Neutron star mass estimates from gamma-ray eclipses in spider millisecond pulsar binaries.

Reliable neutron star mass measurements are key to determining the equation of state of cold nuclear matter, but such measurements are rare. Black widows and redbacks are compact binaries consisting of millisecond pulsars and semi-degenerate companion stars. Spectroscopy of the optically bright companions can determine their radial velocities, providing inclination-dependent pulsar mass estimates. Although inclinations can be inferred from subtle features in optical light curves, such estimates may be systematically biased due to incomplete heating models and poorly understood variability. Using data from the Fermi Large Area Telescope, we have searched for gamma-ray eclipses from 49 spider systems, discovering significant eclipses in 7 systems, including the prototypical black widow PSR B1957+20. Gamma-ray eclipses require direct occultation of the pulsar by the companion, and so the detection, or significant exclusion, of a gamma-ray eclipse strictly limits the binary inclination angle, providing new robust, model-independent pulsar mass constraints. For PSR B1957+20, the eclipse implies a much lighter pulsar (1.81 ± 0.07 solar masses) than inferred from optical light curve modelling.

Universal prenatal HIV screening: are we there yet?

The objectives of this study were to determine the prevalence of and factors associated with prenatal HIV screening and the availability of HIV test results in medical records in Pittsburgh, PA, USA. Three hundred postpartum women were surveyed about demographics and prenatal care provider(s) and practice setting and were asked to recall prenatal HIV screening and reasons for accepting or declining a HIV test. Medical records were reviewed for documentation of HIV results. Overall, 65% of women reported screening. White race, higher annual household income and fewer lifetime sexual partners were independently associated with decreased likelihood of prenatal HIV screening. Provider presentation of screening as standard practice and provider encouragement were associated with prenatal HIV screening. Only 38% of medical records contained HIV results at the time of labour. Universal and routine offering of prenatal HIV screening as standard practice, in conjunction with encouragement from health-care providers, may increase patient acceptability and the uptake of prenatal HIV screening.

Retrospective confidence judgements made by adults with traumatic brain injury: relative and absolute accuracy.

Eighteen adult survivors of moderate or severe traumatic brain injury (TBI) and 18 controls studied and were tested on two lists of noun-pairs, and made item-by-item retrospective confidence judgements (RCJs) of their answers using a Likert scale. For both groups, correlations between RCJ ratings and recall were extremely high, indicating that survivors of TBI were as accurate as non-injured controls when comparing their confidence in one answer to another. However, as groups, survivors of TBI were over-confident and control participants were under-confident, but only when uncertain as to the accuracy of their answer. Recall errors of 'interference' were analysed post-hoc. Survivors of TBI displayed higher confidence in interference errors than in non-interference errors, while control participants did not. These results are discussed within the context of self-monitoring by clinical and non-clinical populations. The importance of both relative and absolute measures of metamemory accuracy is highlighted.

Accuracy of metamemory after traumatic brain injury: predictions during verbal learning.

The primary intent of this study was to investigate the metamemory monitoring abilities of adult survivors of at least moderate traumatic brain injury (TBI) during a verbal-learning activity. Eighteen survivors and 18 non-injured control participants made judgment-of-learning (JOL) predictions of their recall ability immediately after studying 3 lists of noun-pairs or after a slight delay. A secondary intent of this study was to determine if verbal retrieval attempts would enhance predictive accuracy. One half of participants made retrieval attempts during the second and third list-learning task, and the other half made retrieval attempts during the third list-learning task only. Measures of the correlation between JOL predictions and recall accuracy revealed that survivors were as accurate as controls when making delayed predictions and were less accurate when making immediate predictions. This occurred regardless of retrieval attempts. Absolute measures that compared mean JOL ratings to overall recall revealed that the survivor group was well-calibrated when making delayed JOL predictions but overestimated when making immediate JOL predictions. The non-injured control group underestimated when making both types of predictions. However, within-group variability was high. These findings are compared to those from studies that investigated metamemory beliefs in which survivors' ratings were compared to family-member ratings. Clinical implications for basing executive decisions about compensatory strategies on delayed and immediate predictions of future recall are discussed. Additionally, a rationale is provided for the use of both relative and absolute measures of predictive accuracy in metamemory studies involving neurological clinical populations.

Service recovery in health services organizations.

Service recovery is defined as that part of quality management designed to alter the negative perceptions of dissatisfied consumers and to ultimately maintain a business relationship with these consumers. This article explores the theoretical and operational implications of service recovery in health services organizations. A framework that defines the range of possible service recovery actions is presented. Next, the benefits of and obstacles to service recovery in health services firms are discussed, and solutions for overcoming these obstacles are presented. Finally, the critical components of an effective service recovery program are described, and an agenda for empirical research on the efficacy of service recovery activities is proposed.

Homeless and runaway youth mental health issues: no access to the system.

Data from a center for homeless and runaway youth are presented in order to summarize the major mental health problems faced by these youth. This article also identifies indicators related to behavioral and environmental variables that may help in the development of intervention and prevention strategies for this population.

Placental transfer of cefuroxime.

The transfer of cefuroxime across the placenta was studied in 10 women in labour and 12 women being delivered by Caesarean section. Following a single intramuscular injection of 750 mg cefuroxime, high antibiotic concentrations were found in the amniotic fluid in women in labour; the peak concentration of 18 mg/l was achieved after five hours. Therapeutic concentrations of cefuroxime were present in umbilical vein serum for up to eight hours after injection. A similar pharmacokinetic picture was observed in the women undergoing Caesarean section although in the limited time interval (up to four hours) between injection and delivery the amniotic fluid levels of cefuroxime achieved were lower. Cefuroxime appears to cross the placenta well to produce effective concentrations in fetal blood and amniotic fluid.

Experience with cefuroxime in 190 patients with severe respiratory infections.

Cefuroxime is a very effective agent for the treatment of severe purulent respiratory infections. 190 patients with purulent exacerbations of bronchitis or bronchiectasis, pneumonia or secondarily infected lung cancer received 2.25--3.0 g cefuroxime daily for an average of 9 days. A good clinical response was seen in 91% of 184 assessable patients. A remarkable improvement in sputum purulence was observed and side-effects to cefuroxime were minimal.

The intraocular penetration of cefuroxime after parenteral administration.

Cefuroxime (Zinacef) is a new second generation cephalosporin which is resistant to beta-lactamases produced by both Gram-negative and Gram-positive organisms, with an antibacterial spectrum that includes practically all likely ocular pathogens except pseudomonas. It is shown to penetrate into the eye after intravenous (1.5g) or intramuscular (1 g) injection and achieve therapeutic concentrations, with absence of side effects. Cefuroxime is therefore a useful antibiotic for ophthalimic infections and should have a role in combination with gentamicin in intraocular infections, particularly those of unknown aetiology.

A survey of the sensitivity of fresh clinical isolates to cefuroxime and other antibiotics.

The sensitivities to cefuroxime and cephradine of potentially pathogenic bacteria isolated in two British general hospitals comprising 900 beds have been assessed. In a three-month period 2537 strains were studied; 30 microgram cefuroxime discs were used with 2511 strains, and cephradine discs of the same strength were used with 2525 strains. The organisms were also examined routinely for sensitivity to other antibiotics. Overall, 91.7% of the isolates were sensitive to cefuroxime and 85.8% were inhibited by cephradine, the differences in percentage strain susceptibility to cefuroxime and cephradine being mainly a result of the greater activity of cefuroxime against the Gram-negative bacteria. The wide antibacterial effectiveness of cefuroxime should make it a useful antibiotic for the treatment of serious infections including those conditions in which the causative organism has not been identified.