Identification of genetic and physiological mechanisms underlying a drug's or mutation's effects on motor performance could be aided by the existence of a simple observation-based rating scale of ataxia for mice. Rating scales were developed to assess ataxia after ethanol (2.75, 3.0, and 3.25 g/kg) in nine inbred mouse strains. Each scale independently rates a single behavior. Raters, blinded to dose, scored four behaviors (splay of hind legs, wobbling, nose down, and belly drag) at each of four time points after injection. The severities of hind leg splaying and wobbling were quantifiable, whereas nose down and belly dragging were expressed in all-or-none fashion. Interrater reliabilities were substantial (0.75 0 at some time), but all doses were equally effective. Incidence of nose down and belly dragging behaviors increased strain dependently after ethanol, but strains did not differentially respond to dose. Ethanol-induced splaying was modestly, and negatively, genetically correlated with wobbling. Nose down and belly dragging tended to be associated with splaying and wobbling at later times. Four distinct ataxia-related behaviors were sensitive to ethanol. Strains differed in ethanol sensitivity for all measures. Modest strain mean correlations among behaviors indicate that these behaviors are probably under control of largely different genes and that ataxia rating scales should rate separate behaviors on discrete scales.

An estimated 400,000–800,000 sharps-related injuries occur among healthcare workers (HCWs) annually in the United States. The risk of needlestick exposure may be particularly high among emergency medicine (EM) residents, who are learning new procedures in a relatively uncontrolled environment. Despite the potentially serious consequences of percutaneous injuries (PCIs), practitioners in training often down-play the occurrence of PCIs and do not report exposures.Current literature implies that underreporting of needlestick injuries is multifactorial. By not seeking care after needlesticks occur and thereby delaying treatment, residents incur more risk from exposures. We sought to elucidate the underlying issues that might contribute to this lack of reporting needlestick injuries. Using an anonymous survey, we collected information regarding factors that contributed to sustaining a PCI as well as perceived barriers that prevented residents from reporting these exposures. This information is desirable for both residency programs and employee health departments to reduce the occurrence of unreported exposures.The survey contained 19 questions, and all subjects were EM residents from the 8 Accreditation Council for Graduate Medical Education–accredited programs in the state of Illinois during the period January–February 2011. The voluntary survey was distributed via e-mail and through a paper version distributed at a regional EM residency conference.

Patient Willingness and Nonphysicians however, did not place gauze between the toes, which could have resulted in them becoming macerated. In comparing NP performance with expert care, emergency medicine physicians should not be assumed to provide error-free care.Given the results of these studies, potential questions include: What is the appropriate scope of NP practice, and how much deviation from expert care would a reasonable person consider relevant to the selection of a provider? To the extent that NPs' error rate is below this standard, patient consent should not be required for NP treatment. To the extent that patient preferences to be treated by doctors are based on prejudice rather than evidence of an increased risk, the appropriate intervention might be to educate patients more fully about how patients' complaints are triaged and NPs' training, skills, and abilities. While Larkin and Hooker (2010) mention providing information to patients in their discussion, they do not emphasize it in their abstract or conclusions.It should be further noted that one's certification is potentially only a rough marker of the quality of care one provides. To the extent that there is significant variation within, as well as between, disciplines, the reasonable person standard may justify collecting individual provider data and disclosing it to patients. In some instances it may be better to be treated by a knowledgeable and experienced NP than an inexperienced or outdated physician.

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