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This easy-to-follow 'cookbook' guides hand surgeons and radiologists through the process of diagnosis and treatment Mobile ultrasonography is revolutionizing the way hand surgery patients are managed. Ultrasound of the Hand and Upper Extremity: A Step-by-Step Guide is the first book on this field that is intended for practicing hand surgeons and the radiologists who work with them. A stepwise, practical guide specially designed for quick reference, with bullet-point text, informative figures, and detailed clinical examples, this book and its accompanying videos are ideal for the busy clinician. Edited by John R. Fowler and Nandkumar M. Rawool, with contributions by other experts with long experience in ultrasound techniques, this book features a reader-friendly chapter structure that describes the appropriate setup, anatomic landmarks, probe and patient positioning, comparative normal anatomy, relevant pathologic anatomy, and available injection techniques for 14 anatomic areas and conditions. Key Highlights * Full-color photographs to depict proper patient and probe positioning for optimal results * Expert advice on ultrasound machine settings for achieving the best images in various structures * Labeled ultrasound images of deformities and normal anatomy for comparative clinical use * Thirteen instructive videos highlight ultrasound techniques for a range of structures and pathologies This unique guidebook for upper limb ultrasound methods is the essential primary reference for all practicing hand surgeons and residents, as well as orthopedic surgeons, sports medicine specialists, and radiologists who must provide their patients with unrivaled care using state-of-the-art equipment and techniques.

Objective: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. Setting: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). Participants:) The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents who were eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. Intervention Description: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) trainning for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. Conclusions: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed to residents are substantial.

A police spokesman, John Gillespie, said the gunmen approached [Timothy Kelleher] and an another, unidentified Wells Fargo guard in a first floor corridor after the guards had picked up the money bag from the cashier's office. When Kelleher refused their demand to turn over the money bag, he was shot twice in the right leg and once in the left leg. He also suffered head lacerations, apparently when he fell. The second guard stayed with Kelleher. A third Wells Fargo employee was sitting in the company's armored truck. He drove off and pursued the Mazda for about two blocks before losing it. Gillespie said he did not know how the armored car driver was alerted. Police recovered the car on the first floor of the Mission Park garage, about a quarter of a mile from Children's Hospital. Gillespie said Kelleher's empty revolver was found in the garage, one level above where the Mazda was located. The Mazda had been reported stolen earlier in the day from downtown Boston. The FBI impounded the vehicle and it was being checked for evidence.

Georgia has played a formative role in the writing of America. Few states have produced a more impressive array of literary figures, among them Conrad Aiken, Erskine Caldwell, James Dickey, Joel Chandler Harris, Carson McCullers, Flannery O'Connor, Jean Toomer, and Alice Walker. This volume contains biographical and critical discussions of Georgia writers from the nineteenth century to the present as well as other information pertinent to Georgia literature. Organized in alphabetical order by author, the entries discuss each author's life and work, contributions to Georgia history and culture, and relevance to wider currents in regional and national literature. Lists of recommended readings supplement most entries. Especially important Georgia books have their own entries: works of social significance such as Lillian Smith's Strange Fruit, international publishing sensations like Margaret Mitchell's Gone With the Wind, and crowning artistic achievements including Jean Toomer's Cane. The literary culture of the state is also covered, with information on the Georgia Review and other journals; the Georgia Center for the Book, which promotes authors and reading; and the Townsend Prize, given in recognition of the year's best fiction. This is an essential volume for readers who want both to celebrate and learn more about Georgia's literary heritage.

Climate change is governed by changes to the global energy balance. A synthesis of the latest observations suggests that more longwave radiation is received at the Earth's surface than previously thought, and that more precipitation is generated. Climate change is governed by changes to the global energy balance. At the top of the atmosphere, this balance is monitored globally by satellite sensors that provide measurements of energy flowing to and from Earth. By contrast, observations at the surface are limited mostly to land areas. As a result, the global balance of energy fluxes within the atmosphere or at Earth's surface cannot be derived directly from measured fluxes, and is therefore uncertain. This lack of precise knowledge of surface energy fluxes profoundly affects our ability to understand how Earth's climate responds to increasing concentrations of greenhouse gases. In light of compilations of up-to-date surface and satellite data, the surface energy balance needs to be revised. Specifically, the longwave radiation received at the surface is estimated to be significantly larger, by between 10 and 17 Wm −2 , than earlier model-based estimates. Moreover, the latest satellite observations of global precipitation indicate that more precipitation is generated than previously thought. This additional precipitation is sustained by more energy leaving the surface by evaporation — that is, in the form of latent heat flux — and thereby offsets much of the increase in longwave flux to the surface.

James Thompson, vice president of the union, made the charges following the firing yesterday of 11 drivers on the orders of School Supt. Robert R. Spillane. Spillane ordered the dismissals Wednesday after a School Department review of criminal records of bus and van drivers, which disclosed that 50 havecriminal records. The crimes range from manslaughter and armed robbery to driving under the influence of alcohol and drug possession. The superintendent said he would consider taking action against the 39 other drivers after he reviews their work records. The bus drivers are employees of ARA Services, which transports approximately 27,000 Boston area students daily. Under the School Department's contract with ARA, which expires this year, school officials may order the firing of drivers considered unsafe, according to school officials.

•Breastmilk plasmalogen concentration differs over the postpartum period•Obesity may play a role in determining breast milk plasmalogen composition•Breast milk plasmalogen concentration may contribute to infant adiposity Ethanolamine-containing plasmalogens (pPEs) are a unique class of breastmilk (BM) glycerophospholipids containing a vinyl-ether at the sn-1 and a polyunsaturated fatty acid (PUFA) at the sn-2 position of the glycerol moiety. pPEs are present in the milk fat globule membrane, accumulate in the infant brain, and have been implicated in infant development. The study objectives were to: (1) describe the composition of BM pPEs and the variation in monomers at both the sn-1 and sn-2 positions; and (2) quantify the associations between BM pPEs and maternal predictors (body mass index, race, dietary fatty acid intake, gestational age at birth, and days’ postpartum). Secondary objectives were to explore the relationship between BM pPEs and infant anthropometrics and neurodevelopment. This was a secondary analysis of 39 mother–infant dyads in the control group of a randomized controlled trial of vitamin D supplementation during lactation. BM samples and data regarding maternal diet, infant anthropometrics (weight, fat mass index, and fat-free mass index by dual-energy X-ray absorptiometry), and infant development were collected at 1 month (visit 1 [V1], n = 37) and 4 months’ (visit 4 [V4], n = 39) postpartum. BM pPEs were extracted and quantified by using ultra-HPLC/high-resolution MS/MS at V1 and V4 and expressed as percent mass of total phospholipids. Associations of pPEs with infant development and anthropometrics were modeled using linear regression. C(18:0) vinyl ethers and C(18:2) polyunsaturated fatty acid–enriched pPEs predominate in BM. Specific pPEs, as a proportion of total phospholipids, decreased between V1 and V4. Higher maternal body mass index was associated with lower BM pPEs in unadjusted models, but this association was attenuated after adjustment for race, diet, and days’ postpartum. Maternal fatty acid intake, gestational age, and days’ postpartum were not associated with BM pPEs. Total pPEs at V1 were negatively associated with infant fat mass index and positively associated with fat-free mass index at V1 and V4. BM pPE concentrations were not correlated with neurodevelopmental outcomes. BM pPEs decrease over lactation and are associated with lower infant adiposity and higher lean mass. ClinicalTrials.gov identifier: NCT00412074.

HURRICANE GLORIA These Globe reporters...

This study examined children's expectancies about interactions with own- and other-gender peers. Goals were to examine expectancies about the outcomes related to own- versus other-gender group interactions, assess cohort and temporal changes in expectancies, and assess the effect of expectancies on school-related outcomes. Students in second and fourth grades (N = 412, 47% girls, Mage = 7.15 and 9.10 years, respectively) were followed longitudinally for 1 year. Results supported hypotheses that social costs and inclusion–enjoyment that children expect in interactions with own- and other-gender peers represent four constructs. Expectancies varied by gender, age, and differentially predicted school outcomes with inclusion expectancies more strongly relating to outcomes than cost expectancies. Implications of children's expectancies about gendered contexts are discussed.