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141.
Troxclair D Ross KF Newman WP 《The American journal of forensic medicine and pathology》2005,26(3):282-284
Cor triatriatum is a rare congenital cardiac anomaly in which the left atrium is divided into proximal (dorsal or upper) and distal (ventral or lower) chambers by a fibromuscular septum. The upper chamber receives the pulmonary veins and the lower chamber contains the atrial appendage and the mitral valve. The 2 chambers communicate through a defect in the membrane. Cor triatriatum is often associated with other congenital cardiac anomalies. Most frequently, the upper chamber communicates with the right atrium through a patent foramen ovale or atrial septal defect, and the clinical symptoms simulate anomalous pulmonary venous return. Less commonly, the foramen ovale communicates with the distal chamber and the clinical features mimic mitral stenosis. When cor triatriatum is the only abnormality, the clinical findings are also similar to mitral stenosis with development of pulmonary hypertension and subsequent right ventricular hypertrophy and atrial enlargement. The diagnosis is usually made in infancy or childhood, and the lack of treatment results in death in 75% of patients.We report the case of a woman who presented much later in life. The patient was a 57-year-old female with a clinical history of chronic atrial fibrillation who presented to the emergency department because of a "funny sensation" in her chest, though she denied chest pain, nausea, vomiting, or diaphoresis. EKG revealed atrial fibrillation with a rapid ventricular response and a tachycardic rate of 157. She had a therapeutic level of digoxin, and cardiac enzymes were normal. The patient was admitted and placed on Cardizem drip. Serial EKGs remained normal and heart rate control was achieved. On hospital day 2, the patient became dyspneic and cyanotic. She went into cardiac arrest and died.Autopsy revealed cardiomegaly (610 g) with 4-chamber dilatation. A septum divided the left atrium into 2 chambers. The defect in the dividing membrane measured 1 cm in diameter. No other congenital defects were noted. The large size of the defect in the membrane likely accounted for the late onset of symptoms that allowed this patient to survive into adulthood without previous diagnosis or surgical intervention (which is usually required in childhood). 相似文献
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The federal government has exponentially increased funding for abstinence‐only sex education over the last few decades, a position supported by former vice‐presidential candidate Sarah Palin’s daughter Bristol. Unfortunately, empirical research indicates that abstinence‐only education is ineffective and may have negative consequences for adolescents. Despite encouragement of abstinence, adolescents continue to engage in sexual relationships, indicating that a different approach to sex education should be supported. This situation raises a number of justice issues because it is important for the government to fund sex education curricula that instruct adolescents on how to protect themselves from pregnancy and STDs. The majority of parents also disagree with the federal funding of abstinence‐only education and support more comprehensive education. This indicates that funding abstinence‐only education is diametrically opposed to community sentiment. Federal funding of abstinence‐only sex education is also problematic as such policies violate a number of adolescents’ constitutional rights. Therefore, the federal government must revise its current sex education policies. President Obama’s proposed plan has the potential to overcome many of these issues associated with abstinence‐only education. 相似文献
145.
Globalization and the Retreat of Citizen Participation in Collective Action: A Challenge for Public Administration
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Globalization challenges the ability of contemporary public administration to encourage citizen participation in collective action through behaviors such as tax compliance and contributions to public goods. The authors introduce a new individual‐level approach to globalization, arguing that people vary in the extent to which they are globalized and that an individual's level of globalism (ILG) reflects attitudes and dispositions that influence the way he or she resolves the social dilemma of participation in collective action (i.e., the decision to contribute versus follow a “free‐ride” strategy). Using a four‐country sample, the article examines the relationship between ILG and collective action participation decisions in three behavioral experiments. Findings support the hypothesis that regardless of country‐level globalization, a more globalized individual complies less willingly with tax codes, donates less to local nongovernmental organizations, and prefers to adopt a free‐ride strategy in a public goods game. The consequences for public administration are discussed. 相似文献
146.
Cooley-Strickland MR Griffin RS Darney D Otte K Ko J 《Journal of prevention & intervention in the community》2011,39(2):149-166
This study evaluated the efficacy of a school-based anxiety prevention program among urban children exposed to community violence. Students who attended Title 1 public elementary schools were screened. Ninety-eight 3rd-5th-grade students (ages 8-12; 48% female; 92% African American) were randomized into preventive intervention versus wait list comparison groups. Students attended 13 biweekly one-hour group sessions of a modified version of FRIENDS, a cognitive-behavioral anxiety intervention program. Results indicated that both intervention and control groups manifested significant reductions in anxiety symptomatology and total exposure to community violence, along with improved standardized reading achievement scores. Additional gains observed only in the intervention group were increased standardized mathematics achievement scores, decreased life stressors, and reduced victimization by community violence. The intervention was equally efficacious for both genders and for children exposed to higher, compared to lower, levels of community violence. Implications for comprehensive, culturally and contextually relevant prevention programs and research are discussed. 相似文献
147.
Dana Siobhan Atzpodien 《Swiss Political Science Review》2023,29(3):271-289
This article analyses parliamentary debates on marriage equality in Germany to understand what factors shape how parties deal with morality politics argumentatively. I argue that the internal divisions of parties and their coalition parties are crucial for the argumentation strategies used in parliamentary debates on morally charged wedge issues. Internally divided parties and parties that must be loyal to coalition partners confronted with internal divisions are likely to employ a discursive avoidance strategy to mitigate the potential for intra-party and intra-coalition polarization. To test this empirically, I examine the speeches of the German Bundestag on the Life Partnership Act in 2000 and Marriage for All in 2016 and 2017. The qualitative content analysis confirms my argument: The internally divided CDU and its coalition partners applied avoidance strategies by framing the issue primarily around constitutional principles and using procedural arguments, rather than framing the discourse as an issue of morality politics.