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Many contemporary children's novels follow this pattern: a traumatic event; a child who stops speaking; a crisis; the child speaks. These texts falsely claim to represent selective mutism. I propose the term \"literary selective mutism\" (LSM) to reflect the translation of this disorder in children's literature. Literary selective mutism has its own causes, symptoms, and treatment. It generates a particular plot structure and cast of characters. A disability studies perspective allows us to critique the way texts featuring LSM use this condition as a metaphor to focus on questions of silence, voice, and power.

The purpose of this study was to explore sampling options for a reliable and logistically more feasible protocol during a large EHV-1 outbreak. Seventeen horses with clinical infection as well as nineteen healthy herdmates, all part of an EHM outbreak, were enrolled in the study. Each horse was sampled two–four times at intervals of 2–6 days during the outbreak. All samples were collected using 6′′ rayon-tipped swabs. Nasal secretions were used as the diagnostic sample of choice. Additional samples, including swabs from the muzzle/nares, swabs from the front limbs, rectal swabs, swabs of the feed bin, and swabs of the water troughs were collected as well. All swabs were tested for the presence of EHV-1 by qPCR. With the exception of two EHV-1 qPCR-positive swabs from two different horses, all remaining swabs collected from healthy herdmates tested qPCR-negative for EHV-1. For horses with clinical infection, EHV-1 was detected in 31 nasal swabs, 30 muzzle/nares swabs, 7 front limb swabs, 7 feeders, 6 water troughs and 6 rectal swabs. Not all positive muzzle/nares swabs correlated with a positive nasal swab from the same set, however, and all other positive swabs did correlate with a positive nasal swab in their respective set. The agreement between nasal swabs and muzzle/nares swabs was 74%. The sampling of non-invasive swabs from the muzzle/nares should facilitate the identification of EHV-1 shedders during an outbreak, allowing for prompt isolation and implementation of biosecurity measures.

PurposePosterior uveitis is a common chorioretinal pathology affecting all ages worldwide and is a frequent reason for referral to the retina clinic. The spectrum of etiologies for uveitis is very broad and includes infectious and auto-immune diseases. Inflammation can be confined to the eye or may be a part of systemic disease. A useful outline is therefore proposed to aid in the correct diagnosis of these challenging entities. The situation is further complicated by the fact that many neoplastic conditions resemble features of posterior uveitis; they are known as “masqueraders of uveitis”. Here, we summarize different posterior uveitides that present with rare findings, along with masqueraders that can be difficult to distinguish. These conditions pose a diagnostic dilemma resulting in delay in treatment because of diagnostic uncertainty.MethodsAn extensive literature search was performed on the MEDLINE/PUBMED, EBSCO and Cochrane CENTRAL databases from January 1985 to January 2022 for original studies and reviews of predetermined diagnoses that include posterior uveitic entities, panuveitis and masquerade syndromes.ResultsWe described conditions that can present as mimickers of posterior uveitis (i.e., immune check-points inhibitors and Vogt-Koyanagi-Harada-like uveitis; leukemia and lymphoma associated posterior uveitis), inflammatory conditions that present as mimickers of retinal diseases (i.e., Purtscher-like retinopathy as a presentation of systemic lupus erythematosus; central serous chorioretinopathy masquerading inflammatory exudative retinal detachment), and uveitic conditions with rare and diagnostically challenging etiologies (i.e., paradoxical inflammatory effects of anti-TNF-α; post vaccination uveitis; ocular inflammation after intravitreal injection of antiangiogenic drugs).ConclusionThis review of unique posterior uveitis cases highlights the overlapping features of posterior uveitis (paradoxical inflammatory effects of anti -TNF α and uveitis; Purtscher-like retinopathy as a presentation of systemic lupus erythematosus, …) and the nature of retinal conditions (ischemic ocular syndrome, or central retinal vein occlusion, amyloidosis, inherited conditions like retinitis pigmentosa, autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), etc.…) that may mimic them is represented. Careful review of past uveitis history, current medications and recent vaccinations, detailed examination of signs of past or present inflammation, eventually genetic testing and/ or multimodal retinal imaging (like fluorescein angiography, EDI-OCT, OCT-angiography for lupus Purtscher-like retinopathy evaluation, or ICG for central serous retinopathy, or retinal amyloid angiopathy) may aid in correct diagnosis.

Introduction and hypothesis The 24-h pad test and cough stress test are commonly used to assess stress urinary incontinence; however, no comparative data are available. The cough stress test is superior to the 24-h pad test. Methods Women with predominant stress urinary incontinence symptoms underwent a cough stress test, a 24-h pad test, and urodynamic testing. Results Complete data were available on 55 women. Agreement between the urodynamic results and the stress test occurred in 89% of women ( k  = 0.51). Sensitivity, specificity, and positive and negative predictive values were 90%, 80%, 98%, and 44%. Agreement between the urodynamic results and the pad test occurred in 60% of women ( k  = 0.08). Sensitivity, specificity, and positive and negative predictive values were 60%, 60%, 94%, and 13%. Agreement between the cough stress test and the pad test occurred in 67% ( k  = 0.26). Conclusions The cough stress test is more reliable than the pad test for documentation of stress urinary incontinence.

Though international climate governance has had relative success in recent years, it faces difficulties of implementation at the national level and at times fails to garner the domestic support necessary for ratification. This poses issues for global success of climate regimes. To understand how domestic interests influence a state’s ratification behavior of International Environmental Agreements, this study employs a qualitative case study of the United States and its participation in the Kyoto Protocol. This case is understood through theories of cooperation and organization, specifically the concept of segmentation in interest organization. In this framework, hypotheses are developed arguing that higher levels of segment activity, both environmentally-friendly and opposition-oriented segments, increase or decrease the probability of ratification of international environmental agreement respectively. The study finds that entrenched domestic segments bargained at the national level, creating conditions that prevented the successful ratification of the Kyoto Protocol by the United States.

Religion has a well-documented relationship with mental health benefits and has consistently demonstrated an impact on several specific mental health concerns, including suicide, generally finding various religious facets to be inversely associated with suicidal thoughts and behaviors. More specifically, religion has been found to be associated with suicide in a number of ways, including decreased acceptance of suicide, decreased likelihood of suicidal thoughts, decreased likelihood of suicidal attempts, fewer suicide attempts, lower relative risk of suicide, lower suicide rate, and increased reasons for living. Several studies have proposed potential mediators (e.g., social support, locus of control, and substance abuse) of the relationship between religion and mental health, usually in non-clinical samples. The current study sought to examine the association between religious attendance and suicidal ideation using archival data of a clinical sample collected from the University of North Texas Psychology Clinic. Results from this sample revealed no evidence of mediation, instead suggesting a direct effect of religious attendance on suicidal ideation. Two mediation models demonstrated the effects of external locus of control and social support on suicidal ideation. These models are discussed in terms of their directionality, considering the extant research on these associations. Findings of the current study have implications for welcoming the incorporation of salient religious topics throughout treatment in mental health settings, including discussion of religious attendance among those clients who have identified religion as a personal value.

After a couple of days of pondering and worrying, I calmed down and e-mailed my friend. Of course [Joey] could stay. My older son, who had been Joey's schoolmate, would be delighted. I would pick up Joey from his other host at 1 p.m. on Christmas day (I'd calculated that by that time the intimate part of Christmas would be over - the Dutch Christmas breakfast eaten, the presents all unwrapped).