Costs of Horn Fly (Diptera: Muscidae) Control for Cow-calf Producers in Tennessee and Texas, 2016.

Tennessee and Texas cow-calf producers were surveyed to assess their 2016 expenses for horn fly control methods. Cattle producers who were members of the Texas and Southwestern Cattle Raisers Association and Tennessee cattle producers who have participated in the Tennessee Agricultural Enhancement Program participated in the survey. Average horn fly management costs in Tennessee and Texas were $9.50/head and $12.40/head, respectively. An ordinary least squares regression and quantile regression were estimated to examine how horn fly costs are influenced by producer and farm demographics, seasonality of horn flies, producer horn fly perceptions, and management practices. When controlling for these variables, Tennessee and Texas cattle producers did not spend significantly different amounts on horn fly control methods. Horn fly costs were associated with producer and farm demographics, producer perceptions of horn flies, and management practices. For example, results indicate that horn fly management costs vary depending on a producer's level of education and income. Having Angus cattle and larger herd sizes were associated with lower costs per head spent on horn fly management. Producers who did not consider horn flies to be a problem until greater quantities of flies were present on the animal spent 15% less per head on managing horn flies. In terms of horn fly control methods, feedthrough insecticides increased horn fly costs the most, followed by using ear tags. This is the first known research to estimate horn fly management costs among cattle producers.

A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression.

BACKGROUND: It is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions. METHOD: Newly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews. RESULTS: In all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD. CONCLUSIONS: Participants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

Pattern of relapse in patients with osteosarcoma of the extremities treated with neoadjuvant chemotherapy.

570 patients with osteosarcoma of the extremities were treated with five different protocols of neoadjuvant chemotherapy at Rizzoli Institute between 1983 and 1995. Surgery consisted of limb salvage in 83% rotation plasty in 5% and amputation in 12%. The 5-year event-free survival (EFS) was 60% which varied according to the protocol followed, ranging from 47.6% to 66.4%. 234 patients relapsed. The pattern of relapse was analysed. The mean relapse time was 23.8 months (range: 2-96). The first site of systemic relapse was the lung in 88% (32% of these had less than three pulmonary metastases and 68% three or more), bone in 9%, lung and bone in 2% and other sites in 3%. The relapse time and the number of pulmonary metastases were strictly correlated with the efficacy of the protocol of chemotherapy used. Patients treated with the three protocols that gave a 5-year EFS of more than 60% relapsed later and had fewer pulmonary lesions than patients treated with the two protocols that gave a 5-year EFS of 47.6% and 52.5%. The rate of local recurrence was relatively low (6%). This was not correlated with the protocol or the type of surgery used: limb salvage (6.4%), rotation plasty or amputation (4.1%). However, the rate of local recurrence was very high (21.9%) in the few patients (7%) that had less than wide surgical margins. We conclude that for patients with osteosarcoma of the extremities treated with neoadjuvant chemotherapy: (a) the pattern of systemic relapse changes according to the efficacy of the protocol of chemotherapy used. This should be always considered when evaluating the preliminary results of new studies as well as in defining the time of follow-up; (b) limb salvage procedures are safe and do not jeopardise the outcome of the patient, provided that wide surgical margins are achieved.

A holistic life view of human immunodeficiency virus-infected African American women.

Minority women represent the fastest growing segment of the population to acquire HIV/AIDS in the United States. Although African American women are a large proportion of this group, no published study has concentrated solely on a holistic view of the experiences of HIV-infected African American women. The primary purpose of this phenomenological pilot study was to describe the lives of five HIV-infected African American women. Audiotaped interviews were conducted and subsequently were examined, using Giorgi's steps of analysis. Twelve themes emerged from the data: violence, addiction, it couldn't happen to me, shock and denial, education, time, uncertainty, cycles, secretive nature of their lives, someone, survival, and children. It is clear, even from this small pilot study, that these women have complex experiences that must be better understood before effective health care interventions can be designed and implemented.

The delivery of care?

Nursing is multidimensional, interactive, interdisciplinary, and complex. Almost anything that can be said about nursing can be said another way. Some things worth being said and heard will not follow the norms of journal presentation. A forum accommodates the emerging voice, the new format, the innovative approach. Nursing Forum, in an effort to honor the "independent voice" in nursing, presents here the voice who elects to enter the dialogue, but who does so "in another way."

Ethical issues experienced by HIV-infected African-American women.

The epidemic of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) has led to many ethical problems. Most studies have focused on the ethical issues faced by nurses who provide care to persons with AIDS (PWA), rather than the ethical issues faced by PWAs themselves. The purpose of this study, therefore, was to explore the ethical issues faced by five HIV/AIDS-infected African-American women. An analysis of interview data revealed that these women deal with four broad categories of ethical issues: diagnosis; disclosure; treatment by, and of, others; and future pregnancies. The results of this study provide an initial description of the ethical issues faced by HIV/AIDS-infected African-American women, and begin to lay the foundation necessary for nurses appropriately to facilitate and support their decisions.

Ethical decision-making by staff nurses.

Ethical decision-making is inherent in nursing practice. Although a definite portion of the nursing literature is devoted to ethics and ethical decision-making, the profession is just beginning to ground its ethics research in the actual experience of nurses. Therefore, the purpose of this phenomenological study was to examine the experience of staff nurses as they engage in ethical decision-making. Interview data were collected from 19 staff nurses in a large, midwestern American metropolitan hospital. Interviews were subsequently transcribed and Giorgi's method of data analysis applied. The emerging description revealed four common aspects of ethical decision-making among staff nurses: context, trigger, ethical decision-making process (i.e. deliberation and integration), and outcomes. This description provides a foundation for future research regarding a descriptive theory of ethical decision-making in nursing.

Ethical decision-making in nursing: implications for continuing education.

Staff nurses make ethical decisions daily. It is important that nurses know how to manage those decisions appropriately so that clients' ethical rights are honored without compromising the nurse's own moral conscience. In this phenomenological study, 19 staff nurses described their experiences in making ethical decisions in their practices. The interviews were transcribed and analyzed using Giorgi's phenomenological steps. The description of the nurses' experiences identified two distinct components of the ethical decision-making process: deliberation and integration. The findings suggest that nurses need to: a) recognize the ethical nature of their work, b) discern which ethical decisions are theirs to make, and c) acknowledge their authority to make ethical decisions in their practices. These findings have important implications for the continuing education of nurses regarding ethical decision-making.

Determinants of exercise and aerobic fitness in outpatients with arthritis.

Factors that influenced exercise behaviors and aerobic fitness were identified in 100 outpatients with rheumatoid arthritis or osteoarthritis. Data included perceived health status, benefits of and barriers to exercise, and impact of arthritis on health; demographic and biologic characteristics; and past exercise behavior. Exercise measures included range-of-motion and strengthening exercises, 7-day activity recall, and the exercise subscale of the Health-Promoting Lifestyle Profile. An aerobic fitness level was obtained on each subject by bicycle ergometer testing. The theoretical model predicted 20% of the variance in composite exercise scores but none of the variance in aerobic fitness levels. Perceived benefits of exercise was a significant predictor of exercise participation. Subjects with less formal education, longer duration of arthritis, and higher impact of arthritis scores perceived fewer benefits of exercise, while subjects who reported exercising in their youth perceived more benefits of exercise.

Promoting self-care in clients with arthritis.

Preliminary work regarding the development and pilot study of an individualized instructional program for rheumatoid arthritis clients is presented. The effect of the individualized instructional program was tested with 31 outpatients. Using analysis of covariance, the experimental group subjects scored significantly higher on the knowledge post-test when compared to scores of control group subjects (P = 0.0045). Analysis of variance for repeated measures revealed no significant difference in performance of tasks for the control group and experimental group (P = 0.08). In a follow-up study, the effect of the self-instructional program, practice time, and contracting were explored for their effect on adherence to self-care activities. Experimental groups (n = 42) scored significantly better than the control group (n = 11) on the knowledge post-test (P < 0.01), performance of joint protection practices (P = 0.01), range of motion exercises (P = 0.01), and adherence to joint protection practices at home (P < 0.01). Groups did not differ on adherence to range of motion exercises at home (P = 0.83).

Association of central nervous system sarcoma with familial polyposis coli.

Familial polyposis of the colon is associated with an increased incidence in other parts of the body of benign and malignant, soft and hard connective tissue tumours. Clinical details and autopsy findings are reported in a 35-year-old man with familial polyposis who died from reticulum cell sarcoma (microglioma) involving his brain stem and upper spinal cord. While other central nervous system malignancy has been reported in association with familial polyposis, a sarcomatous tumour has not been previously described. In the clinical assessment of patients with familial polyposis the possibility should be considered of associated tumours in extracolonic sites, including the central nervous system.

Chronic melioidosis.

This report is of a man who suffered from chronic melioidosis contracted in Malaysia. In the course of the disease he had a lobe of a lung resected, developed empyema and, while this was still draining, developed infection in an ankle. Both the empyema thoracis and the ankle infection were due to Pseudomonas pseudomallel. He now appears to be cured, probably by massive doses of tetracycline.