Decolonizing Care at Diagnosis: Culture, History, and Family at an Urban Inter-tribal Clinic.

The decolonization framework in medical anthropology is slowly reframing tropes of cultural competency toward decolonizing health care. For decolonization of health care to occur, both colonial histories and continuing postcolonial inequities must be recognized from the first diagnostic moment. We report on qualitative research into the role of culture, history, and family experience in person-specific reactions to receipt of a diagnosis. A collaborative approach at an urban inter-tribal clinic was used to interview patients with a recent (within six months) diagnosis of diabetes or related condition. Interviews revealed ways that the Relocation Act eventuated in isolation, poverty, and diabetes among now-urban Native Americans. We discuss how patients may or may not have the ability to (re)connect with their heritage and may simultaneously perceive only recent family contexts as influential in their diabetes. We conclude by acknowledging how postcolonial harms are not captured in diagnoses but should not be left out of diagnostic discussions.

Eye exercises for treatment of idiopathic cranial nerve VII paresis: pilot study.

BACKGROUND: To determine if fine-motor eye exercises can be used for treatment of unilateral, idiopathic cranial nerve VII paresis to improve rate of recovery. METHODS: In this prospective, randomized controlled trial, eligible patients were randomized to perform fine-motor eye exercises (n=18) or to do no exercise (n=9) for a period of four weeks. Orbicularis oculi muscle strength was measured in paretic and unaffected eyes at baseline, two weeks and four weeks using an Orbicularis Oculi Pressure Sensor. RESULTS: The average initial strength of the paretic orbicularis oculi muscle was 34±10 mm Hg compared to the unaffected muscle which was 103±17 mm Hg at baseline (n=27). By four weeks, patients who performed eye exercises improved more than those who did not (74.4 versus 47.4 mm Hg, p=0.029). While there was some loss to follow-up, 63.8% of patients performing exercises (7/11) achieved functional recovery at four weeks compared to 12.5% (1/8) of those who did not (p=0.059). Steroids and antivirals were found to have independent positive effects on improving functional outcome. CONCLUSIONS: Eye exercises have a potential role in the treatment of idiopathic cranial nerve VII paresis and warrant consideration in the management of these patients.

Everyday magical powers: the role of apparent mental causation in the overestimation of personal influence.

These studies examined whether having thoughts related to an event before it occurs leads people to infer that they caused the event--even when such causation might otherwise seem magical. In Study 1, people perceived that they had harmed another person via a voodoo hex. These perceptions were more likely among those who had first been induced to harbor evil thoughts about their victim. In Study 2, spectators of a peer's basketball-shooting performance were more likely to perceive that they had influenced his success if they had first generated positive visualizations consistent with that success. Observers privy to those spectators' visualizations made similar attributions about the spectators' influence. Finally, additional studies suggested that these results occur even when the thought-about outcome is viewed as unwanted by the thinker and even in field settings where the relevant outcome is occurring as part of a live athletic competition.

Primary embryonal carcinoma of the orbit in a 10-month-old female: a seven-year follow-up.

PURPOSE: Extra-gonadal germ cell tumors (GCTs) are rare and can be highly aggressive. If correctly identified and treated with multimodality chemotherapy, their prognosis can be significantly improved. We examined a 10 month-old female with primary embryonal carcinoma of the orbit. DESIGN: Case report and literature review. METHODS: Case study with 7-year follow-up and literature review of intracranial and intraorbital GCT cases. RESULTS: The patient presented with progressive proptosis and ophthalmoplegia. CT scan revealed an orbital apex mass and biopsy demonstrated a nongerminomatous GCT--an embryonal carcinoma. The patient is tumor-free 7 years after multimodality chemotherapy. She has mild amblyopia and a right micro esotropia. CONCLUSIONS: Nongonadal GCTs of the orbit can occur and should be considered in the differential diagnosis of a young child with proptosis and ophthalmoplegia. Five-year survival rates improve significantly with accurate identification and treatment.

After All I Have Done For You: Self-silencing Accommodations Fuel Women's Post-Rejection Hostility.

An experimental study tests if people's hostility after experiencing rejection is partly explained by the degree to which they had initially suppressed their own feelings and beliefs to please the source of rejection. This hypothesis emerges from the literatures on women's self-silencing and that on rejection-sensitivity, which has documented that rejection-sensitive women show strong responses to rejection, but are also likely to self-silence to please their partners. An online dating paradigm examined if this self-silencing drives post-rejection hostility among women. Participants were given the opportunity to read about a potential dating partner before meeting that person, and were randomly assigned to one of 3 experimental conditions that resulted in rejection from the potential date or from another dater. Self-silencing was captured as the suppression of tastes and opinions that clashed with those of the prospective partner. Self-silencing moderated the effect of rejection on hostility: Self-silencing to the prospective partner was associated with greater post-rejection hostility among women, but not men. Self-silencing to someone other than the rejecter was not predictive of hostility. Women's dispositional rejection-sensitivity predicted greater hostility after rejection, and self-silencing mediated this association. Efforts to secure acceptance through accommodation may help explain the paradoxical tendency of some people to show strong rejection-induced hostility toward those whose acceptance they have sought.

Evaluation of the level of Mx3 protein synthesis induced by infectious pancreatic necrosis virus (IPNV) strains of different infectivity.

The in vitro infectivity and genotype of three IPNV strains (V70, V112 and V98) was linked to the level of transcript synthesis for the Mx3 protein in RTG-2 (Rainbow trout gonad) cells and in Salmo salar. The V70 and V98 strains corresponded to the Sp genotype, whilst the V112 corresponded to VR-299; the presence of Pro-217 and Ala-221 in VP2 identified V70 as a strain of medium virulence level whilst V112 (Ala-217 and Thr-221) and V98 (Pro-217 and Thr-221) were of low virulence. This is concurrent with several in vitro tests which showed V70 to be a strain with highly infectivity (P<0.05). In both the in vitro and in vivo trials, the strains demonstrated the induction of the Mx transcript, although no differences were detected, and the level always were significantly lesser that observed in poly I:C samples. The results suggest that the infectivity observed is related to the presence of certain specific residues in VP2, and that neither the infectivity nor the genotype appears to bear any relation to Mx induction capacity.

Paying to belong: when does rejection trigger ingratiation?

Societies and social scientists have long held the belief that exclusion induces ingratiation and conformity, an idea in contradiction to robust empirical evidence linking rejection with hostility and aggression. The classic literatures on ingratiation and conformity help resolve this contradiction by identifying circumstances under which rejection may trigger efforts to ingratiate. Jointly, findings from these literatures suggest that when people are given an opportunity to impress their rejecters, ingratiation is likely after rejection experiences that are harsh and that occur in important situations that threaten the individual's self-definition. Four studies tested the hypothesis that people high in rejection sensitivity and therefore dispositionally concerned about rejection will utilize opportunities to ingratiate after harsh rejection in situations that are self-defining. In 3 studies of situations that are particularly self-defining for men, rejection predicted ingratiation among men (but not women) who were high in rejection sensitivity. In a 4th study, harsh rejection in a situation particularly self-defining for women predicted ingratiation among highly rejection-sensitive women (but not men). These findings help identify the specific circumstances under which people are willing to act in socially desirable ways toward those who have rejected them harshly.

Field testing of the plusoptiX S04 photoscreener.

PURPOSE: To evaluate the diagnostic accuracy of the plusoptiX S04 digital photoscreener in a school screening program. METHODS: Between 2006 and 2007, 1343 information pamphlets/consent forms were sent to all junior kindergarten students in a local school district. Assistants from a local public health unit photographed 307 children. Of these, 271 children received an independent ophthalmic examination by a physician. Photographic results were compared with the those of the ophthalmic examination. Amblyopia risk factors were defined as anisometropia >1 D (sphere or cylinder), astigmatism >1.25 D, myopia >3 D, hyperopia >3.5 D, any manifest strabismus, and any media opacity. RESULTS: Photographic and examination results agreed in 94% of cases. Sensitivity in detecting amblyopia risk factors was 83%; specificity was 95%. The positive and negative predictive values were 73% and 97%, respectively. The untestable/unusable rate was 1%. CONCLUSIONS: These results compare favorably with a previously reported (but no longer available) digital photoscreening camera and are superior to results obtained with other off-axis photoscreening devices that require human interpretation. On the basis of these results, in a real-world screening program, the camera would falsely refer 4% of those screened and would fail to correctly refer 2%. The accuracy of the plusoptiX S04 camera in detecting amblyopia risk factors appears sufficiently high to consider its further deployment in a widespread school screening program.

Apoyo sanitario interdisciplinario en educación inicial / Multiprofessional health promotion in preschool

Objetivo. Realizado en centros de educación de ANEP del Departamento de Canelones, Jardines Privados de Montevideo - Uruguay. Objetiivos: Optimizar las potencialidades de cada niño, através de : 1) Detectar alteraciones del normal desarrollo (visión, audición, nutricional, habla, bucal, algunos aspectos del área psicomotriz) en preescolares presuntamente sanos. 2) Sensibilizar, capacitar a padres y maestros, en la importancia de la detección, diagnóstico y tratamiento de las alteraciones. Metodología: 1) Se realizó un corte transversal mediante técnicas de screening, a niños del nivel de 4 años: 400 de jardines de ANEP, de niveles socieconómico y culturales bajo y medio; y 120 de jardines privados de nivel alto. Los niños con alteraciones se derivaron talleres de capacitación y sensibilización con padres y docentes en 15 meses entre 1995 y 1996 con evaluación de los niños. El 14 por ciento del nivel bajo y medio y el 31 por ciento de nivel alto, no necesitaron derivación u orientacón. Derivaciones: Los niveles medio y bajo se comportaron en forma similar, no existiendo diferencias estadísticamente significativas en sus resultados. Sí con respecto al nivel alto en: visión, hbla, salud bucal, y en la derivación a pediatria en el área psicomotriz. Resultados de los talleres: con docentes partiparon el 61 por ciento, con padres el 35 por ciento. Más del 95 por ciento de padres y docentes manifestaron su satisfacción con el proyeto y las actividades. Conclusiones: Los primeros años en la vida del niño son decisivos en la formación y el desarrollo de la inteligencia, la personalidad y el comportamento social. La adopción de conductas intervencionistas de antipación y prevención favorece el normal desarrollo y maduración. Por est la importancia de realizar este tipo de despitaje a nivel masivo en la etapa preescolar Fundamentalmente en la población más pobre siendo el compromiso de padres y docentes fundamental para logrario

Programa de detección precoz de alteraciones: evaluación interdisciplinaria / Schedule for early detection of disturbs: interdisciplinary evaluation

Se describe un programa experimental de detección precoz de alteraciones, para aplicar en poblaciones presuntamente sanas. Se detallan las técnicas aplicadas y se realiza la presentación de los screening en 79 niños preescolares. Se presentan los resultados en cada área (visual, auditivo, articulación de la palabra, bucal y psicomotriz). Se jerarquiza la tarea en equipo interdisciplinario: en la capacitación de los técnicos que realizan el primer nivel de detección y en la etapa de correlación diagnóstica