Sporadic bloody diarrhoea-associated thrombotic thrombocytopenic purpura-haemolytic uraemic syndrome: an adult and paediatric comparison

Although diarrhoea-associated haemolytic uremic syndrome (HUS) in children is well described, the clinical features of bloody diarrhoea-associated thrombotic thrombocytopenic purpura (TTP)-HUS in adults are not documented. Twenty-one adults, 6.5% of the 322 adults in The Oklahoma TTP-HUS Registry, 1989-2006, have presented with bloody diarrhoea. There were no case clusters. Escherichia coli O157:H7 was identified in five patients, but many patients did not have appropriate studies. The annual incidence was 0.68/10(6), 10-fold less than the incidence of diarrhoea-associated HUS in children in Oklahoma. Two (13%) of 16 patients in whom ADAMTS13 (A Disintegrin And Metalloproteinase with a ThromboSpondin type 1 motif, member 13) was measured had <10% activity. Severe neurological abnormalities (67%) and renal failure (62%) were common; seven patients (33%) died; no survivors have relapsed. Compared to the 38 other Oklahoma Registry patients with ADAMTS13 <10%, frequency of severe neurological abnormalities and death was not different; frequency of renal failure was greater; frequency of relapse was less. Compared to 5999 children with sporadic diarrhoea-associated HUS in published reports, frequency of renal failure and relapse was not different; frequency of severe neurological abnormalities and death was greater (P < 0.05 for all differences). Awareness of the continuous occurrence of sporadic bloody diarrhoea-associated TTP-HUS in adults is important for prompt diagnosis and appropriate management.

The asymptotic distribution of canonical correlations and vectors in higher-order cointegrated models

The study of the large-sample distribution of the canonical correlations and variates in cointegrated models is extended from the first-order autoregression model to autoregression of any (finite) order. The cointegrated process considered here is nonstationary in some dimensions and stationary in some other directions, but the first difference (the “error-correction form”) is stationary. The asymptotic distribution of the canonical correlations between the first differences and the predictor variables as well as the corresponding canonical variables is obtained under the assumption that the process is Gaussian. The method of analysis is similar to that used for the first-order process.

The Effect of the Farmer Assurance Provision of the Consolidated and Continuing Appropriations Act, 2013 on Biodiversity and Global Food Security

A rider to a US law, the Consolidated and Continuing Appropriations Act, 2013, known as the Farmer Assurance Provision, encourages the large-scale genetic modification and global distribution of agricultural crops, thereby undermining the Food and Agriculture Organization of the United Nations' determination that food security rests on biodiversity. The rider blocks the US Department of Agriculture's mandate to prohibit farmers from growing crops from biotechnological seeds where the courts have found that this farm practice may cause damage to human health and/or degrade the environment. Despite genetically modified organisms (GMOs) reducing unwanted traits in plants, the paper supports the UN's mission for biodiversity and that more long-term testing was (and is) needed for GMO products, developed from 1994 on, before a hasty piece of Congressional legislation as was made in this case.

Rape protocol and child interview techniques : a basic guide for professionals who deal with adult and child victims of sexual abuse.

Jointly funded by ILEC Grant no. 2437 & 2915 and the Chicago Community Trust.

Assessment of adult and youth performance standards under the Job Training Partnership Act /

"November 1985."

Myelitis of the anterior horns, or spinal paralysis of the adult and child,

Mode of access: Internet.

Rapid genotyping of Pseudomonas aeruginosa isolates harboured by adult and paediatric patients with cystic fibrosis using repetitive-element-based PCR assays

In this study, the suitability of two repetitive-element-based PCR (rep-PCR) assays, enterobacterial repetitive intergenic consensus (ERIC)-PCR and BOX-PCR, to rapidly characterize Pseudomonas aeruginosa strains isolated from patients with cystic fibrosis (CF) was examined. ERIC-PCR utilizes paired sequence-specific primers and BOX-PCR a single primer that target highly conserved repetitive elements in the P. aeruginosa genome. Using these rep-PCR assays, 163 P. aeruginosa isolates cultured from sputa collected from 50 patients attending an adult CF clinic and 50 children attending a paediatric CF clinic were typed. The results of the rep-PCR assays were compared to the results of PFGE. All three assays revealed the presence of six major clonal groups shared by multiple patients attending either of the CF clinics, with the dominant clonal group infecting 38% of all patients. This dominant clonal group was not related to the dominant clonal group detected in Sydney or Melbourne (pulsotype 1), nor was it related to the dominant groups detected in the UK. In all, PFGE and rep-PCR identified 58 distinct clonal groups, with only three of these shared between the two clinics. The results of this study showed that both ERIC-PCR and BOX-PCR are rapid, highly discriminatory and reproducible assays that proved to be powerful surveillance screening tools for the typing of clinical P. aeruginosa isolates recovered from patients with CF.

HPA Axis Activation by Ethanol Dependence in Adult and Adolescent Rats

Alcoholism is a disorder marked by cycles of heavy drinking and chronic relapse, and adolescents are an age cohort particularly susceptible to consuming large amounts of alcohol, placing them at high risk for developing an alcohol use disorder. Adolescent humans and rats voluntarily consume more alcohol than their adult counterparts, suggesting that younger consumers of alcohol may be less sensitive to its aversive effects, which are regulated by the function of the hypothalamic-pituitary-adrenal (HPA) stress axis. While HPA axis dysfunction resulting from ethanol exposure has been extensively studied in adult animals, what happens in the adolescent brain remains largely unclear. In this study, chronic injections of ethanol was used to model alcohol dependence in adult and adolescent rats, and post-withdrawal anxiety behaviors were measured using light-dark box testing. Furthermore, corticosterone (CORT) release during treatment and after withdrawal was measured by collecting fecal and plasma samples from adults and adolescents. It was found that adults, but not adolescents, exhibit significant anxiety-like behavior following chronic ethanol withdrawal. Additionally, while the process of chronic ethanol treatment elicits an increase in day-by-day CORT release in both adults and adolescents, significantly sustained levels of CORT were not observed during withdrawal for either age group. Moreover, it was found that adults experience a longer-lasting CORT increase during chronic treatment, suggesting a larger and more robust period of dysfunction in the HPA axis for older consumers of alcohol. These results highlight CORT and glucocorticoids in general as a potential therapeutic target for treatment for alcoholism, especially that which has an onset during adolescence.

Examining the needs for student services of adult learners in continuing higher education

The primary purpose of this study was to examine the availability and quality of student services offered to adult learners in selected continuing education programs in Dade County, Florida. The two basic research questions addressed in this study were: 1) What are the student services being provided to adult learners by the selected colleges and universities? 2) What is the quality of these services being provided as perceived by administrators and adult learners at their institutions? Two groups comprised the population for this study. One group sample of adult learners enrolled in credit courses being offered by the continuing education unit. The second group sample was comprised of administrators in the areas of Admissions, Financial Aid, Registration, Student Services and Continuing Education at each of the five colleges and universities in Dade County, Florida. Data were collected from 107 students and 25 administrators using the Continuing Education Student Services Questionnaire (CESSQ) developed by the researcher in a pilot study. The questionnaire, one for administrators and a similar one for adult learners, consisted of two parts. One consisted of eight demographic items and the second one of twenty items describing student services. An overview of responses by institutions showed that only the following services received a 100% response as available at one or more institutions: 1) Admissions Information, 2) Convenient Hours for Registration, 3) Assistance in Class Registration, 4) Assistance in Planning a Class Schedule, 5) Access to the Library in Evening and Weekends, 6) Parking and Security, 7) Food Services, 8) Bookstore and 9) Access to Computers.

The development of a knowledge-based society - Challenges for e-learning and adult students in higher education

This chapter appears in Encyclopaedia of Distance Learning 2nd Edition edit by Rogers, P.; Berg, Gary; Boettecher, Judith V.; Howard, Caroline; Justice, Lorraine; Schenk, Karen D.. Copyright 2009, IGI Global, www.igi-global.com. Posted by permission of the publisher. URL: http://www.igi-global.com/reference/ details.asp?ID=9703&v=tableOfContents

Learning in higher education: strategies to overcome challenges faced by adult students – lessons drawn from two case studies in Portugal

This paper appears in International Journal of Information and Communication Technology Education edited by Lawrence A. Tomei (Ed.) Copyright 2007, IGI Global, www.igi-global.com. Posted by permission of the publisher. URL:http://www.idea-group.com/journals/details.asp?id=4287.

Higher education of tourism in Spain and its adaptation to the European higher education area

The international tourism system has deeply undergone structural changes in the last decades which not remain outside the subsystem higher education in tourism, especially in the European case. This article has two objectives: firstly, describes the European higher education area and the objectives, skills and subjects taught in the main Spanish universities that offer higher education in tourism. On the other hand, in the light of knowledge that researchers' descriptive models, provide experience of the implementation of European credit and thorough a deeply review of the literature on the topic higher education in tourism, to propose strategies that will enable other tourism higher education systems approach to the European reality. These policy proposals are aimed at agents and elements from higher education in tourism subsystem and they specifically include: the institutions providing education in tourism, the curriculum, the teaching methods, teachers and students.