscient observer would have to consider this first plant on a totally sterile island as mighty exotic, and surely invasive. This first species spread as far as it could, and, as did the following 39, diversified into different niches (or something like that). Each species moved forward, and probably backward, with newly evolved species probably invading the landscapes of their ancestors (one count shows some 1500 species evolved from the 40 originals). Some of them managed somehow to float or be carried to other islands. While there are “island endemics,” others seem to have moved throughout the island chain. The youngest islands are to the east, the oldest to the west (a number of them totally submerged by now). But the point here is that each and every one of those species moved somewhere from somewhere else. A particular individual new species of the adaptive radiation may have emerged in one of those All Plants are “Exotic Invasives”

Normalization of glucose in the intensive care unit: Does one size really fit all?*

Division of Endocrinology and Metabolism, Cooper University Health System, Cherry Hill, NJ For information regarding this article, E-mail: [email protected] The author has not disclosed any potential conflicts of interest.

CAUSE OF HEPARIN WOES UNCLEAR

FDA AND BAXTER HEALTHCARE are searching, so far fruitlessly, for the cause of about 350 adverse reactions to Baxter’s heparin drug, a blood thinner used, for example, by patients undergoing kidney dialysis. Four patients have died after receiving heparin. Under scrutiny as possible contributors to the heparin problem are Baxter, its Chinese drug ingredient supplier, and FDA itself. Meanwhile, supplies of the critical anticoagulant could be in jeopardy. Last week, FDA officials said agency inspectors were on their way to Changzhou SPL, a Chinese facility owned by Scientific Protein Laboratories, a Wisconsin-based firm that has been Baxter’s main active ingredient supplier. Earlier, FDA started investigations at facilities run by Baxter in Cherry Hill, N.J., and by SPL in Waunakee, Wis., to find the source of the problem. The Changzhou plant was never evaluated the way it should have been as a supplier of materials to the U.S., acknowledged Joseph Famulare, deputy director of FDA’s Office ...

Letter

Back to table of contents Previous article Next article LetterFull AccessLetterNarsimha R. Pinninti M.D.Shaila Bokkala-Pinninti D.O.Narsimha R. Pinninti M.D.Search for more papers by this authorShaila Bokkala-Pinninti D.O.Search for more papers by this authorPublished Online:1 Mar 2007https://doi.org/10.1176/ps.2007.58.3.414AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Shared Decision Making and Humanistic Care In the November Open Forum, Deegan and Drake ( 1 ) make a compelling case to replace the compliance model of medication management with a shared decision-making model that is consistent with person-centered care and evidence-based medicine. There are additional benefits of a shared decision-making model that need mention. Building a relationship at a deeper and meaningful level with an individual who is in profound psychological distress is professionally very satisfying for psychiatrists. The shared decision-making model helps in building and maintaining such a relationship with clients and can enhance the professional satisfaction of psychiatrists. From clients' perspective, it is extremely affirming to their sense of self to have a physician who respects them as an individual and treats them as an equal partner. Also, the positive and mutually respectful relationship that is the basis of shared decision making is a very good corrective emotional experience for the stigma and discrimination experienced by individuals with psychiatric disabilities, even at the hands of some treatment providers. However, two factors need to be addressed so that physicians will embrace and practice such a model. The first factor is the lack of training in medical schools about the values inherent in the humanistic approach and person-centered care. Medical training places an undue emphasis on biomedical aspects of client care, generally ignoring psychological and humanistic aspects ( 2 ). Senior clinicians should be good role models in the practical implementation of a shared decision-making model in various clinical settings, such as psychiatric emergency services and inpatient and outpatient settings. However, medical students and residents find that a significant number of their teachers do not practice client-centered care and are not good role models for humanistic care ( 3 ). A second factor is the focus of the psychiatric field on symptom identification and management, with very little attention to individual functioning, quality of life, and recovery ( 4 ). Most of the funding for research comes from the pharmaceutical industry, and its main focus is evaluating and disseminating information on the efficacy of pharmaceutical strategies. The primary outcome measure in pharmaceutical research trials is symptom reduction or remission, whereas other outcome measures that are more meaningful for clients, such as improvement in functioning, quality of life, and reclamation of lost roles, are not routinely evaluated. Also, there is very limited research on self-initiated, nonpharmaceutical coping strategies (personal medicine) used by clients and on the most effective ways for clinicians to identify and strengthen these strategies. In addition, various payers, such as health maintenance organizations and publicly funded agencies, evaluate the efficacy of pharmacological management on the basis of its ability to reduce symptoms, thereby reinforcing the focus on symptom management. Medical schools should emphasize teaching and modeling humanistic aspects of providing care. More research is needed to evaluate and strengthen the natural coping abilities of individuals with psychiatric illnesses. The field of psychiatry should also shift its focus from symptoms to factors that are relevant to clients—for example, quality of life and recovery—so that the shared decision-making model of providing care becomes the norm.Dr. Pinninti is associate professor of psychiatry, School of Osteopathic Medicine, University of Medicine and Dentistry of New Jersey, Newark, and medical director, Steininger Behavioral Care Services Inc., Cherry Hill, New Jersey. Dr. Bokkala-Pinninti is a resident in the Department of Neurology, Drexel University, Philadelphia.