Mass murders involving firearms and other methods in school, college, and university settings: Findings from the Columbia Mass Murder Database.

While mass murders involving academic settings, especially using firearms, are of grave, growing public concern, identifying consistent patterns to aid prevention has proved challenging. Although some characteristics, such as male sex, have been routinely associated with these events, another hypothesized risk factor, severe mental illness, has been less reliably predictive. We isolated cases of mass murder perpetrated at least in part at schools, colleges, and universities from the Columbia Mass Murder Database (CMDD) and categorized them by location (within or outside of the US), and whether firearms were used. Demographic similarities and differences between groups were analyzed statistically wherever possible. We examined 82 incidents of mass murder, by any means, involving academic settings. Nearly half of all incidents (47.6%), and most involving firearms (63.2%), were U.S.-based, whereas those not involving firearms largely occurred elsewhere (88.0%). Consistent with previous reports, perpetrators of mass shootings involving academic settings are primarily Caucasian (66.7%) and male (100%). Severe mental illness (i.e., psychosis) was absent in the majority of perpetrators (firearms: 80.7%; nonfirearms: 68.0%). About half (45.6%) of mass school shootings ended with the perpetrator's suicide. When present, psychotic symptoms are more associated with mass murders in academic settings involving means other than firearms. The question of whether perpetrators of such incidents may perceive their actions as a kind of final act might enhance policy development and/or how law enforcement intervenes.

A Thematic Analysis of Osteopathic Physicians' Identities and Experiences in North American Professional Sports.

Objective: This interview-based thematic analysis examines the evolving professional identities and practices of osteopathic physicians (DOs) in North American professional sports (baseball, basketball, football, hockey, and soccer) to understand the extent to which DOs employ osteopathic-specific skill sets in their work with player-patients. In addition, the study sought to understand the prevalence of professional bias, interprofessional dynamics between DOs and other health professionals, and other factors such as management. Methods: This qualitative, interview-based study is grounded in twelve semi-structured interviews with 41% of DOs (all nonsurgical, primary care sports medicine trained) working with North American professional sports teams. Interviews were transcribed and coded to identify key themes and representative quotes. Results: Findings suggest that DOs believe their training and philosophical orientation positions them well to make important contributions to serving the medical needs of professional sports teams. At the same time, DOs are careful about championing an osteopathically-specific approach to patient care, such as evoking osteopathic principles of care or techniques such as Osteopathic Manipulative Medicine. This is the case for several reasons, the most important of which is a strong drive toward collaboration and collegiality within professional sports medicine teams. Conclusion: This study finds that in navigating the complexities of osteopathic identity, DOs working in professional sports are proud of their osteopathic orientation and report experiencing little discrimination, but also downplay what has historically distinguished their practice from that of other healthcare professionals. These findings have consequences for how scholars think about emerging professional identities in sports medicine, generally, as well as the fast-growing profession of osteopathic medicine specifically.

The incidence of post-dural puncture headache in the obese parturient compared to the non-obese parturient after an accidental dural puncture: a systematic review protocol.

OBJECTIVE: The purpose of this systematic review is to determine if there is a difference in the incidence of post-dural puncture headache in the obese parturient compared to the non-obese parturient after an accidental dural puncture. INTRODUCTION: Placement of an epidural catheter is a common technique to ease the pain of childbirth. One potential complication is a headache that occurs if the dura mater is accidentally punctured with the epidural needle during the procedure. Certain factors impact the likelihood of a postdural puncture headache after an accidental dural puncture in parturients. One potential factor is obesity. There is evidence to suggest that obesity lowers the risk of postdural puncture headache, although not all studies agree. There are no current or active systematic reviews that address whether or not obesity in parturients is protective against postdural puncture headache. INCLUSION CRITERIA: Studies with parturients aged 18 to 45 who have had a documented accidental dural puncture with an epidural needle will be included in this review. Studies with parturients with a history of spinal surgery or pre-existing headache pathology will be excluded. Studies involving non-obstetrical patients will be excluded. METHODS: A systematic search of MEDLINE, CINAHL Complete, Scopus, and Wiley Online Library will be conducted to identify studies on the topic of interest. Studies will be selected for review based on the inclusion criteria and will be appraised by two reviewers using the appropriate JBI standardized appraisal tool. SYSTEMATIC REVIEW REGISTRATION NUMBER: 136047 (PROSPERO).

Farmers' perceptions of local food procurement, Mississippi, 2013.

We sought to understand the experiences and perceptions of food producers regarding food procurement programs for local institutions. A total of 72 (45%) Mississippi fruit and vegetable growers completed a mailed survey, and of those that reported selling to local businesses and institutions (54%), few were selling to schools (13%). The primary motivations to sell to institutions were to increase profits (67%) and to improve nutrition within their communities (57%), while the most commonly reported barrier was a lack of knowledge about how to sell to institutions (39%). Farm to institution programs must develop evidence-based practices designed to address barriers to producers' participation in local institutional food procurement programs.

A drag reducing surfactant threadlike micelle system with unusual rheological responses to pH.

A pH-responsive threadlike micellar system was developed by mixing alkyl bis(2-hydroxyethyl)methylammonium chloride (EO12) and trans-o-coumaric acid (tOCA). The rheological response of this system to pH is unusual in that it has viscoelasticity at both high and low pH levels, while it shows water-like behaviors at medium pH. Cryogenic transmission electron microscopy (Cryo-TEM) images confirmed the presence of TLMs at pH 3.5 and pH 9.8. This system also had DR (drag reduction) capability at low and high pH. The unusual rheological and micellar responses of this system to pH are caused by the dual pK(a)'s of tOCA. (1)H NMR and zeta potential results support this hypothesis.