Radiology Case of the Month: Idiopathic CD4 Lymphocytopenia.

A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. During hospital course the patient underwent a lumbar puncture and multiple imaging exams, including both CT and MR. Except for occasional nausea and vomiting controlled by therapeutic lumbar punctures, phenergan, and dilaudid the patient's hospital course was uncomplicated.

Associations among fluid intake, cognitive function, and length of stay in psychogeriatric inpatients.

PURPOSE: The purpose of this study was to examine differences, interactions, and associations among cognition, fluid intake, and demographic variables that may affect length of stay (LOS) for psychogeriatric inpatients aged 65 years or older. DESIGN AND METHODS: Descriptive, comparative, correlational secondary analysis of data from a primary study of 202 inpatients. FINDINGS: Older adults with and without cognitive impairment had different fluid intake over time (F = 3.50; p = .03), but had no difference in LOS in relation to cognitive functioning (p = .23); additional factors may predict LOS. PRACTICE IMPLICATIONS: Care providers must monitor the fluid intake of elderly patients with and without cognitive impairment throughout their hospitalization.

Medication adherence among pediatric patients with sickle cell disease: a systematic review.

OBJECTIVES: Describe rates of adherence for sickle cell disease (SCD) medications, identify patient and medication characteristics associated with nonadherence, and determine the effect of nonadherence and moderate adherence (defined as taking 60%-80% of doses) on clinical outcomes. METHODS: In February 2012 we systematically searched 6 databases for peer-reviewed articles published after 1940. We identified articles evaluating medication adherence among patients <25 years old with SCD. Two authors reviewed each article to determine whether it should be included. Two authors extracted data, including medication studied, adherence measures used, rates of adherence, and barriers to adherence. RESULTS: Of 24 articles in the final review, 23 focused on 1 medication type: antibiotic prophylaxis (13 articles), iron chelation (5 articles), or hydroxyurea (5 articles). Adherence rates ranged from 16% to 89%; most reported moderate adherence. Medication factors contributed to adherence. For example, prophylactic antibiotic adherence was better with intramuscular than oral administration. Barriers included fear of side effects, incorrect dosing, and forgetting. Nonadherence was associated with more vaso-occlusive crises and hospitalizations. The limited data available on moderate adherence to iron chelation and hydroxyurea indicates some clinical benefit. CONCLUSIONS: Moderate adherence is typical among pediatric patients with SCD. Multicomponent interventions are needed to optimally deliver life-changing medications to these children and should include routine monitoring of adherence, support to prevent mistakes, and education to improve understanding of medication risks and benefits.

Brands as Intentional Agents Framework: How Perceived Intentions and Ability Can Map Brand Perception.

Building on the Stereotype Content Model, this paper introduces and tests the Brands as Intentional Agents Framework. A growing body of research suggests that consumers have relationships with brands that resemble relations between people. We propose that consumers perceive brands in the same way they perceive people. This approach allows us to explore how social perception theories and processes can predict brand purchase interest and loyalty. Brands as Intentional Agents Framework is based on a well-established social perception approach: the Stereotype Content Model. Two studies support the Brands as Intentional Agents Framework prediction that consumers assess a brand's perceived intentions and ability and that these perceptions elicit distinct emotions and drive differential brand behaviors. The research shows that human social interaction relationships translate to consumer-brand interactions in ways that are useful to inform brand positioning and brand communications.

Provision of information to patients in an NHS IVF unit.

There is strong emphasis in the literature on the importance of the provision of high quality information to patients before invasive fertility treatments such as in vitro fertilization and intracytoplasmic sperm injection. The introduction and development of a structured information evening for patients has facilitated the provision of such information, evidenced by the positive feedback observed in patient evaluation forms. Furthermore, the introduction of this system has led to a marked reduction in non-attendance at clinic appointments. The Commission for Health Improvement praised this system at a recent inspection. The provision of information before treatment is an essential aspect of fertility care in terms of patient satisfaction, preparation and reducing anxiety. The patient information evening is now routine practice for the Reproductive Medicine Unit at the Liverpool Women's Hospital.