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Congress is faced with moving forward a pressing health care agenda while the federal deficit demands major budget cuts in Medicare. A pivotal player in this chess game is Senator John D. Rockefeller IV (D-WV). In this interview with Nursing Economic+, Sen. Rockefeller discusses catastrophic health insurance, Medicare, long-term care, and other health care issues.
A simplified algorithm is presented for determining the palsied cyclovertical muscle, once the three-step test is completed. The examiner is required only to remember the three-step test characteristics of two muscles (right superior oblique, left inferior oblique) and the Knight's move in chess.
Visual evoked potentials to reversed chess patterns have been examined in children with dysbinocular and refraction amblyopia of varying severity before and after pleoptic treatment. This method appears to be helpful for the prediction of the visual results and for monitoring the vision acuity restoration during the treatment of amblyopia in children.
Examination of visual induced potentials on reversible chess-pattern in 46 children with bilateral congenital zonular cataracts before and after surgical intervention has revealed correlation between these potentials and degree of lens opacification. After cataract extraction, positive dynamics of the potentials was observed in case of slightly opacified lenses and was absent in intensive lens opacification. The authors consider it reasonable to use visual induced potentials for prognosticating visual results after surgical treatment of bilateral congenital zonular cataracts, this being of particular importance for early surgical interventions.
The paper is concerned with the results of roentgenofunctional investigation of 293 miners, among them there were 63 patients with dust bronchitis and 230 patients with the main types of dust disease (anthracosis, silicosis and anthracosilicosis). Two-stage roentgenopneumopolygraphy (RPPG) with a chess grid and spiral pneumoroentgenography (SPRG) with a spiral grid were employed. Respiratory dysfunction in patients with pneumoconiosis depended on an x-ray and morphological type of fibrosis and stage of disease rather than on its type. The formation of zones of emphysematous inflation in the apical area, in the upper and middle regions of the lungs was revealed, however signs of basal emphysema were ++undetectable. Analysis of RPPG and SPRG findings has shown that unlike pneumoconiosis, dust bronchitis is characterized by earlier development of respiratory dysfunction of more noticeable type, particularly in early signs of disease.
There is no contradiction between rating scales and clinical judgment: the former represent only a codification of the latter. There is no contradiction either between clinical judgment and statistical judgment. Rating scales are elaborated with hopes of quantifying symptomatology and its change under treatment. In the field of comprehensive scales, let us mention the AMDP, the BPRS/BPHF, the IMPS and the PSE. Among depression scales, the HAMD is being superseded by the MADRS; our Department has also made an extensive use of the Overall Depression scale. Mania scales insufficiently discriminate between manic mood and agitation. As regards anxiety scales, the HAMA is an excellent one. In the field of somatic scales, we have developed the CHESS, which appears promising. In the field of diagnostic typology, the recent criteria by Pull might bring better results that previous research. Adequate scales are missing in mania, in the distinction between the psychostimulant and the antidepressant effects, in the field of vigilance-attention-memory and in the measurement of psychotherapeutic change.
The main standardized instruments for clinical assessment of depression and anxiety are diagnostic criteria, rating scales, and mental tests, mainly questionnaires. The systematic use of rigorous diagnostic criteria is useful in recruiting sufficiently homogeneous patient groups for clinical research. The polydiagnostic system represents, in this perspective, a stimulating trend of research, as it is not linked to a sole nosographic reference system. Some rating scales have recently been developed in Europe such as the MADRS, the Retardation Scale ERD of Widlöcher, the depression rating scale of Pichot, and the mania-depression scale of AMDP system. In the field of anxiety, standardized tools being used more and more are the Sheehan scales battery, some fear rating scales such as the FSS III, the brief scale of Tyrer, the anxiety scale from AMDP system, the BATE questionnaire of De Bonis, or the checklist of evaluation of somatic symptoms (CHESS). The sensitivity to changes of these different tools is their main value.
The model under consideration relates to the spread of a disease in a finite population where removal of infectives is allowed to occur. It is equivalent to a restricted random walk over a discrete grid of points interior to a trapezium. We consider an artificial barrier on the grid at which the epidemic ceases. The barrier is a semi-diagonal resembling the path of the knight in chess and allows some simplification of the analysis. In particular, we investigate the probability distribution along this barrier when time is infinite. Recursive relations are obtained for these terminal distributions and are used to develop an exact numerical method for their computation. In certain cases, a slight modification of the binomial distribution provides a good approximation to the actual distribution. A direct recursive method for calculating moments of the distribution is given and we show how the whole distribution may be recovered from these moments.
We have denoted two possible models of gene order evolution as the "card" and "chess" models. The first suggests random shuffling of genes during evolution, the second--non-random gene transposition, gene order being checked by natural selection. We discuss here localization of the mating type locus in fungal genomes. In 8 of 10 genetically well studied species of ascomycetous fungi, the mating type locus is linked to a centromere; in one species, it segregates regularly during the second meiotic division, and only one species does not show any regularity in the mating type locus segregation. Centromeric linkage of the mating type locus maintains heterozygosity of all centromeric genome regions during intratetrad fertilization observed in some fungi. Non-random localization of mating type locus can be considered as the means for conservation of heterozygosity.
The anxiolytic efficacy of tetrabamate was evaluated in 68 out-patients presenting an anxiety state with alcohol abuse according to DSM III criteria. The study followed a double-blind placebo-controlled design with parallel groups and lasted for 21 days. Anxiety was evaluated by the Hamilton anxiety scale, Norris visual analog scales, and the Hopkins Symptom Check List, along with the investigator's assessment. Safety was evaluated in terms of somatic symptoms (CHESS 84) and the physician's overall evaluation. The anxiolytic activity of tetrabamate (three 300 mg tablets/day) was significantly greater than that of placebo from seventh day on. There were no statistically significant differences in safety profile between tetrabamate and placebo. Moreover, in the tetrabamate group the significantly greater improvement in the scores of somatic symptoms indicates that the compound caused no notable adverse effects and its activity on somatic complaints (psychopathologic and/or toxic).
Dynamics of changes of visual evoked potentials recorded in patients with optico-chiasmatic arachnoiditis in response to a flash of light were revealed during restoration of visual function in the postoperative period. In improvement of visual functions no changes were found of evoked potentials recorded in a chess pattern in the immediate postoperative period.
The structure of nocturnal sleep was studied in two groups of subjects: the group I subjects had been given 60 unfamiliar English words to learn, whereas Group II subjects had been playing games of chess. The paradoxical sleep (PS) latency in the 1 st cycle, the type of falling into the PS, and intensity of rapid eye movements were recorded. No reliable difference was found in the sleep structure of both test groups. No correlation either was observed between the sleep characteristics and the quality of memorizing the verbal material.
Lately it appeared to be necessary to develop-alternative methods for control of antibiotic therapy. Detection of low molecular substances based on the immunoenzymatic assay (IEA) is one of the most promising approaches to the development of such methods. The authors developed a quantitative method for determination of benzylpenicillin (BP) according to the procedure described earlier by Van Weemen. The BP antisera were prepared by immunization of rabbits with a conjugate of bovine serum albumin. The gamma-globulin fraction isolated from the antisera was conjugated with peroxidase. The working dilution of the conjugate was determined by the chess titration method. The test system of competitive binding developed by the authors provides detection of BP in the biological fluids in concentrations of 0.1 to 0.0001 microgram/ml (by BP dry weight).
The efficacy of the combinations of aminoglycosides and penicillin with respect to Pseudomonas, Klebsiella and Escherichia strains was estimated with the methods of two-fold serial dilutions of aminoglycosides and constant concentrations of penicillin and the "chess board" method. Correlation between the synergistic effect and sensitivity of the strains to separate components of the combinations was observed. For prediction of the combination efficacy these methods are not useful, since they are labour-intensive and their results are very variable. In this connection a simple informative test is recommended. With the use of this test it is possible to judge the chemotherapeutic efficacy of antibiotics and their combinations by the value of the serum antibacterial activity (titer) against the infection causative agent. The blood serum titer of at least 1:8 is accompanied by a pronounced effect. The test also indirectly provides information on the sensitivity of isolated pathogens and adequacy of the drug blood levels after administration of the chosen dose.
In 1972, Halliday and co-workers [13] inaugurated the rotary mirror method for producing the visually evoked potential (VEP) by means of pattern reversal. The so-called pattern reversal VEP (PRVEP) is at present frequently obtained by means of a television monitor (TV stimulation) or light-emitting diode system (LED system). Independent of its special advantages and disadvantages, the stimulation by means of these systems as compared to the simple flash stimulation potentials seems to evoke with considerably better reproduceable latency indices, which enables a clearer separation of normal and pathological values. This is in particular true of the P100 component, which is the most prominent part of the VEP. The size of the individual squares of the chess-board pattern, of the whole stimulus field, the brightness and the intensity of the contrasts exert an influence on amplitudes and latencies of the PRVEP. The hitherto lacking standardisation of the recording technique makes it necessary that laboratory develops its own standard values. The domain of the PRVEP at the time being is the demonstration of demyelinising processes in the region of the optical nerve. That is why the PRVEP plays an important role in the diagnosis of multiple sclerosis, especially in subclinical processes and seemingly only spinal symptoms. Extension of the P100 latency, however, are not specific of multiple sclerosis and can also be caused by other lesions of the optical nerve or by a delayed maturing of the neuronal systems generating the VEP.
Intrapair resemblance of the wave form and amplitude-temporal parameters of evoked potentials (EPs) to flashes, chess field, house image, the word "house" and a series of other stimuli was evaluated in 20 pairs of monozygotic and 20 pairs of homosexual dizygotic adult twins. In the occipital area the maximum of genetic dependence was characteristic of EPs to flashes, the minimum--of EPs--to the word "house". In vertex EPs parameters genotypic effects were manifest irrespectively of the stimulus type. Genotypic dependence differed for the amplitudes and latencies of separate EP components.
The mutual interaction on the antibacterial activity of metronidazole and tinidazole with ampicillin, doxycycline and co-trimoxazole was studied by two-fold agar dilution series and chess-board determinations with 24 anaerobic bacterial strains which were recent clinical isolates. The nitroimidazoles had similar activity, and partial or complete synergy was observed in 83 - 88% of the strains when they were combined with ampicillin and doxycycline and 83 - 100% when combined with co-trimoxazole, which was moderately less active on a weight basis. A combination between ampicillin and a nitroimidazole would be preferable due to high level of synergy, high activity against anaerobes, and a more consistent supplementary activity against enterococci.
A study was made of age peculiarities of EPs to spatially structurized stimuli in the shape of chess fields with different dimensions of their cells in children and juveniles with normal vision, aged from seven to seventeen. Heterochroneity has been established in maturation of EPs to a homogeneous and a spatially structurized stimuli. In accordance with the criterion of "maturity" of the EP to a spatially structurized stimulus, an enhanced probability of "mature" EPs appearance was observed with age, from 0.23 in seven year old to 0.75 in 11 to 17 years old. Correspondence was shown of age EP dynamics to age changes of the visual system sensitivity to deprivation.