Baseline hypovitaminosis D is not associated with poor clinical outcomes in osteoarticular infections

OBJECTIVES Although vitamin D is recognized as an important factor in bone health, its role in osteoarticular infections is unclear. We hypothesized that low vitamin D (25-hydroxycholecalciferol) levels are associated with a lower likelihood of treatment success in osteoarticular infections. METHODS This was a retrospective cohort study of patients with orthopedic infections who had a 25-hydroxycholecalciferol level drawn when their infection was diagnosed. Outcomes were determined at early (3-6 months) and late (≥6 months) follow-up after completing intravenous antibiotics. RESULTS We included 223 patients seen during an 11-month period with osteoarticular infections and baseline 25-hydroxycholecalciferol levels. During the initial inpatient management of the infection, hypovitaminosis D was identified and treated. The mean 25-hydroxycholecalciferol level was 23±14ng/ml; 167 (75%) patients had levels <30ng/ml. Overall, infection treatment success was 91% (159/174) at early follow-up and 88% (145/164) at late follow-up. 25-Hydroxycholecalciferol baseline levels were similar in those with and without successful clinical outcomes, both at early (25±15 vs. 21±9ng/ml; p=0.3) and late follow-up (25±15 vs. 23±16ng/ml; p=0.6). CONCLUSIONS To our knowledge this is the first report on hypovitaminosis D and its impact on outcomes of osteoarticular infections. Hypovitaminosis D was frequent in this cohort. With vitamin D repletion, there was no difference in treatment success whether patients had baseline hypovitaminosis or not.

Low correlation between self-report and medical record documentation of urinary tract infection symptoms.

BACKGROUND Correlations between symptom documentation in medical records and patient self-report (SR) vary depending on the condition studied. Patient symptoms are particularly important in urinary tract infection (UTI) diagnosis, and this correlation for UTI symptoms is currently unknown. METHODS This is a cross-sectional survey study in hospitalized patients with Escherichia coli bacteriuria. Patients were interviewed within 24 hours of diagnosis for the SR of UTI symptoms. We reviewed medical records for UTI symptoms documented by admitting or treating inpatient physicians (IPs), nurses (RNs), and emergency physicians (EPs). The level of agreement between groups was assessed using Cohen κ coefficient. RESULTS Out of 43 patients, 34 (79%) self-reported at least 1 of 6 primary symptoms. The most common self-reported symptoms were urinary frequency (53.5%); retention (41.9%); flank pain, suprapubic pain, and fatigue (37.2% each); and dysuria (30.2%). Correlation between SR and medical record documentation was slight to fair (κ, 0.06-0.4 between SR and IPs and 0.09-0.5 between SR and EDs). Positive agreement was highest for dysuria and frequency. CONCLUSION Correlation between self-reported UTI symptoms and health care providers' documentation was low to fair. Because medical records are a vital source of information for clinicians and researchers and symptom assessment and documentation are vital in distinguishing UTI from asymptomatic bacteriuria, efforts must be made to improve documentation.

Targeted immunization to protect infants against pertussis in the United States

Pertussis is an infectious disease caused by the bacteria Bordetella pertussis, and is associated with a serious respiratory infection, a prolonged cough, and can require hospitalization. A vaccine for adolescents and adults has been available since 2005. This paper examines one recommended immunization strategy to prevent pertussis among infants, called “cocooning.” The strategy focuses on creating immunity among adult caregivers so they serve as a protective cocoon to the newborns, who are too young to be vaccinated. This paper looks at relevant studies summarizing implementation of cocooning strategies and addresses the question – Does the research literature support the view of using cocooning as an effective strategy to prevent pertussis in infants? After exclusions, 8 studies remained for synthesis. The evidence shows that cocooning is complex strategy and the evidence is mixed when it comes to ensuring an increase in immunization of caregivers. ^

Protein kinase C as a signal for exocytosis

We have studied signaling mechanisms that stimulate exocytosis and luteinizing hormone secretion in isolated male rat pituitary gonadotropes. As judged by reverse hemolytic plaque assays, phorbol-12-myristate-13-acetate (PMA) stimulates as many gonadotropes to secrete as does gonadotropin-releasing hormone (GnRH). However, PMA and GnRH use different signaling pathways. The secretagogue action of GnRH is not very sensitive to bisindolylmaleimide I, an inhibitor of protein kinase C, but is blocked by loading cells with a calcium chelator, 1,2-bis-(2-aminophenoxy)ethane-N,N,N′,N′-tetraacetic acid. The secretagogue action of PMA is blocked by bisindolylmaleimide I and is not very sensitive to the intracellular calcium chelator. GnRH induces intracellular calcium elevations, whereas PMA does not. As judged by amperometric measurements of quantal catecholamine secretion from dopamine- or serotonin-loaded gonadotropes, the secretagogue action of PMA develops more slowly (in several minutes) than that of GnRH. We conclude that exocytosis of secretory vesicles can be stimulated independently either by calcium elevations or by activation of protein kinase C.

Indium-cadmium-oxide films having exceptional electrical conductivity and optical transparency: Clues for optimizing transparent conductors

Materials with high electrical conductivity and optical transparency are needed for future flat panel display, solar energy, and other opto-electronic technologies. InxCd1-xO films having a simple cubic microstructure have been grown on amorphous glass substrates by a straightforward chemical vapor deposition process. The x = 0.05 film conductivity of 17,000 S/cm, carrier mobility of 70 cm2/Vs, and visible region optical transparency window considerably exceed the corresponding parameters for commercial indium-tin oxide. Ab initio electronic structure calculations reveal small conduction electron effective masses, a dramatic shift of the CdO band gap with doping, and a conduction band hybridization gap caused by extensive Cd 5s + In 5s mixing.

Women Leaders Resolving Conflict in Higher Education: A Feminist Epistemological Perspective

In an American postsecondary context, conflict is inherent (Gianneschi & Yanagiura, 2006; Valian, 1999). Successful navigation of conflict in the academy is vital for those who aspire to leadership positions (Nadler & Nadler, 1987; Walters, Stuhlmacher, & Meyer, 1998). Presently, however, women face significant barriers to achieving success in higher education administration, including gender expectations for conflict resolution behavior (Bartunek, 1992; Bowles, Babcock, & McGinn, 2005; Gayle, Preiss, & Allen, 2002). While a considerable body of literature exists for understanding gender negotiation, it remains rooted in a masculine paradigm (Kolb & Putnam, 2006; Shuter & Turner, 1997), and, as such, established theories lack a feminist epistemological perspective. Consequently, my primary research question is, How do women leaders experience and perceive conflict in the higher education work environment? I conduct a qualitative study that examines workplace conflict experiences of 15 women leaders from diverse personal and professional backgrounds. Hartsock's (1983) three-tiered gender-sensitive analysis of power, updated to include multicultural perspectives, serves as my theoretical framework. It is a lens through which I evaluate theories, finding multicultural organizational, higher education conflict, and gender negotiation theories most applicable to this study. The framework also creates the foundation upon which I build my study. Specifically, I determine that a feminist research method is most relevant to this investigation. To analyze data obtained through in depth interviews, I employ a highly structured form of grounded theory called dimensional analysis. Based on my findings, I co-construct with study participants a Feminist Conflict Process Theory and Flowchart in which initially the nature of the relationship, and subsequently the level of risk to the relationship, institution, or self, is evaluated. This study supports that which is observed in the conflict resolution practitioner literature, but is unique in its observation of factors that influence decisions within a dynamic conflict resolution process. My findings are significant to women who aspire to serve in leadership positions in higher education, as well as to the academy as a whole, for it expands our knowledge of women's ontological and epistemological perspectives on resolving conflict in postsecondary education.

1963 Ice Hockey Team

1925 UM Football Team Reunion, 1975 Indiana game

[L-R: George Babcock, Sam Babcock, Bob Brown capt., Sid Dewey, Bill Flora, Ben Friedman, Fred fuller, Charles Grube, Louie Gilbert, George Hawkins, , Ben Oosterbaan (obscured), Fred Parker; Dutch Stamman, Wally Weber]

University of Michigan Women's Cross Country Team, 1987

Back Row: Melanie Richards, Jodi Maastricht, Pam Barstow, Kathleen Kennedy, Andrea Barnes, Traci Babcock, Sarah Gray, coach Sue Frederick Foster

Front Row: Cheri Sly, Karen, Welke, Ava Udvadia, Jenny Sarri, Debbie Palmer, Jennifer McPeck, Mindy Rowand, Kim Klinke</p>

University of Michigan Women's Cross Country Team, 1991

Back Row: head coach Sue Foster, Amy Bucholz, Kate Jackson, Kelly Chard, Courtney Babcock, Jennifer Kiel, Kristine Westerby. Jenny Stuht, Kathie Nordquist, Michelle Radcliffe</p>

Front Row: Chris Szabo, Mayrie Richards, Kristi Wink, Megan Nortz, Jessica Kluge, Karen Harvey, Carrie Yates, Rachel Mann (not pictured: Molly McClimon)

University of Michigan Women's Cross Country Team, 1992

Back Row: Jacqueline Concaugh, Jennifer Stuht, Jessica Kluge, Karen Harvey, Mayrie Richards, Kelly Chard, Courtney Babcock, Michelle Spannagel, Christie Wilson, Amy Parker, head coach Mike McGuire</p>

Front Row: Kate Jackson, Chris Szabo, Kristin Wink, Molly McClimon, Amy Bucholz, Kristine Westerby, Jennifer Barber, Molly Lori, Katy Holbacher

University of Michigan Women's Cross Country Team, 1993

Back Row: Mara Guillemette, Betsey Vandervelde, Molly McClimon, Heather Grigg, Molly Lori, Mayrie Richards, Jenny Barber, Christie Wilson, Michelle Spannagel, Sharmila Prasad, Kathy Huffman, Annie Erlewine, Ingrid Sharphorn

Front Row: Jessica Kluge, Kristine Westerby, Holly Logue, Amy Parker, Kelly Chard, Katy Hollbacher, Chris Szabo, Karen Harvey, Kristi Wink, Courtney Babcock, Jackie Concaugh, Emily Shively, head coach Mike McGuire.

University of Michigan Women's Cross Country Team, 1994

Back Row: Bridget Mann, Pauline Arnill, Jennifer Barber, Molly Lori, Susan Kaminski, Heather Grigg, Christie Wilson, Deanna Arnill, Eileen Fleck

Middle Row: Mayrie Richards, Amy Parker, Michelle Spannagel, Tanya Mason, Katy Hollbacher, Ashley Zongker, Michelle Slater, Emily Shively, Wendy Robertson

Front Row: Jackie Concaugh, Holly Logue, Kelly Chard, Karen Harvey, Courtney Babcock, Tiffin Goodman, Jessica Kluge</p>

UM Women's Track Team, 1994

Front Row: Heather Grigg, Abbie Schaefer, Molly McClimon, Jennifer Barber, Christie Wilson, Amy Parker, Theresa Hall, Carrie Stewart, Mara Guillemette

Second Row: Laura Jerman, Holly Logue, Monika Black, Denise James, Katy Hollbacher, Kelly Chard, Courtney Babcock, Jackie Concaugh, Tearza Johnson, Emily Shively, Sharmila Prasad, Kim Skryd

Third Row: Kathryn Huffman, Annie Erlewine, Beth Gould, Richelle Webb, Michelle Spannagel, Kristie Wink, Chris Szabo, Karen Harvey, Jessica Kluge, Kristine Westerby, Ebony McClain, Colette Savage, Tonya Broad, Lisa Adams

Fourth Row: Ingrid Sharphorn, Elizabeth VanderVelde, Molly Lori, Jen Peterson, Ronda Meyers, Linda Stuck, Deb Mans, Jayna Greiner, Kathy Tomko, Laura Molnar