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Vertebrate hearing and balance are based in complex asymmetries of inner ear structure. Here, we identify retinoic acid (RA) as an extrinsic signal that acts directly on the ear rudiment to affect its compartmentalization along the anterior-posterior axis. A rostrocaudal wave of RA activity, generated by tissues surrounding the nascent ear, induces distinct responses from anterior and posterior halves of the inner ear rudiment. Prolonged response to RA by posterior otic tissue correlates with Tbx1 transcription and formation of mostly nonsensory inner ear structures. By contrast, anterior otic tissue displays only a brief response to RA and forms neuronal elements and most sensory structures of the inner ear.

PURPOSE: Children who experience long periods of auditory deprivation are susceptible to large-scale reorganization of auditory cortical areas responsible for the perception of speech and language. One consequence of this reorganization is that integration of combined auditory and visual information may be altered after hearing is restored with a cochlear implant. Our goal was to investigate the effects of reorganization in a task that examines performance during multisensory integration.

METHODS: Reaction times to the detection of basic auditory (A), visual (V), and combined auditory-visual (AV) stimuli were examined in a group of normally hearing children, and in two groups of cochlear implanted children: (1) early implanted children in whom cortical auditory evoked potentials (CAEPs) fell within normal developmental limits, and (2) late implanted children in whom CAEPs were outside of normal developmental limits. Miller's test of the race model inequality was performed for each group in order to examine the effects of auditory deprivation on multisensory integration abilities after implantation.

RESULTS: Results revealed a significant violation of the race model inequality in the normally hearing and early implanted children, but not in the group of late implanted children.

CONCLUSION: These results suggest that coactivation to multi-modal sensory input cannot explain the decreased reaction times to multi-modal input in late implanted children. These results are discussed in regards to current models for coactivation to redundant sensory information.

Nurses' fear of blame following a medication event and confusion about the error-reporting requirements of multiple regulatory bodies that oversee nursing practice and nursing home operations can stifle the discussion and analysis of medication administration events to promote patient safety. The Massachusetts Board of Registration in Nursing and the University of Massachusetts Medical School Center for Health Policy and Research convened the Massachusetts Medication Safety Alliance, a 15-member collaborative of regulatory agencies and long-term care providers, to develop the Nurse-Employer Medication Safety Partnership Model to cultivate a safety culture in Massachusetts nursing homes that supports voluntary medication-event recognition and disclosure by nurses. A proactive approach to the Board's public protection mission, the model will promote public safety through early intervention and quality improvement. To guide the model's development, the Alliance assessed the perceptions of 1,286 nurses working in 109 Massachusetts nursing homes, finding more than half rated their practice environment as punitive and identified fears of blame, disciplinary action, and lawsuits as barriers to medication-event reporting.

To address the mental health needs of children and adolescents, Patient-Centered Medical Homes (PCMHs) need the capacity to screen for and detect significant mental health symptoms at the earliest stages of expression, the ability to develop treatment plans with patients and families, and systems to monitor and guide treatment over time. Given the complex nature of children’s mental health issues, primary care providers cannot be expected to perform these functions without the help of specialized child psychiatry resources offered in a collaborative fashion. PCMHs need access to consultation services and specialized care coordination.

In this article we provide an overview of the different study designs commonly utilized in carrying out clinical and public health research and of the points to consider in reviewing these study designs. The design and conduct of cross-sectional health surveys, case-control, prospective, and case-crossover observational studies, and randomized controlled trials, are discussed in this review article. It is hoped that careful attention to the concerns we have raised will lead to the design and conduct of high-quality research projects and their write-up.

BACKGROUND:

The present feasibility study describes engagement and spread of a Twitter-based core-strengthening challenge.

METHODS:

A challenge that entailed completing a core-strengthening exercise using a hashtag (#PlankADay) was circulated via Twitter. We surveyed users who joined during the first 2 months of the challenge to describe their characteristics, including social support for exercise and to what extent they invited others to join. We continued to track total users for 10 months.

RESULTS:

Of 407 individuals who joined in the first 2 months, 105 completed surveys. Among these, 81% were female and 86% Caucasian and mean age was 35.8. 72% participated for at least 1 month and 47% participated for at least 2 months. Survey participants reported that the challenge increased their enjoyment of abdominal exercise. Of the 68% of participants who invited others to participate, 28% recruited none, 66% recruited 1-5 users, and 6% recruited 10 or more users. Participants reported that online friends provided as much positive social support for exercise as family and in-person friends. In 14 months, 4,941 users produced 76,746 tweets and mean total tweets per user was 15.86 (SD = 75.34; range= 1-2888).

CONCLUSION:

Online social networks may be a promising mechanism to spread brief exercise behaviors.