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The cranial vault in an adult is an enclosed space encased by the rigid skull. The Monro–Kellie doctrine proposed in the early nineteenth century states that the volume inside the cranium is fixed and normally filled with the brain, cerebral spinal fluid, and blood in a state of equilibrium. An increase in the volume of one of these constituents must be compensated by a decrease in another. Intracranial pressure (ICP) is the pressure inside the skull due to the volume within the cranium. Elevated ICP can be severely debilitating and even life-threatening. It is very important to quickly identify signs and symptoms of elevated ICP, diagnose the pathology, and promptly initiate treatment in the emergency setting to prevent irreparable brain damage, significant disability, or death.
Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable.
We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit.
This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy).
Smokers who lived in homes with more restrictive household smoking rules, and/or reported having ‘important others’ who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting.
Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
Over the past two decades, thousands of studies have demonstrated that Blacks receive lower quality medical care than Whites, independent of disease status, setting, insurance, and other clinically relevant factors. Despite this, there has been little progress towards eradicating these inequities. Almost a decade ago we proposed a conceptual model identifying mechanisms through which clinicians' behavior, cognition, and decision making might be influenced by implicit racial biases and explicit racial stereotypes, and thereby contribute to racial inequities in care. Empirical evidence has supported many of these hypothesized mechanisms, demonstrating that White medical care clinicians: (1) hold negative implicit racial biases and explicit racial stereotypes, (2) have implicit racial biases that persist independently of and in contrast to their explicit (conscious) racial attitudes, and (3) can be influenced by racial bias in their clinical decision making and behavior during encounters with Black patients. This paper applies evidence from several disciplines to further specify our original model and elaborate on the ways racism can interact with cognitive biases to affect clinicians' behavior and decisions and in turn, patient behavior and decisions. We then highlight avenues for intervention and make specific recommendations to medical care and grant-making organizations.
Mutants of Pseudomonas aeruginosa tolerant to the action of trypsinsensitive aeruginocins can be readily isolated. They are found to be heterogeneous for a range of phenotypic characteristics (including the pattern of membrane protein components in polyacrylamide gel electrophoresis), response to bacteriophages (including both plaque formation and the ability to be lysogenized), sensitivity to various toxic agents, colonial morphology, and cellular morphology. The nature of these changes strongly supports the view that the mutants examined have undergone alteration in membrane structure. A limited genetic analysis indicates that at least two chromosomal regions are involved.
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