WPL (United States)

Retropharyngeal abscesses are a difficult to diagnose condition in children. Though some children with such abscesses can be managed with intravenous (IV) antibiotics alone, our group has argued that surgical drainage is the gold standard for safe management and likely leads to shorter hospital stays. We present prospective data on children with retropharyngeal infections who were managed according to a clinical practice guideline that emphasizes reliance on computed tomography and prompt surgical drainage when pus is felt to be present. Prospective observational study at a tertiary care children's hospital. Children were included in the study if a retropharyngeal infection was suspected and they were treated according to the clinical guideline between July 2001 and March 2004. Of 111 children in the study, 73 were ultimately treated with incision and drainage. There was no long-term morbidity or mortality. Surgical patients were more likely to require an intensive care unit (ICU) admission than patients managed with IV antibiotics alone (26.0% vs. 5.3%, P < .01) and on average cost nearly $8,000 more ($22,071 and $14,950; P < .01). However, these results may be biased, as patients requiring surgery were younger, which likely influenced the decision for ICU admission. It is possible to treat pediatric retropharyngeal infections according to our clinical guideline with nearly zero long-term morbidity and mortality. Our data showed good outcomes for both groups, and substantially higher costs for patients treated surgically. These results cannot be regarded as definitive, because surgery was consistently advised for all patients with suspected pus, and because the surgical group was younger than the nonsurgical group.

HIV intervention and education efforts in China continue to be frustrated by the clear stigma associated with the disease inherent in Chinese culture. While modernizing and evolving rapidly, the Chinese sociocultural context continues to be influenced by traditional Confucian and Taoist philosophies. At the same time, there is growing tolerance of premarital and extramarital sex, particularly among younger groups as a result of their access to and interest in media and other resources exposing them to world outside traditional Chinese culture. The dangers of sexual behavior risk inherent in this changing environment are clear and worthy of serious attention. In this study, we address the issues surrounding a need for innovative and effective HIV/STD prevention efforts given the influence of social stigma, traditional values and expectations, a relative absence of reliable and trustworthy information about sexual health, and expanding and unguided exposure to information from outside sources. Identifying and working respectfully within the cultural belief systems dominant in the sociocultural context is as important to intervention design as a thorough evaluation of a target population’s needs, behaviors, and characteristics. Findings from a relatively young and uneducated sample expose and explicate the salient cultural schemata in this context, as well as how these schemata, coupled with the rapidly changing social environment, should inform intervention planning and implementation. We expect that the benefits of this study’s approach, framework, and findings can be incorporated into future intervention design among Chinese populations. These considerations will help guide a program’s effectiveness by enhancing the “fit” of the intervention to the target population and help boost program strength and sustainability.

One or more devices described in Chapter 5 can be used to implement an SDR. This chapter considers SDR architectures based on each DSP option. The receiver in an SDR almost always requires significantly more computational resources than the transmitter. Thus, only receiver architectures will be discussed in this chapter.

At first glance most radios appear to be single function—a first-generation cellular phone sends your voice, while a WiFi base station connects you to the Internet. Upon closer inspection, both of these devices are actually quite flexible and support different waveforms. Looking at all the radio devices in my house, only the garage door opener and the car key fob seem to be truly fixed. With this introduction, clearly a software-defined radio’s main characteristic is its ability to support different waveforms.

The distributed frontal–subcortical system consists of connected cortical and subcortical structures. While this can be referred to as the frontostriatal system, the anatomic connections originate in the prefrontal and frontal cortices, and project to the striatum, the globus pallidus, the thalamus, and back to the cortex (see Chapters 2 and 3). The term frontostriatal system sometimes represents a convenient shorthand label for this entire circuitry that extends beyond the striatum. Very similar behaviors, signs, and symptoms will be seen in disorders that affect the frontal cortices, the subcortical white matter projections, the striatum, the globus pallidus, or the thalamus (Chow & Cummings, 2007; Stewart, 2006). This chapter presents a series of cases that illustrate the manner in which currently available neuropsychological tests can begin to assess the functioning of this extended region.

Previous chapters of this book have demonstrated that behavioral output is a function of cooperation between three brain regions, namely, the cortex, the basal ganglia, and the cerebellum. It was proposed that posterior cortices primarily function to process sensory–perceptual information. The frontal lobes and prefrontal cortices generate action or motor programs. The basal ganglia participate in attention and action selections and in binding action sequences as instrumental and procedural learning mechanisms. The cerebellum refines these selections of potential behavioral output to meet the amplification requirements of the given behavioral context. This “division of labor” has implications for neuropsychological testing because test results are affected by these same three brain-related sources of variability.

Covers advancements in spacecraft and tactical and strategic missile systems, including subsystem design and application, mission design and analysis, materials and structures, developments in space sciences, space processing and manufacturing, space operations, and applications of space technologies to other fields.