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Molecular characterization of IS1541 insertions in the genome of Yersinia pestis.

The genome of Yersinia pestis, the causative agent of plague, contains at least 30 copies of an element, designated IS1541, which is structurally related to IS200 (85% identity). One such element is inserted within the chromosomal inv gene (M. Simonet, B. Riot, N. Fortineau, and P. Berche, Infect. Immun. 64:375-379, 1996). We characterized other IS1541 insertions by cloning 14 different Y. pestis 6/69M loci carrying a single copy of this insertion sequence (IS) into Escherichia coli and, for each element, sequencing 250 bp of both flanking regions. In no case was this IS element inserted into large open reading frames; however, in eight cases, it was detected downstream (17 to 139 bp) of genes thought to be transcribed monocistronically or which constituted the last gene of an operon, and in only one case was it detected upstream (37 bp) of the first gene of an operon. Sequence analysis revealed stem-loop structures (deltaG, < -10 kcal) resembling rho-independent transcription terminators in 8 of the 14 insertion sites. These motifs might constitute hot spots for insertion of this IS1541 element within the Y. pestis genome.

Amino Acid Sequence↗

Epidemic neuropathy in Cuba: a public health problem related to the Cuban Democracy Act of the United States.

In 1992, the USA embargo on Cuba was tightened through the passage of the Cuban Democracy Act (CDA) that explicitly restricts food and medical supplies. The embargo has contributed to cause a number of public health problems in Cuba including: (1) an epidemic of more than 50,000 cases of optic and peripheral neuropathies in 1992-1993, resulting from dietary deficiency; (2) an epidemic of esophageal stenoses in toddlers who inadvertently drank liquid lye as a result of a soap shortage for which liquid lye was substituted; (3) an outbreak of Guillain-Barré syndrome in Havana, in June and July 1994, resulting from water contamination due to lack of chemicals for water treatment to eliminate Campylobacter sp.; (4) outbreaks of self-inflicted disease and injuries caused by rioting among Cubans detained at the US Naval base at Guantánamo Bay, and (5) a decline in medical practice standards and public health indicators in Cuba resulting from the enactment of the CDA, documented by the American Public Health Association in 1993 and confirmed in March 1997 by the American Association for World Health. Despite this evidence, the Cuban embargo remains a politically sensitive subject in the USA, resistant to public health concerns, as evidenced by the recent passage of the Helms-Burton Act. The public health effects of the CDA need to be reviewed with possible revocation or at least modification.

Adolescent↗

Glasgow resurrectionists.

The Napoleonic Wars and the colonial campaigns of the early 1800s created a great need for surgical training. Many of the cadavers used in Glasgow's schools of Anatomy were resurrected from local churchyards or imported from Ireland. In the 1820s, the activities of some resurrectionists showed gross insensitivity, with bodies being stolen before the funeral. In the early 1830s, cholera riots and the fear of "burking" led to the Anatomy Bill of 1832 receiving the Royal Assent.

Anatomy↗

Flashback: psychiatric experimentation with LSD in historical perspective.

In the popular mind, d-lysergic acid diethylamide (LSD) research in psychiatry has long been associated with the CIA-funded experiments conducted by Ewen Cameron at the Allen Memorial Institute in Montreal, Quebec. Despite this reputation, a host of medical researchers in the post World War II era explored LSD for its potential therapeutic value. Some of the most widespread trials in the Western world occurred in Saskatchewan, under the direction of psychiatrists Humphry Osmond (in Weyburn) and Abram Hoffer (in Saskatoon). These medical researchers were first drawn to LSD because of its ability to produce a "model psychosis." Their experiments with the drug that Osmond was to famously describe as a "psychedelic" led them to hypothesize and promote the biochemical nature of schizophrenia. This brief paper examines the early trials in Saskatchewan, drawing on hospital records, interviews with former research subjects, and the private papers of Hoffer and Osmond. It demonstrates that, far from being fringe medical research, these LSD trials represented a fruitful, and indeed encouraging, branch of psychiatric research occurring alongside more famous and successful trials of the first generation of psychopharmacological agents, such as chlropromazine and imipramine. Ultimately, these LSD experiments failed for 2 reasons, one scientific and the other cultural. First, in the 1950s and early 1960s, the scientific parameters of clinical trials shifted to necessitate randomized controlled trials, which the Saskatchewan researchers had failed to construct. Second, as LSD became increasingly associated with student riots, antiwar demonstrations, and the counterculture, governments intervened to criminalize the drug, restricting and then terminating formal medical research into its potential therapeutic effects.

History, 20th Century↗

Psychiatric aspects of terrorist violence: Northern Ireland 1969-1987.

For 18 years, Northern Ireland has suffered a changing pattern of civil disorder. Early years were marked by widespread sectarian rioting, shootings, and bombings, which heightened community tension and caused much social and commercial disruption. However, in recent years, terrorist organisations have been more selective in their acts of violence. There are methodological difficulties in assessing the psychological impact of civil disorder and terrorism. But, as well as can be judged from community surveys, hospital admissions and referral data, psychotropic drug usage, suicide and attempted suicide rates, and from assessment of the actual victims of violence, society has not 'broken down' nor has the impact been judged considerable. Possible explanations are discussed.

Civil Disorders↗

Man/boy love and the American gay movement.

The issue of man/boy love has intersected the gay movement since the late nineteenth century, with the rise of the first gay rights movement in Germany. In the United States, as the gay movement has retreated from its vision of sexual freedom for all in favor of integration into existing social and political structures, it has sought to marginalize cross-generational love as a "non-gay" issue. The two movements continue to overlap, amid signs of mutual support as well as tension--a state of affairs that also characterizes their interrelationship in other countries. This article offers an overview and analysis of that interrelationship in the United States since the Stonewall Riots in New York City in June 1969, which marked the beginning of a reinvigorated struggle for gay liberation.

Adolescent↗

Homosexuality and the American left: the impact of Stonewall.

Following the Stonewall Riots in New York City in June 1969, the left had to reassess negative appraisals of homosexuality that prevailed among virtually all leftist currents. Pressure for change came from within and from without. By the mid-1970s, three approaches had emerged: (1) radical support for sexual liberation and acceptance of same-sex love as being on a par with heterosexuality; (2) liberal support for the civil rights of homosexuals but without challenging heterosupremacy; and (3) continued adherence to the (Stalinist) view that homosexuality is a form of "bourgeois decadence" alien to the working class. This essay assesses the ways in which the left adapted to the new challenges that confronted it, with particular focus on attitudes toward the nature of homosexuality and its relation to the broader goals of the left.

Adolescent↗

Assessing stressors experienced through news media.

The Persian Gulf war of 1991 and the Los Angeles riots of 1992 highlight the importance of better understanding the effects of specific stressors that come to be known to the population solely through the news media. A standard scale to measure or categorize such stressors is suggested as a means of promoting further research.

Adult↗

Providing more than just care to neighborhoods.

The riots in Los Angeles focused new attention on the needs of inner cities. Many urban hospitals have played an active role in responding to and attempting to alleviate the woes afflicting cities. They've volunteered personnel and helped to develop programs ranging from job creation to property development to neighborhood beautification. Hospitals' efforts have benefited both neighborhoods and facilities.

Community-Institutional Relations↗

Shelter in the storm: disasters put hospitals to the test.

If disaster response is the ultimate test of our health care delivery system, California hospitals over the past three years have been subjected to what seems like final exams. Beginning with the Loma Prieta earthquake in 1989 and continuing with the Oakland firestorm in October 1991, the I-5 dust storm in November 1991, the Cape Mendocino quake in April, the Los Angeles riots in May, the Landers and Bear Lake quakes in June, and forest fires throughout the summer, California hospitals have risen to each and every occasion, showing consistent dedication to quality care while under tremendous stress. During these disasters, hospitals served as shelters in the storm for their communities, as thousands of wounded, sick and frightened poured through their doors. Staff performed more than their usual duties during these crises. Some worked double shifts. Others came to work and pitched in even though they were off duty. Many comforted patients while they worried about the safety of their own families and homes. Following are the experiences of some of these individuals.

California↗

Mass gathering medical care: a twenty-five year review.

INTRODUCTION: The purpose of this study was to critically review the provision of medical care at mass gatherings as described in 25 years of case reports. Specifically measured was the relationship between the size of a mass gathering and the frequency of patients seeking medical aid and the effects of certain event characteristics on this relationship. METHODS: Data were obtained through a retrospective literature review. Medline and CINHAL computerized databases were searched for English language articles using several keywords: "mass gathering", "concert", "festival", "Olympics", "crowd"; "riot", "stadium", "sports", "games", "papal", and "football". Only articles containing complete information on the number of spectators, number of patients, type, location, and duration of the mass gathering were included in the primary analysis. As available, additional information was added including the described weather patterns, number of patients transported to a hospital, and number of patients suffering a cardiac arrest. Thirty-five of the approximately 100 articles reviewed, met these criteria. RESULTS: A Spearman Rank Correlation Coefficient was calculated for number of spectators and patients and a significant relationship was identified (p = 0.0001). Mann-Whitney U-tests indicated that papal masses (p = 0.04), rock concerts (p = 0.005), hot climatic conditions (p = 0.03), and events held in the British Commonwealth (p = 0.03) had a significantly higher frequency of patient visits. Significantly more cardiac arrests occurred at papal masses (p = 0.04) and sporting events (p = 0.0002). CONCLUSIONS: Type of event, country, weather, and the size of the mass gathering had a significant effect on the numbers of spectators seeking medical care. A uniform classification scheme is necessary for future prospective studies of mass gatherings.

First Aid↗

Budget crisis: how six Ontario CEOs erased their deficits.

Earlier this year, about half of Ontario's 222 hospitals faced a funding crisis. In the spring, Ontario's treasurer read the riot act: the province wouldn't bail out hospitals with deficits. It was the first time any Ontario government followed through on its commitment to slash hospital costs. A recent report based on 23 operational reviews concluded in part that to control costs, hospitals must "realign, reduce, cap or eliminate certain services and programs." Here's what six CEOs did to erase their deficits for 1988-89.

Budgets↗

Sex oriented torture--an overview.

Sexual torture was prevalent in ancient times. It may take place in any form e.g., violence against sexual organs, physical sexual assault and mental sexual assault. There are many examples of sexual torture throughout the world. Indonesia in 1998 riot has witnessed several cases of sexual tortures. There are always some forms of motives in sexual torture. Methods employed in sexual torture are many--with or without using instruments or animals. The revival or moral values in the society, respect for women, sanctity of the family, respect for individual's dignity and awakening at social levels can meet the challenge.

Female↗

Art macabre: resurrectionists and anatomists.

The teaching of anatomy in England and Scotland from the 16th to the 19th centuries was carried out by the Companies of Barber Surgeons and also there were a number of private schools. The only sources of material for dissection and study were the gallows or the grave and the supply from the former was limited by law. Therefore the latter became the source of a saleable commodity, and so the profession of grave robbing became established. The taking of bodies was abhorrent to the populace, fights and riots would sometimes occur and public outrage was directed towards anatomists. The passing of the Anatomy Act of 1832 helped bring an end to the grisly business of snatching bodies, but the supply of material for study still remained a problem. In the 1920s there was a change in public attitude toward dissection which resulted in an increase in the donation of bodies.

Anatomy↗

[Cholera in Europe and Denmark in the 19th century].

There are several reasons for dealing with cholera in the 19th century: it acted as a spotlight throwing into sharp relief the darkest corners of society that are seldom mentioned in the sources. We learn about everyday life in large parts of the population, especially the poor. The fight against the disease also reveals how a society worked socially and politically. When cholera arrived in Europe -- the first time was in the 1830's and several times after that--the population reacted very violently, often by lynching doctors, while the authorities more or less let matters take their course. That is why international researchers have come to see cholera as a catalyst for the constantly latent social unrest following in the train of wars and revolutions. During my research on cholera in Denmark it became clear to me that matters were different here. There were no riots, nor any signs of social unrest--neither before nor after the outbreak of cholera. On the contrary, the authorities and the population joined forces against the epidemic. There was an atmosphere of mutual trust, and almost everybody turned out to be worthy of such trust. That points to a balanced society based on consensus, so cholera also functions as a detector of the fundamental structure of a society.

Cholera↗

Acute pulmonary effects from o-chlorobenzylidenemalonitrile "tear gas": a unique exposure outcome unmasked by strenuous exercise after a military training event.

o-Chlorobenzylidenemalonitrile, more commonly called CS, is grouped with several other irritant agents referred to as "tear gas." It is a riot-control agent used frequently in military settings to test the ability and speed of personnel in donning their military gas masks. When personnel are exposed to CS without proper personal protective equipment, it has potent irritant effects. We report a unique cluster of hospitalizations of nine U.S. Marines who developed a transient pulmonary syndrome. All nine patients had symptoms of cough and shortness of breath. Five of the nine presented with hemoptysis, and four presented with hypoxia. Symptoms were associated with strenuous physical exercise from 36 to 84 hours after heavy exposure of CS in a field training setting. Four of the nine Marines required intensive care observation as a result of profound hypoxia. All signs and symptoms resolved within 72 hours of hospital admission. One week after CS exposure, all nine Marines demonstrated normal lung function during spirometry before and after exercise challenge using cycle ergometry.

Adolescent↗

[Potential neurosurgical damage of rubber bullets. Analysis of 2 pediatric cases].

We present 2 cases of craniocerebral injuries in children caused by rubber bullets. The potential severity of these projectiles is discussed. The first case was an eleven-year-old boy who died a few days after having been injured by a rubber bullet during a riot. He presented with a bi-hemispheric fronto-parietal craniocerebral injury with massive intraventricular hemorrhage. The second case was a fourteen-year-old boy also injured by a similar rubber bullet with an important left fronto-temporal cerebral contusion. These projectiles were composed of a metal cylinder (length: 1.7 cm, diameter: 1.7 cm) covered by a 2 mm layer of rubber. The term "rubber bullet" could give the impression that these projectiles are harmless. But, based on these observations and on the literature, these rubber bullets (like their predecessors) can induce severe, or even fatal craniocerebral injuries.

Adolescent↗

Dams, environment and regional development--harnessing the "elixir of life: water" for overall development.

Water--the Elixir of Life--has the potential to sustain human life and also to develop it further, and that is why various international instruments have aptly recognized its role in sustainable development. This paper reviews the global and Indian water scenario before presenting the case of Gujarat State, where perennial water scarcity has raised serious threats to the existence of millions of people and cattle and has led to environmental degradation and constrained economic development. More than 13,000 villages out of 18,028 villages of the State are facing scarcity in terms of crop failure this year. Drinking water supply is maintained by transporting water by road tankers, "water special" trains and even by ships via a sea route. Lack of access to safe and clean water for domestic use has a detrimental effect on the social fabric, and even incidences of migration and water riots are recorded. The paper discusses the efficacy of available options including rain water harvesting. The efforts of the State to harness the untapped waters of Narmada for the survival of millions and sustainable development of western India, are discussed adjudging socioeconomic and environmental impacts. The paper concludes that assured water supply is essentially critical for overall development.

Agriculture↗