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We examined whether resting anterior electroencephalographic (EEG) asymmetry in the alpha frequency band has psychometric properties that would be expected of a measure assessing individual differences. In each of two experimental sessions, separated by three weeks, resting EEG in midfrontal and anterior temporal sites was recorded from 85 female adults during eight 60-s baselines. Resting alpha asymmetry demonstrated acceptable test-retest stability and excellent internal consistency reliability. Analyses including other frequency bands indicated that degree of stability varied somewhat as a function of band and region. In addition, asymmetry was less stable than absolute power. Discussion focuses on the implications of the present findings for the measurement and conceptualization of resting anterior asymmetry.

Background: Adverse drug events (ADEs) account for considerable patient morbidity and mortality as well as legal, operational and patient care costs. In Veterans Affairs (VA) hospitals in the USA, all serious adverse events and ''potential'' adverse events are reviewed using root cause analysis (RCA). This study characterised RCA reports associated with ADEs to determine what actions VA RCA teams took to reduce the number or severity of ADEs, and to evaluate which actions were effective in doing so. Methods: Every medication-related RCA submitted to the VA National Center for Patient Safety in the fiscal year 2004 (143 reports), and one medication-related aggregated RCA from each facility (111 reports covering 4834 ADEs) were reviewed and coded. Facilities were interviewed about specifics of their reports and the results of their interventions. Results: The commonest classes of medication for which ADEs were reported were narcotics, chemotherapy, and diabetic and cardiovascular medications. The most common types of ADE were ''wrong dose'', ''wrong medication'', ''failed to give medication'', and ''wrong patient''. 993 actions were taken to address these ADEs, the majority (75.7%) of which were reported to be fully implemented. Improvements in equipment and improving clinical care at the bedside were associated with reports of improved outcomes (p = 0.018, and p = 0.017 respectively), and training and education were negatively correlated with reports of improved outcome (p = 0.005). Improving the process of medication order entry through the use of alerts or forcing functions was positively correlated with reports of improved outcomes (p = 0.022). Leadership support and involving staff were associated with higher implementation rates (p = 0.001 and p = 0.010, respectively). Conclusions: Changes at the bedside and improvement in equipment and computers are effective at reducing ADEs. Well-organised tracking and support from leadership and staff were characteristics of facilities successful at improving outcomes. Training without action was associated with worse outcomes.Adverse drug events account for considerable patient morbidity and mortality 1-3 as well as legal, operational and patient care costs.4 5 Common causes of adverse drug events have been described in the literature, such as lack of knowledge of the medication, lack of information about the patient, rule violations and transcription errors.6 7 The systems failures that frequently lead to these events can be potentially prevented both at the level of the event, where workplace design issues predominate 8 and at the organisational level, where policies that inadvertently promote the risk for failure are primary. 9 The tightly coupled (interdependent) processes in medication use systems typify the situation where the risk of failure is increased with the complexity. 10Adverse drug events can be detected in a variety of ways, including voluntary reporting, [11][12][13] prompted reporting, 13-15 patient interviews, 13 16-18 chart review 11-13 1...

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The objective of this study was to develop a simple, safe, minimally invasive protocol to evaluate the hepatic vasculature. Five purpose-bred Beagle dogs underwent noncontrast-enhanced computed tomographic scan of the entire abdomen. A dynamic, nonincremental computed tomography scan at the level of T11 was then performed using a test bolus of contrast medium to determine time to peak opacification and to aid in the calculation of scan delay. The time to peak arterial enhancement ranged from 2.0 to 7.0 s, with a median of 2.0 s. The time to peak portal venous enhancement ranged from 23.0 to 46.0 s, with a median of 32.0 s. Scan delay for arterial opacification ranged from 0 to 5.0 s, with a median of 0 s. Scan delay for the portal phase of opacification ranged from 6.0 to 21.0 s, with a median of 17.0 s. Using this information, two separate computed tomographic studies were used to image the arterial and portal venous phases of circulatory opacification, respectively. The dogs were hyperventilated to prevent breathing motion during the scan, each of which required approximately 20 s. A power injector was used to inject diatrizoate meglumine (128 mg I/kg) through an 18-gauge cephalic vein catheter at a rate of 5 ml/s. Scanning was initiated after the appropriate scan delay to optimize the specific phase of vascular filling. Maximum intensity projections allowed clear delineation of the hepatic arteries and the portal venous system, while eliminating overlying structures that might interfere with image analysis. Time/density curves were generated, and the time needed for each study was recorded. Hepatic arteries and portal veins were clearly visualized in all dogs. Parenchymal opacification was also observed.

Background: In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England. Methods: This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England. Results: Median age of first injection was 22 years (interquartile range 18–28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection. Conclusions: Trauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas.

A statewide assessment was conducted of assaults, experiences, needs, and recommendations of 125 adult victims receiving care at 19 sexual assault centers (SACs) in the State of Maryland. More than one half of the victims (55.6%) waited years before disclosing, with delays in reporting especially likely if the assault was perpetrated by a family member (the most frequent perpetrators at 42.4% of respondents). About one half of the victims (51.3%) had been previously sexually assaulted, yet only 9% of these victims had sought treatment. The majority of respondents (69.4%) indicated they would not be filing charges against perpetrators, and of those who did, 46.2% reported dissatisfaction with the interview with police. Psychological symptoms such as depression and anxiety were the most common reasons for seeking care at the centers. Nearly all of respondents rated the care they received at the centers as very good or excellent. Respondents recommended more SACs, better advertising of their services, more mental health care within them (especially group therapy), and improved laws and law enforcement of perpetrators.

Clergy members are frequently cited as a potential source of community support to victims of sexual abuse or assault, as well as one likely avenue for disclosure. However, research and curricula on the topic are poorly developed, and studies show that victims' interactions with clergy are often negative. In the current study, a series of focus groups were conducted with clergy members of several denominations as part of a multi-faceted effort to improve the community response to victims in one state. Participating clergy reported inadequate education, support, and connections to community resources to respond adequately to the needs of sexual assault victims. The discussion presents recommendations for training and community policy, many voiced by participating clergy members themselves.