Changing spatial distribution of water flow charts major change in Mars's greenhouse effect

Early Mars had rivers, but the cause of Mars's wet-to-dry transition remains unknown. Past climate on Mars can be probed using the spatial distribution of climate-sensitive landforms. We analyzed global databases of water-worked landforms and identified changes in the spatial distribution of rivers over time. These changes are simply explained by comparison to a simplified meltwater model driven by an ensemble of global climate model simulations, as the result of ≳10 K global cooling, from global average surface temperature [Formula: see text] ≥ 268 K to [Formula: see text] ~ 258 K, due to a weaker greenhouse effect. In other words, river-forming climates on early Mars were warm and wet first, and cold and wet later. Unexpectedly, analysis of the greenhouse effect within our ensemble of global climate model simulations suggests that this shift was primarily driven by waning non-CO₂ radiative forcing, and not changes in CO₂ radiative forcing.

Persistence of intense, climate-driven runoff late in Mars history

Mars is dry today, but numerous precipitation-fed paleo-rivers are found across the planet's surface. These rivers' existence is a challenge to models of planetary climate evolution. We report results indicating that, for a given catchment area, rivers on Mars were wider than rivers on Earth today. We use the scale (width and wavelength) of Mars paleo-rivers as a proxy for past runoff production. Using multiple methods, we infer that intense runoff production of >(3-20) kg/m² per day persisted until <3 billion years (Ga) ago and probably <1 Ga ago, and was globally distributed. Therefore, the intense runoff production inferred from the results of the Mars Science Laboratory rover was not a short-lived or local anomaly. Rather, precipitation-fed runoff production was globally distributed, was intense, and persisted intermittently over >1 Ga. Our improved history of Mars' river runoff places new constraints on the unknown mechanism that caused wet climates on Mars.

Using reference materials to improve the quality of data generated by USEPA analytical methods

The quality of data generated for the analysis of environmental samples is critical to State and Federal regulatory agencies to ensure that decisions based upon the amounts of contaminants in environmental samples are truly protective of public health. The quality and validation of these measurements using the approved analytical methodology could be significantly enhanced by incorporating certified reference materials as part of the quality control protocols, yet this has not been widely implemented. Data from certified reference materials can provide critical information that can impact assessments regarding data use that is unavailable by other means. Using the analysis of Cr(vi) in soil extracts as the test case, some of the issues surrounding the use of certified reference materials for environmental applications are discussed in this paper, including the relative cost, and the availability and applicability regarding element coverage and content.

Development and certification of the new SRM 695 trace elements in multi-nutrient fertilizer

During the past seven years, several states within the US have enacted regulations that limit the amounts of selected non-nutritive elements in fertilizers. Internationally, several countries, including Japan, China, and Australia, and the European Union also limit the amount of selected elements in fertilizers. The elements of interest include As, Cd, Co, Cr, Cu, Hg, Mo, Ni, Pb, Se, and Zn. Fertilizer manufacturers and state regulatory authorities, faced with meeting and verifying these limits, need to develop analytical methods for determination of the elements of concern and to validate results obtained using these methods. Until now, there were no certified reference materials available with certified mass fraction values for all elements of interest in a blended, multi-nutrient fertilizer matrix. A new standard reference material (SRM) 695 trace elements in multi-nutrient fertilizer, has been developed to help meet these needs. SRM 695 has recently been issued with certified mass fraction values for seventeen elements, reference values for an additional five elements, and information values for two elements. The certificate of analysis includes an addendum listing percentage recovery for eight of these elements, determined using an acid-extraction inductively-coupled plasma optical-emission spectrometry (ICP-OES) method recently developed and tested by members of the Association of American Plant Food Control Officials.

Dignified dying: phenomenon and actions among nurses in India

PURPOSE

This study contributes to the ongoing efforts of the International Classification for Nursing Practice (ICNP) to describe the phenomenon of dignified dying, to describe nursing actions used to promote dignified dying, and to evaluate the validity of a dignified dying scale among practising nurses in India.

DESIGN AND SAMPLE

This descriptive study surveyed 229 nurses who had cared for dying patients and were currently practising in government and private hospitals in India.

METHODS

Nurses were recruited to complete a survey in either Hindi or English. The survey included demographic, open-ended questions, and a dignified dying scale of Likert-like items. Nurses also identified nursing interventions used in practice to promote dignified dying.

FINDINGS

The descriptions of dignified dying phenomenon fit within the three major areas of the Dignity-Conserving Model of Care. A variety of interventions were reported, with more focusing on spiritual than physical factors. The 14 items selected reliably measured dignified dying, with a Cronbach's alpha of 0.79. Factor analysis yielded a 4-factor solution, with 11 items accounting for 56% of the variance.

CONCLUSIONS

Nurses in India endorsed spirituality as an essential aspect of the phenomenon of dignified dying. Nursing actions to promote dignified dying supported finding spiritual comfort at end of life. These results contribute to an understanding of nursing phenomena and actions worldwide.

Changes in median nerve somatosensory transmission and motor output following transient deafferentation of the radial nerve in humans

OBJECTIVE

To determine if transient anaesthetic deafferentation of the radial nerve would lead to alterations in processing of early somatosensory evoked potentials (SEPs) from the median nerve or alter cortico-motor output to the median nerve innervated abductor pollicis brevis (APB) muscle.

METHODS

Spinal, brainstem, and cortical SEPs to median nerve stimulation were recorded before, during and after ipsilateral radial nerve block with local anaesthesia. Motor evoked potentials (MEPs) and motor cortex output maps were recorded from the APB muscle.

RESULTS

There were no significant changes to most early SEP peaks. The N30 peak, however, showed a significant increase in amplitude, which remained elevated throughout the anaesthetic period, returning to baseline once the anaesthetic had completely worn off. MEP amplitude of the median nerve innervated APB muscle was significantly decreased during the radial nerve blockade. There was also a significant alteration in the APB optimal site location, and a small but significant decrease in the silent period during the radial nerve blockade.

CONCLUSIONS

Transient anaesthetic deafferentation of the radial nerve at the elbow leads to a rapid modulation of cortical processing of median nerve input and output. These changes suggest an overall decrease in motor cortex output to a median nerve innervated muscle not affected by the radial nerve block, occurring concomitantly with an increased amplitude of the median nerve generated N30 SEP peak, thought to represent processing in the supplementary motor area (SMA). Independent subcortical connections to the SMA are thought to contribute to the N30 response observed in this study. Unmasking of pre-existing but latent cortico-cortical and/or thalamo-cortical connections may be the mechanism underlying the cortical SEP increases observed following radial nerve deafferentation.

SIGNIFICANCE

Transient deafferentation of the radial nerve, which supplies wrist and hand extensor muscles, has been shown to alter sensory processing from and motor output to the median nerve innervated thenar muscles.

Rapid reversible changes to multiple levels of the human somatosensory system following the cessation of repetitive contractions: a somatosensory evoked potential study

OBJECTIVE

Numerous somatosensory evoked potential (SEP) studies have provided clear evidence that during repetitive voluntary movement, the transmission of somatosensory afferent information is attenuated. The objective of this work was to determine if this gating phenomenon could persist beyond the period of repetitive movement.

METHODS

We recorded spinal, brainstem, and cortical SEPs to median nerve stimulation before and immediately after a modified 20 min repetitive typing task that did not involve the thenar muscles.

RESULTS

There were significant decreases in pre-central cortical and subcortical SEP amplitudes for several minutes following task cessation.

CONCLUSIONS

These results demonstrate the persistence of the gating phenomenon beyond the cessation of the actual repetitive movement. They also indicate that plastic changes do occur in cortical and subcortical components of the somatosensory system, following voluntary repetitive contractions.

SIGNIFICANCE

The persistence of changes in somatosensory processing beyond the period of repetitive activity may be relevant to the initiation of overuse injuries.

A comprehensive investigation of barriers to adult immunization: a methods paper

OBJECTIVE

Immunization rates for influenza and pneumococcal vaccines among the elderly (especially minority elderly) are below desired levels. We sought to answer 4 questions: (1) What factors explain most missed immunizations? (2) How are patient beliefs and practices regarding adult immunization affected by racial or cultural factors? (3) How are immunizations and patient beliefs affected by physician, organizational, and operational factors? and (4) Based on the relationships identified, can typologies be created that foster the tailoring of interventions to improve immunization rates?

STUDY DESIGN

A multidisciplinary team chose the PRECEDE-PROCEED framework, the Awareness-to-Adherence model of clinician response to guidelines, and the Triandis model of consumer decision making as the best models to assess barriers to and facilitators of immunization. Our data collection methods included focus groups, face-to-face and telephone interviews, self-administered surveys, site visits, participant observation, and medical record review.

POPULATION

To encounter a broad spectrum of patients, facilities, systems, and interventions, we sampled from 4 strata: inner-city neighborhood health centers, clinics in Veterans Administration facilities, rural practices in a network, and urban/suburban practices in a network. In stage 1, a stratified random cluster sample of 60 primary care clinicians was selected, 15 in each of the strata. In stage 2, a random sample of 15 patients was selected from each clinician's list of patients, aiming for 900 total interviews.

CONCLUSIONS

This multicomponent approach is well suited to identifying barriers to and facilitators of adult immunizations among a variety of populations, including the disadvantaged.

Evidence of hypertriglyceridemia in managing HIV patients on efavirenz

Of the recently approved antiretroviral agents, efavirenz has become a popular medication for the treatment of HIV infection. The efficacy of an efavirenz-based regimen has allowed the use of a combination of this medication with other antiretroviral agents in all levels of HIV disease, resulting in decreased viral replication and positive clinical results. Efavirenz is also proposed as an acceptable agent to switch to from a protease inhibitor-based regimen to reduce the risk of metabolic complications. In addition, the favorable side-effect profile, diminished pill burden for clients, and daily dosing have contributed to its popularity. Primary care practitioners should be cognizant of the possible side-effect profile of antiretroviral therapy combinations and enter into a collaborative relationship with the infectious disease clinician to ensure safe and effective patient care.

Vibrio gastroenteritis in the US Gulf of Mexico region: the role of raw oysters

We examined clinical and epidemiological features of 575 laboratory-confirmed cases of vibrio gastroenteritis in Alabama, Florida, Louisiana, and Texas from 1988 to 1997 (the US Gulf of Mexico Regional Vibrio Surveillance System). Illnesses occurred year round, with peaks in spring and autumn. Illnesses lasted a median of 7 days and included fever in half of patients and bloody stools in 25% of patients with relevant information. Seventy-two percent of patients reported no underlying illnesses. In the week before onset, 236 (53%) of 445 patients for whom data were available ate raw oysters, generally at a restaurant or bar. Educational efforts should address the risk of vibrio gastroenteritis for raw oyster consumers, including healthy individuals. Further studies should examine environmental conditions affecting vibrio counts on seafood and processing technologies to enhance the safety of raw oysters.

1,3,5-Trialkyl-2,4,6-triiodobenzenes: novel X-ray contrast agents for gastrointestinal imaging

Examination of the gastrointestinal (GI) tract has been performed for decades using barium sulfate. Although this agent has many recognized limitations including extreme radiopacity, poor intrinsic affinity for the GI mucosa, and very high density, no alternative contrast agents have emerged which produce comparable or better contrast visualization. In fact, the various techniques of the GI radiologic examination (i.e., single contrast, double contrast, biphasic) were developed to compensate for its limitations. Each of these techniques requires complex patient manipulation to achieve adequate mucosal coating or compression to overcome the marked radiopacity of barium sulfate in order to obtain a diagnostically useful examination. A series of novel radiopaque oils, the 1,3, 5-trialkyl-2,4,6-triiodobenzenes, was designed to improve the efficacy, stability, and safety of barium formulations. These substances were prepared in two steps from 1,3,5-trichlorobenzene. Compound 17 (1,3,5-tri-n-hexyl-2,4,6-triiodobenzene), formulated as an oil-in-water emulsion, was found to be well-tolerated in rodents (mice, hamsters, rats) following acute oral and/or intraperitoneal administrations at 4 times the anticipated human clinical dose. No metabolism of 17 was detected in rat, hamster, dog, monkey, or human hepatic microsomes, suggesting the lack of oral toxicity was a consequence of poor absorption. In imaging experiments in dogs, emulsions of 17 have demonstrated excellent mucosal coating and improved radiodensity relative to barium sulfate suspensions. On the basis of the preliminary imaging and toxicity data, compound 17 was selected as a potential development candidate.

Effects of atropine and L-NAME on cutaneous blood flow during body heating in humans

We sought to investigate further the roles of sweating, ACh spillover, and nitric oxide (NO) in the neurally mediated cutaneous vasodilation during body heating in humans. Six subjects were heated with a water-perfused suit while cutaneous blood flow was measured with a laser-Doppler flowmeter. After a rise in core temperature (1. 0 +/- 0.1 degrees C) and the establishment of cutaneous vasodilation, atropine and subsequently the NO synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME) were given to the forearm via a brachial artery catheter. After atropine infusion, cutaneous vascular conductance (CVC) remained constant in five of six subjects, whereas L-NAME administration blunted the rise in CVC in three of six subjects. A subsequent set of studies using intradermal microdialysis probes to selectively deliver drugs into forearm skin confirmed that atropine did not affect CVC. However, perfusion of L-NAME resulted in a significant decrease in CVC (37 +/- 4%, P < 0.05). The results indicate that neither sweating nor NO release via muscarinic receptor activation is essential to sustain cutaneous dilation during heating in humans.

Structural adaptation to selective pressure for altered ligand specificity in the Pseudomonas aeruginosa amide receptor, amiC

The AmiC protein in Pseudomonas aeruginosa is the negative regulator and ligand receptor for an amide-inducible aliphatic amidase operon. In the wild-type PAC1 strain, amidase expression is induced by acetamide or lactamide, but not by butyramide. A mutant strain of P. aeruginosa, PAC181, was selected for its sensitivity to induction by butyramide. The molecular basis for the butyramide inducible phenotype of P.aeruginosa PAC181 has now been determined, and results from a Thr-->Asn mutation at position 106 in PAC181-AmiC. In the wild-type PAC1-AmiC protein this residue forms part of the side wall of the amide-binding pocket but does not interact with the acetamide ligand directly. In the crystal structure of PAC181-AmiC complexed with butyramide, the Thr-->Asn mutation increases the size of the ligand binding site such that the mutant protein is able to close into its 'on' configuration even in the presence of butyramide. Although the mutation allows butyramide to be recognized as an inducer of amidase expression, the mutation is structurally sub-optimal, and produces a significant decrease in the stability of the mutant protein.

Family perspectives on dying in long-term care settings

Dying is a central experience in the life of a family. Yet there are few studies of dying in long-term care and the role of a family. The dynamic relationships among families, staff, and residents in long-term care facilities related to the process of dying is an area where research is needed. As part of a larger study of death and dying in long-term care settings, 11 family members who recently had experienced the loss of a relative in the long-term care setting were interviewed. The purpose of this study was to describe family perspectives on death and dying in long-term care facilities and to discuss ways staff may be helpful to families in coping with the loss of a family member. Analyzing death and dying from the family perspective offers health care providers an opportunity to expand the understanding of the phenomenon of death in long-term care facilities and to incorporate care activities that families view as helpful. Major themes emerged from this study, including the caring behaviors of staff, participating in the dying process, and providing spiritual support. The themes and practice implications are discussed in this article.

Cloning and characterization of hIF2, a human homologue of bacterial translation initiation factor 2, and its interaction with HIV-1 matrix

The cDNA for a human homologue (hIF2) of bacterial (bIF2) and yeast (yIF2) translation initiation factor two (IF2) has been identified during a screen for proteins which interact with HIV-1 matrix. The hIF2 cDNA encodes a 1220-amino-acid protein with a predicted relative molecular mass of 139 kDa, though endogeneous hIF2 migrates anomalously on SDS/PAGE at 180 kDa. hIF2 has an extended N-terminus compared with its homologues, although its central GTP-binding domain and C-terminus are highly conserved, with 58% sequence identity with yIF2. We have confirmed that hIF2 is required for general translation in human cells by generation of a point mutation in the P-loop of the GTP-binding domain. This mutant protein behaves in a transdominant manner in transient transfections and leads to a significant decrease in the translation of a reporter gene. hIF2 interacts directly with HIV-1 matrix and Gag in vitro, and the protein complex can be immunoprecipitated from human cells. This interaction appears to block hIF2 function, since purified matrix protein inhibits translation in a reticulocyte lysate. hIF2 does not correspond to any of the previously characterized translation initiation factors identified in mammals, but its essential role in translation appears to have been conserved from bacteria to humans.

Satiety related to 24 h diet-induced thermogenesis during high protein/carbohydrate vs high fat diets measured in a respiration chamber

OBJECTIVE

Assessment of a possible relationship between perception of satiety and diet-induced thermogenesis, with different macronutrient compositions, in a controlled situation over 24 h.

DESIGN

Two diets with different macronutrient compositions were offered to all subjects in randomized order.

SETTING

The study was executed in the respiration chambers at the department of Human Biology, Maastricht University.

SUBJECTS

Subjects were eight females, ages 23-33 y, BMI 23+/-3 kg/m2, recruited from University staff and students.

INTERVENTIONS

Subjects were fed in energy balance, with protein/carbohydrate/fat: 29/61/10 and 9/30/61 percentage of energy, with fixed meal sizes and meal intervals, and a fixed activity protocol, during 36 h experiments in a respiration chamber. The appetite profile was assessed by questionnaires during the day and during meals. Diet induced thermogenesis was determined as part of the energy expenditure.

RESULTS

Energy balance was almost complete, with non-significant deviations. Diet-Induced-Thermogenesis (DIT) was 14.6+/-2.9%, on the high protein/carbohydrate diet, and 10.5+/-3.8% on the high fat diet (P < 0.01). With the high protein/high carbohydrate diet, satiety was higher during meals (P < 0.001; P < 0.05), as well as over 24 h (P < 0.001), than with the high fat diet. Within one diet, 24 h DIT and satiety were correlated (r = 0.6; P < 0.05). The difference in DIT between the diets correlated with the differences in satiety (r = 0.8; P < 0.01).

CONCLUSION

In lean women, satiety and DIT were synchronously higher with a high protein/high carbohydrate diet than with a high fat diet. Differences (due to the different macronutrient compositions) in DIT correlated with differences in satiety over 24 h.

Physiological studies of the corticomotor projection to the hand after subcortical stroke

OBJECTIVE

The mechanisms which lead to recovery of motor function after a stroke are poorly understood. Functional reorganization of cortical motor centres is thought to be one of the factors which may contribute to recovery. We have investigated the extent of reorganization which occurs at the level of the primary motor cortex after a lesion of the corticospinal pathway.

METHODS

Transcranial magnetic stimulation was used to map the topography of the primary corticomotor projection to the abductor pollicis brevis muscle and study changes in cortical motor thresholds and corticospinal conduction in a group of 20 subjects with subcortical infarcts of varying duration (1 week to 15 years) and varying degrees of motor deficit.

RESULTS

There was a broad correlation between motor evoked potential (MEP) amplitude and motor thresholds on the one hand and the severity of motor deficit and site and extent of the lesion on the other. Shifts in the cortical motor maps were found in both early and late cases, irrespective of the site of the lesion, but were more frequent in the longer standing cases. Shifts were usually along the mediolateral axis but anteroposterior shifts were found in some late cases.

CONCLUSION

Our findings indicate that there is functional reorganization of the corticomotor projection in subjects who regain a degree of motor control following a subcortical lesion sparing the motor cortex.

Diet induced thermogenesis measured over 24h in a respiration chamber: effect of diet composition

OBJECTIVE

To study the effect of diet composition on diet-induced thermogenesis (DIT) over 24h in a respiration chamber.

SUBJECTS

Eight healthy female volunteers (age 27 +/- 3 y; body mass index, BMI 23 +/- 3 kg/m2). DIETS: A high protein and carbohydrate (HP/C) (60:10:30; percentage energy (E%)carbohydrate, fat and protein, respectively) and high fat (HF) (30:60:10 respectively) diet, both isoenergetic, isovolumetric, composed of normal food items and matched for organoleptic properties (taste, smell, appearance).

DESIGN

Subjects spent two 36h periods each in a respiration chamber consuming both test diets in random order. Components of 24h energy expenditure (24h EE): sleeping metabolic rate, DIT and activity induced energy expenditure were measured.

RESULTS

DIT was higher in all subjects while on the HP/C diet (1295 kJ/d vs 931 kJ/d; 14.6% vs 10.5% of energy intake; P < 0.02). There was no significant difference in other components or total 24h EE, although there was a trend towards higher EE on the HP/C diet.

CONCLUSION

A high protein and carbohydrate diet induces a greater thermic response in healthy individuals when compared to a high fat diet.

TRIP: a novel double stranded RNA binding protein which interacts with the leucine rich repeat of flightless I

A northwestern screen of a CHO-K1 cell line cDNA library with radiolabelled HIV-1 TAR RNA identified a novel TAR RNA interacting protein, TRIP. The human trip cDNA was also cloned and its expression is induced by phorbol esters. The N-terminus of TRIP shows high homology to the coiled coil domain of FLAP, a protein which binds the leucine-rich repeat (LRR) of Flightless I (FLI) and the interaction of TRIP with the FLI LRR has been confirmed in vitro . TRIP does not bind single stranded DNA or RNA significantly and binds double stranded DNA weakly. In contrast, TRIP binds double stranded RNA with high affinity and two molecules of TRIP bind the TAR stem. The RNA binding domain has been identified and encompasses a lysine-rich motif. A TRIP-GFP fusion is localised in the cytoplasm and excluded from the nucleus. FLI has a C-terminal gelsolin-like domain which binds actin and therefore the association of TRIP with the FLI LRR may provide a link between the actin cytoskeleton and RNA in mammalian cells.

The corticomotor representation of upper limb muscles in writer's cramp and changes following botulinum toxin injection

Transcranial magnetic stimulation was used to investigate the properties of the corticomotor pathway and to map the primary motor cortex projection to hand and forearm muscles during a sustained isometric contraction in a group of subjects with writer's cramp of varying duration. Corticomotor threshold, motor evoked potential amplitude and latency, and silent-period duration were normal on both sides in all subjects. The maps of the corticomotor projection were displaced relative to normal in all subjects, and in some cases were distorted in shape, with extensions of the lateral borders and the emergence of almost discrete secondary motor areas. The degree of map distortion and displacement was greatest in subjects with long-standing writer's cramp (> 5 years), and was bilateral in some cases. Injection of botulinum toxin into affected muscles demonstrated that the alterations in map topography were not fixed, and could be temporarily reversed during the period when the clinical effects of the injection were greatest, with the maps returning to their original positions as the effects of the injection wore off. It is concluded from this study that there are slowly evolving reorganizational changes in the primary motor cortex in writer's cramp, and that these changes may be secondary to altered afferent inputs from both clinically affected and unaffected muscles.

Synthesis and endectocidal activity of novel 1-(arylsulfonyl)-1-[(trifluoromethyl)sulfonyl]methane derivatives

We have recently synthesized a series of novel disulfonylmethane compounds that have shown anthelmintic and insecticidal (endectocidal) activity. Several analogues have shown activity against the internal nematode Haemonchus contortus. In sheep studies, these analogues have shown 100% control of this internal parasite at a 10 mg/kg rate. In vitro activity against the biting flies, Stomoxys calcitrans and Haematobia irritans, has been observed at rates as low as 25 and 2.3 ppm, respectively. Only marginal activity against the liver fluke Fasciola hepatica and Trichostrongylus colubriformis was seen. Respiratory control index values on rat liver mitochondria for this series suggested uncoupling of oxidative phosphorylation as a mechanism of action. Compound 1 is considered to be a promising agent for treatment of parasitized sheep.

Attachment/Detachment: Forces Influencing Care of the Dying in Long-Term Care

Death occurs among older adults in institutions more often than at home with family and friends. The older people are, the more likely they are to die in a nursing home. The purpose of this study was to describe staff and administrator's perspectives on death and dying in long-term care and to explore problems in providing humane care to dying residents that fosters gentle closure to life. Using focus group interviews as the primary data collection method, 22 focus group sessions were conducted in 11 nursing homes. Separate group sessions were held for staff and administrators in the nursing homes. The core variable identified in this study was the attachment of staff to residents in long term care. Attachment enhanced the quality of terminal care and fostered a gentle closure to life. Mediating forces influencing the process of attachment were identified as individual forces, as well as forces internal and external to the nursing home.

Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment, PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S.A. Wilson, L.A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed.

Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment, PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S.A. Wilson, L.A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed.

The transition to nursing home life: a comparison of planned and unplanned admissions

The percentage of elderly people in nursing homes increases with age from 7% for adults aged 75-84 years to 20% for those over 85 years old. Limited research has been done with elderly people whose admission to a nursing home was planned or unplanned. This study addressed: what are the initial experiences of elderly people in making the transition to nursing home life when the admission was planned or unplanned? A grounded theory approach using constant comparative methods was used to discover the process and patterns of transition to nursing home life. Data were collected 24 hours after admission and every other day for 2 weeks, and 1 month post-admission using in-depth semistructured interviews and field notes. Data analysis demonstrated that the transition to nursing home life occurred in three phases: overwhelmed, adjustment and initial acceptance phase. The phases of adjustment are discussed along with interventions to assist older adults in making this transition.