ARION: Greek Myth or Educational Hit?

ERIC Educational Resources Information Center

Chambers, Gary

1995-01-01

This article explicates ARION, which is part of the package of European funding programs that facilitate participation in study visits on a range of educational themes. The visits are designed to assist educational leaders in reviewing and modifying their own work as a result of experiencing educational structures outside their own country. (five…

South Africa, 2004: Power, Passion, Promise

ERIC Educational Resources Information Center

Bruckner, Martha

2005-01-01

Although the education system in post-apartheid South Africa has its share of serious challenges, the accompanying reforms carried out are inspiring as the ASCD Board of Directors and staff discovered when they visited the country in October 2004. The visit was organized around the theme of the 2005 ASCD Annual Conference: "Voices of…

What have positron emission tomography and ‘Zippy’ told us about the neuropharmacology of drug addiction?

PubMed Central

Cumming, Paul; Caprioli, Daniele; Dalley, Jeffrey W

2011-01-01

Translational molecular imaging with positron emission tomography (PET) and allied technologies offer unrivalled applications in the discovery of biomarkers and aetiological mechanisms relevant to human disease. Foremost among clinical PET findings during the past two decades of addiction research is the seminal discovery of reduced dopamine D2/3 receptor expression in the striatum of drug addicts, which could indicate a predisposing factor and/or compensatory reaction to the chronic abuse of stimulant drugs. In parallel, recent years have witnessed significant improvements in the performance of small animal tomographs (microPET) and a refinement of animal models of addiction based on clinically relevant diagnostic criteria. This review surveys the utility of PET in the elucidation of neuropharmacological mechanisms underlying drug addiction. It considers the consequences of chronic drug exposure on regional brain metabolism and neurotransmitter function and identifies those areas where further research is needed, especially concerning the implementation of PET tracers targeting neurotransmitter systems other than dopamine, which increasingly have been implicated in the pathophysiology of drug addiction. In addition, this review considers the causal effects of behavioural traits such as impulsivity and novelty/sensation-seeking on the emergence of compulsive drug-taking. Previous research indicates that spontaneously high-impulsive rats – as exemplified by ‘Zippy’– are pre-disposed to escalate intravenous cocaine self-administration, and subsequently to develop compulsive drug taking tendencies that endure despite concurrent adverse consequences of such behaviour, just as in human addiction. The discovery using microPET of pre-existing differences in dopamine D2/3 receptor expression in the striatum of high-impulsive rats suggests a neural endophenotype that may likewise pre-dispose to stimulant addiction in humans. LINKED ARTICLES This article is part of a themed section on Imaging. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2011.163.issue-8BJP has previously published an Imaging in Pharmacology themed section, edited by A Davenport and C Daly. To view this section visit http://dx.doi.org/10.1111/bph.2010.159.issue-4 PMID:20846139

Exploring home visits in a faith community as a service-learning opportunity.

PubMed

du Plessis, Emmerentia; Koen, Magdalene P; Bester, Petra

2013-08-01

Within South Africa the Psychiatric Nursing Science curriculum in undergraduate Baccalaureate nursing education utilizes home visits as a service-learning opportunity. In this context faith communities are currently unexplored with regards to service-learning opportunities. With limited literature available on this topic, the question was raised as to what are these students' and family members' experience of home visits within a faith community. To explore and describe nursing students' and family members' experiences of home visits within a faith community. A qualitative approach was used that was phenomenological, explorative and descriptive and contextual in nature. The research was conducted within a faith community as service learning opportunity for Baccalaureate degree nursing students. This community was situated in a semi-urban area in the North-West Province, South Africa. Eighteen (n=18) final year nursing students from different cultural representations, grouped into seven groups conducted home visits at seven (n=7) families. Comprehensive reflective reporting after the visits, namely that the students participated in a World Café data collection technique and interviews were conducted with family members. Three main themes emerged: students' initial experiences of feeling overwhelmed but later felt more competent; students' awareness of religious and cultural factors; and students' perception of their role. Two main themes from the family members emerged: experiencing caring and growth. There is mutual benefit for nursing students and family members. Students' experiences progress during home visits from feeling overwhelmed and incompetent towards a trusting relationship. Home visits in a faith community seems to be a valuable service learning opportunity, and the emotional competence, as well as spiritual and cultural awareness of nursing students should be facilitated in preparation for such home visits. Copyright © 2012 Elsevier Ltd. All rights reserved.

Perspectives of host faculty and trainees on international visiting faculty to paediatric academic departments in East Africa

PubMed Central

Russ, Christiana M; Ganapathi, Lakshmi; Marangu, Diana; Silverman, Melanie; Kija, Edward; Bakeera-Kitaka, Sabrina; Laving, Ahmed

2016-01-01

Background Investments in faculty exchanges to build physician workforce capacity are increasing. Little attention has been paid to the expectations of host institution faculty and trainees. This prospective qualitative research study explored faculty and resident perspectives about guest faculty in paediatric departments in East Africa, asking (1) What are the benefits and challenges of hosting guest faculty, (2) What factors influence the effectiveness of faculty visits and (3) How do host institutions prepare for faculty visits? Methods We recruited 36 faculty members and residents from among four paediatric departments in East Africa to participate in semistructured interviews which were audio recorded and transcribed. Data were qualitatively analysed using principles of open coding and thematic analysis. We achieved saturation of themes. Results Benefits of faculty visits varied based on the size and needs of host institutions. Emergent themes included the importance of guest faculty time commitment, and mutual preparation to ensure that visit goals and scheduling met host needs. We documented conflicts that developed around guest emotional responses and ethical approaches to clinical resource limitations, which some hosts tried to prepare for and mitigate. Imbalance in resources led to power differentials; some hosts sought partnerships to re-establish control over the process of having guests. Conclusions We identified that guest faculty can assist paediatric institutions in building capacity; however, effective visits require: (1) mutually agreed on goals with appropriate scheduling, visit length and commitment to ensure that the visits meet the host's needs, (2) careful selection and preparation of guest faculty to meet the host's goals, (3) emotional preparation by prospective guests along with host orientation to clinical work in the host's setting and (4) attention to funding sources for the visit and mitigation of resulting power differentials. PMID:28588960

Strategies to improve chronic disease management in seven metro Boston community health centers.

PubMed

Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S

2009-01-01

The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

Teen, Parent, and Clinician Expectations About Obesity and Related Conditions During the Annual Well-Child Visit

PubMed Central

Bossick, Andrew S.; Barone, Charles; Alexander, Gwen L.; Olden, Heather; Troy, Tanya; Cassidy-Bushrow, Andrea E.

2018-01-01

Purpose To examine family (patient and parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit. Methods Four focus groups with teen patients (n=16), four focus groups with parents (n=15), and one focus group with providers (n=12) were conducted using a structured moderator guide tailored to each specific population. Eligible patients had a well-child visit during the past 12 months and a diagnosis of overweight, obesity, hyperlipidemia, or elevated blood pressure. Parents who attended their child’s well-child visit and had a child meeting these same criteria were eligible. Teen focus groups were divided by gender (male/female) and age (14-15y/16-17y). Focus group transcripts were coded for concepts and themes using qualitative data and thematic analysis. Analysis was performed across groups to determine common themes and domains of intersect. Results Teens and parents expect weight to be discussed at well-child visits, and prefer discussions to come from a trusted clinician who uses serious, consistent language. Teens did not recognize the health implications from excess weight, and both parents and teens express the need for more information on strategies to change behavior. Providers recognize several challenges and barriers to discussing weight management in the well-child visit. Conclusion A clinician-teen-family relationship built on trust, longevity, teamwork, support, and encouragement can create a positive atmosphere and may improve understanding for weight-related messages for teens and families during a well-child visit. PMID:29546229

Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives.

PubMed

Knierim, Shanna Doucette; Moore, Susan L; Raghunath, Silvia Gutiérrez; Yun, Lourdes; Boles, Richard E; Davidson, Arthur J

2018-06-23

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator's role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore.

Advocating for Antarctic wilderness: Short-term visits and human values

Treesearch

Patrick T. Maher

2007-01-01

This research examined the nature of experience for visitors to the Ross Sea Region (RSR) of Antarctica. By monitoring visitors before, during, and after their onsite visit, using a mixed methodology approach, several interesting themes have arisen. In terms of advocacy, are we preaching to the converted? Is advocacy the awareness or the action? How do we adequately...

Measles outbreak--California, December 2014-February 2015.

PubMed

Zipprich, Jennifer; Winter, Kathleen; Hacker, Jill; Xia, Dongxiang; Watt, James; Harriman, Kathleen

2015-02-20

On January 5, 2015, the California Department of Public Health (CDPH) was notified about a suspected measles case. The patient was a hospitalized, unvaccinated child, aged 11 years with rash onset on December 28. The only notable travel history during the exposure period was a visit to one of two adjacent Disney theme parks located in Orange County, California. On the same day, CDPH received reports of four additional suspected measles cases in California residents and two in Utah residents, all of whom reported visiting one or both Disney theme parks during December 17-20. By January 7,seven California measles cases had been confirmed, and CDPH issued a press release and an Epidemic Information Exchange (Epi-X) notification to other states regarding this outbreak. Measles transmission is ongoing.

TRP channels in the skin

PubMed Central

Tóth, Balázs I; Oláh, Attila; Szöllősi, Attila Gábor; Bíró, Tamás

2014-01-01

Emerging evidence suggests that transient receptor potential (TRP) ion channels not only act as ‘polymodal cellular sensors’ on sensory neurons but are also functionally expressed by a multitude of non-neuronal cell types. This is especially true in the skin, one of the largest organs of the body, where they appear to be critically involved in regulating various cutaneous functions both under physiological and pathophysiological conditions. In this review, we focus on introducing the roles of several cutaneous TRP channels in the regulation of the skin barrier, skin cell proliferation and differentiation, and immune functions. Moreover, we also describe the putative involvement of several TRP channels in the development of certain skin diseases and identify future TRP channel-targeted therapeutic opportunities. Linked Articles This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-10 PMID:24372189

Death receptors as targets in cancer.

PubMed

Micheau, O; Shirley, S; Dufour, F

2013-08-01

Anti-tumour therapies based on the use pro-apoptotic receptor agonists, including TNF-related apoptosis-inducing ligand (TRAIL) or monoclonal antibodies targeting TRAIL-R1 or TRAIL-R2, have been disappointing so far, despite clear evidence of clinical activity and lack of adverse events for the vast majority of these compounds, whether combined or not with conventional or targeted anti-cancer therapies. This brief review aims at discussing the possible reasons for the lack of apparent success of these therapeutic approaches and at providing hints in order to rationally design optimal protocols based on our current understanding of TRAIL signalling regulation or resistance for future clinical trials. This article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-8. © 2013 The British Pharmacological Society.

Improvement in Context: Exploring Aims, Improvement Priorities, and Environmental Considerations in a National Sample of Programs Using "Small Data".

PubMed

Philibert, Ingrid; Beernink, John H; Bush, Barbara H; Caniano, Donna A; Chow, Andrea; Coyle, John J; Gilhooly, Joseph; Kraybill, Donald E; Larson, David; Moran, Sarah; Nace, Mary Catherine; Robertson, William W; Rubin, Judith D; Sanford, Theodore

2017-12-01

In 2013, the Accreditation Council for Graduate Medical Education (ACGME) transitioned into a new accreditation system to reduce burden, focus on outcomes, and promote innovation and improvement. One component is a self-study that includes aims, an environmental assessment, and setting improvement priorities. The ACGME initiated voluntary site visits following the self-study. We explored common themes in program aims and assessment of their environment. Using grounded theory, inductive and deductive qualitative methods, and truth grounding, we analyzed data from voluntary site visits of 396 core and subspecialty programs between June 2015 and September 2017, with a focus on common themes. We report common themes for aims and the dimensions of the environmental assessment. Themes for strengths include a collegial, supportive learning environment; responsive leaders; and experiences that prepare residents for unsupervised practice. Improvement priorities encompass low learner engagement and "content mismatch" in didactic education, balancing education and service at a time of growing clinical volumes, and improving the utility of assessment systems. Common opportunities encompass collaborations that improve education, involving alumni and harnessing technology to enrich education, while threats include an unsustainable effort for many program leaders, clinical pressures on faculty, and loss of external sites important for education. Linked dimensions of the environmental assessment suggest benefit in a growing focus on learners, and approaches to ensure a humanistic learning environment that allows for growth, self-determination, and inclusion. The findings highlight actionable themes for the environmental assessment. We discuss implications for programs, institutions, and the ACGME.

Barriers to patient-centered human immunodeficiency virus (HIV) care with African American patients who use drugs: Social construction of the typical and ideal care visit.

PubMed

Carlberg-Racich, Suzanne; Roden, Lindsey

2017-01-01

A successful patient-provider relationship ensures that patients are treated as individuals and receive appropriate care for their unique circumstances. For this to occur, the relationship needs open communication and trust. African American persons who inject drugs (PWIDs) and who smoke crack cocaine are at elevated risks of poor health outcomes and are often lost to care. In addition, providers often experience difficulty serving this population. Although some barriers are documented in the peer-reviewed literature, this study sought to provide in-depth context to the relationship and how it is constructed. Individual, semistructured interviews were conducted with human immunodeficiency virus (HIV) care providers and their patients, specifically PWIDs and persons who smoke crack cocaine, in publicly funded HIV clinics in low-resource urban communities. n = 31 patients and n = 7 providers were interviewed about their perceptions of the other and the relationship. Interview transcripts were coded and analyzed for common themes, which were used to generate a conceptual, constructionist model of the HIV care visit. Common patient themes included the tendency to describe providers in familial terms, match between their current provider and ideal provider, concern about stigma related to their use, and expression of unmet needs. Provider themes revealed less match with their ideal patient-preferring patients who were both abstinent and adherent, and expressing frustration with patient refusal to change. Thematic results were used to create a visual and conceptual model for the HIV care visit. The model demonstrates both the positive and negative perceptions that inform the visit, and the barriers that impede a more fruitful patient-provider dynamic with a shared power structure. Provider training in communication and other identified topics may begin to lay the foundation for a shift in this structure.

The Day We Went to Auschwitz.

ERIC Educational Resources Information Center

Corr, Charles A.

1993-01-01

Physician reports some impressions and reflections deriving from a visit in June of 1990 to the Nazi death camp at Auschwitz-Birkenau in southwestern Poland. Its themes are incongruity, horror, and moments when one encounters hitherto unexplored and startling terrain. (Author)

Hospital and asylum visiting in historical perspective: themes and issues.

PubMed

Mooney, Graham; Reinarz, Jonathan

2009-01-01

Compared to doctors, patients and institutions, visitors are an understudied constituency in medical history. The collection of essays in this book situates the historical practice of hospital and asylum visiting in broad social, cultural and geographical perspectives. This introduction loosely categorises visitors into four groups: patient visitors, including family and friends; public visitors, such as entertainers, tourists and the clergy, who have no direct formal ties with the institution or the patients; house visitors involved with the management and government of the hospital; and official visitors, who have inspectorial responsibilities. Discussion of the wider historical significance of visiting draws attention to issues such as urban governance, philanthropy, the public sphere, civil society and citizenship.

The Experience of Women Veterans Coming Back from War.

PubMed

Maiocco, Gina; Smith, Mary Jane

2016-06-01

Issues surrounding mental health are common for women veterans who have served in Iraq and Afghanistan wars. The goal of this phenomenological study was to document themes in the stories gathered from eight women veterans who had come back from war. Themes in the stories were: arriving with mixed sentiments; evolving to a changed view of self; permeating aggravation; confounding broken relationships, frequent deployments, and change in military status; remembering war experiences; and seeking opportunity for what is possible. Mental health issues can be observed in the themes. Including story as part of the mental health visit with veterans may be beneficial to veterans as they deal with the transition of coming back. Copyright © 2016 Elsevier Inc. All rights reserved.

PCI Choice: Cardiovascular clinicians' perceptions of shared decision making in stable coronary artery disease.

PubMed

Coylewright, Megan; O'Neill, Elizabeth S; Dick, Sara; Grande, Stuart W

2017-06-01

Describe cardiovascular clinicians' perceptions of Shared Decision Making following use of a decision aid (DA) for stable coronary artery disease (CAD) "PCI Choice", in a randomized controlled trial. We conducted a semi-structured qualitative interview study with cardiologists and physician extenders (n=13) after using PCI Choice in practice. Interviews were transcribed then coded. Codes were organized into salient themes. Final themes were determined by consensus with all authors. Most clinicians (70%) had no prior knowledge of SDM or DAs. Mixed views about the role of the DA in the visit were related to misconceptions of how patient education differed from SDM. Qualitative assessment of clinician perceptions generated three themes: 1) Gaps exist in clinician knowledge around SDM; 2) Clinicians are often uncomfortable with modifying baseline practice; and 3) Clinicians express interest in using DAs after initial exposure within a research setting. Use of DAs by clinicians during clinic visits may improve understanding of SDM. Initial use is marked by a reluctance to modify established practice patterns. As clinicians explore new approaches to benefit their patients, there is an opportunity for DAs that provide clinician instruction on core elements of SDM to lead to enhanced SDM in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Farm Education at Stony Kill.

ERIC Educational Resources Information Center

Parisio, Richard

1986-01-01

Describes typical winter farm lessons for students visiting Stony Kill Farm Environmental Education Center located 70 miles north of New York City: butter and corncake making, soil erosion experiments, dissecting and growing seeds. Emphasizes major theme of conservation of farmland from destructive farming practices and careless development. (NEC)

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

PubMed

Linton, Julie M; Stockton, Maria Paz; Andrade, Berta; Daniel, Stephanie

2018-01-01

Positive parenting programs, developmental support services, and evidence-based home visiting programs can effectively provide parenting support and improve health and developmental outcomes for at-risk children. Few models, however, have integrated referrals for on-site support and home visiting programs into the provision of routine pediatric care within a medical home. This article describes an innovative approach, through partnership with a community-based organization, to deliver on-site and home visiting support services for children and families within and beyond the medical home. Our model offers a system of on-site services, including parenting, behavior, and/or development support, with optional intensive home visiting services. Assessment included description of the population served, delineation of services provided, and qualitative identification of key themes of the impact of services, illustrated by case examples. This replicable model describes untapped potential of the pediatric medical home as a springboard to mitigate risk and optimize children's health and development.

An Analysis of the Climate Data Initiative's Data Collection

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Bugbee, K.

2015-12-01

The Climate Data Initiative (CDI) is a broad multi-agency effort of the U.S. government that seeks to leverage the extensive existing federal climate-relevant data to stimulate innovation and private-sector entrepreneurship to support national climate-change preparedness. The CDI project is a systematic effort to manually curate and share openly available climate data from various federal agencies. To date, the CDI has curated seven themes, or topics, relevant to climate change resiliency. These themes include Coastal Flooding, Food Resilience, Water, Ecosystem Vulnerability, Human Health, Energy Infrastructure, and Transportation. Each theme was curated by subject matter experts who selected datasets relevant to the topic at hand. An analysis of the entire Climate Data Initiative data collection and the data curated for each theme offers insights into which datasets are considered most relevant in addressing climate resiliency. Other aspects of the data collection will be examined including which datasets were the most visited or popular and which datasets were the most sought after for curation by the theme teams. Results from the analysis of the CDI collection will be presented in this talk.

The development of an educational video to motivate teens with asthma to be more involved during medical visits and to improve medication adherence.

PubMed

Sleath, Betsy; Carpenter, Delesha M; Lee, Charles; Loughlin, Ceila E; Etheridge, Dana; Rivera-Duchesne, Laura; Reuland, Daniel S; Batey, Karolyne; Duchesne, Cristina I; Garcia, Nacire; Tudor, Gail

2016-09-01

Our objective was to develop a series of short educational videos for teens and parents to watch before pediatric visits to motivate teens to be more actively involved during their visits. The development of the short educational videos was theoretically guided by Social Cognitive Theory. First we conducted four focus groups with teens (ages 11 to 17) with asthma, four focus groups with the teens' parents, and seven focus groups with pediatric providers from four clinics. The research team, which included two teens with asthma and their parents, analyzed the focus group transcripts for themes and then developed the initial video script. Next, a visual storyboard was reviewed by focus groups with parents and four with teens to identify areas of the script for improvement. The English videos were then produced. Focus groups with Hispanic parents and teens were then conducted for advice on how to modify the videos to make a more culturally appropriate Spanish version. Based on focus group results, teen newscasters narrate six one- to two-minute videos with different themes: (a) how to get mom off your back, (b) asthma triggers, (c) staying active with asthma, (d) tracking asthma symptoms, (e) how to talk to your doctor and (f) having confidence with asthma. Each video clip has three key messages and emphasizes how teens should discuss these messages with their providers. Teens, parents, and providers gave us excellent insight into developing videos to increase teen involvement during medical visits.

Successful AP Music Theory Instruction: A Case Study

ERIC Educational Resources Information Center

Buonviri, Nathan O.

2018-01-01

The purpose of this case study was to examine the instructional approach of a highly successful Advanced Placement Music Theory teacher. I visited the participant's class twice a week for 14 weeks, taking field notes, conducting interviews, and collecting instructional artifacts. Analysis of qualitative data revealed three main themes: classroom…

Ecology as the Theme of a High School Advanced Biology Course

ERIC Educational Resources Information Center

Phillips, Lida

1977-01-01

This article describes an ecology course based upon the concepts of diversity and dynamic interaction. Most of the class time is spent doing field or laboratory activities; students assume most of the preparation and participation responsibilities. Activities include aquatic studies, museum visits, and terrestrial studies. (MA)

Bimolecular fluorescence complementation: lighting up seven transmembrane domain receptor signalling networks

PubMed Central

Rose, Rachel H; Briddon, Stephen J; Holliday, Nicholas D

2010-01-01

There is increasing complexity in the organization of seven transmembrane domain (7TM) receptor signalling pathways, and in the ability of their ligands to modulate and direct this signalling. Underlying these events is a network of protein interactions between the 7TM receptors themselves and associated effectors, such as G proteins and β-arrestins. Bimolecular fluorescence complementation, or BiFC, is a technique capable of detecting these protein–protein events essential for 7TM receptor function. Fluorescent proteins, such as those from Aequorea victoria, are split into two non-fluorescent halves, which then tag the proteins under study. On association, these fragments refold and regenerate a mature fluorescent protein, producing a BiFC signal indicative of complex formation. Here, we review the experimental criteria for successful application of BiFC, considered in the context of 7TM receptor signalling events such as receptor dimerization, G protein and β-arrestin signalling. The advantages and limitations of BiFC imaging are compared with alternative resonance energy transfer techniques. We show that the essential simplicity of the fluorescent BiFC measurement allows high-content and advanced imaging applications, and that it can probe more complex multi-protein interactions alone or in combination with resonance energy transfer. These capabilities suggest that BiFC techniques will become ever more useful in the analysis of ligand and 7TM receptor pharmacology at the molecular level of protein–protein interactions. This article is part of a themed section on Imaging in Pharmacology. To view the editorial for this themed section visit http://dx.doi.org/10.1111/j.1476-5381.2010.00685.x PMID:20015298

Opioid receptor trafficking and interaction in nociceptors

PubMed Central

Zhang, X; Bao, L; Li, S

2015-01-01

Opiate analgesics such as morphine are often used for pain therapy. However, antinociceptive tolerance and dependence may develop with long-term use of these drugs. It was found that μ-opioid receptors can interact with δ-opioid receptors, and morphine antinociceptive tolerance can be reduced by blocking δ-opioid receptors. Recent studies have shown that μ- and δ-opioid receptors are co-expressed in a considerable number of small neurons in the dorsal root ganglion. The interaction of μ-opioid receptors with δ-opioid receptors in the nociceptive afferents is facilitated by the stimulus-induced cell-surface expression of δ-opioid receptors, and contributes to morphine tolerance. Further analysis of the molecular, cellular and neural circuit mechanisms that regulate the trafficking and interaction of opioid receptors and related signalling molecules in the pain pathway would help to elucidate the mechanism of opiate analgesia and improve pain therapy. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2 PMID:24611685

Microvascular responsiveness in obesity: implications for therapeutic intervention

PubMed Central

Bagi, Zsolt; Feher, Attila; Cassuto, James

2012-01-01

Obesity has detrimental effects on the microcirculation. Functional changes in microvascular responsiveness may increase the risk of developing cardiovascular complications in obese patients. Emerging evidence indicates that selective therapeutic targeting of the microvessels may prevent life-threatening obesity-related vascular complications, such as ischaemic heart disease, heart failure and hypertension. It is also plausible that alterations in adipose tissue microcirculation contribute to the development of obesity. Therefore, targeting adipose tissue arterioles could represent a novel approach to reducing obesity. This review aims to examine recent studies that have been focused on vasomotor dysfunction of resistance arteries in obese humans and animal models of obesity. Particularly, findings in coronary resistance arteries are contrasted to those obtained in other vascular beds. We provide examples of therapeutic attempts, such as use of statins, ACE inhibitors and insulin sensitizers to prevent obesity-related microvascular complications. We further identify some of the important challenges and opportunities going forward. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3 PMID:21797844

The pharmacology of palmitoylethanolamide and first data on the therapeutic efficacy of some of its new formulations.

PubMed

Petrosino, Stefania; Di Marzo, Vincenzo

2017-06-01

Palmitoylethanolamide (PEA) has emerged as a potential nutraceutical, because this compound is naturally produced in many plant and animal food sources, as well as in cells and tissues of mammals, and endowed with important neuroprotective, anti-inflammatory and analgesic actions. Several efforts have been made to identify the molecular mechanism of action of PEA and explain its multiple effects both in the central and the peripheral nervous system. Here, we provide an overview of the pharmacology, efficacy and safety of PEA in neurodegenerative disorders, pain perception and inflammatory diseases. The current knowledge of new formulations of PEA with smaller particle size (i.e. micronized and ultra-micronized) when given alone or in combination with antioxidant flavonoids (i.e. luteolin) and stilbenes (i.e. polydatin) is also reviewed. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

"Sports Splash" 1980. A Librarian's Planning Handbook.

ERIC Educational Resources Information Center

Thomas, James L.; Thomas, Carol H.

This handbook has been developed as an aid for librarians in planning summer 1980 reading programs on a sports theme for children from preschool through the elementary years. The program encourages children to visit the library, become familiar with its resources, and promote reading and enjoyment of books. The handbook is complemented by…

Your Library--Greatest Show of All! Activity Manual.

ERIC Educational Resources Information Center

Jackson, Mary, Ed.

Intended as a companion volume for librarians planning a children's summer reading program, this activity manual provides ideas for games, puzzles, puppet shows, story reading, and more, all based on the theme of "Circus Summer." The manual suggests ways to promote the program, such as visits to schools, and provides directions for…

How to Visit a Museum.

ERIC Educational Resources Information Center

Rebetez, Pierre

The primary aim of this study is to encourage schools and museums to unite their efforts to further the use of the museum for teaching purposes and to promote the full development of creative faculties. The educational function of the museum is explored in consideration of the thirteen to eighteen year old age group. A recurring theme throughout…

St. Louis Educational Museum: A Centennial Commemoration

ERIC Educational Resources Information Center

Allen, James A.

2005-01-01

The St. Louis, Missouri Educational Museum has its roots in the 1904 Centennial Exposition, held at Forest Park on the edge of the city. The theme of the exposition was education and technology. Seventy thousand local school children visited the exposition, and at its conclusion an initiative was launched to purchase some of the exhibitions as…

Attachment-focused integrative reminiscence with older African Americans: a randomized controlled intervention study.

PubMed

Sabir, Myra; Henderson, Charles R; Kang, Suk-Young; Pillemer, Karl

2016-01-01

Prior integrative reminiscence interventions have had a limited focus on attachment themes. The attachment-focused integrative reminiscence (AFIR) intervention differs from these in its central emphasis on attachment themes. The wide range of health benefits resulting from integrative reminiscence may be due in part to reminiscing about, mourning, and integrating unresolved attachment experiences. Participants were randomized into treatment and wait-list control conditions, completed a pre-test, met for eight consecutive weekly two-hour sessions of largely attachment-focused reminiscence, then completed post-tests immediately following the intervention and again six months later. Results show treatment effects for depression (p = .01 and .05 at eight weeks and six months), perceived stress (p = .01 and .04), and emergency room (ER) visits at six months (p = .04), with the intervention group showing lower depression and stress and fewer ER visits. Integrative reminiscence interventions are cost effective, have rapid impact, and carry a certain appeal to older adults. Augmenting such interventions with a focus on attachment experiences may reduce perceived stress, an important health risk factor. Wider application of AFIRs may further reduce health disparities among US older adults.

KENNEDY SPACE CENTER, FLA. - Dennis Tito, the first private citizen to visit the International Space Station, shares his experiences with visitors at the 40th Space Congress. Held April 29-May 2, 2003, in Cape Canaveral, Fla., the Space Congress is an international conference that gathers attendees from the scientific community, the space industry workforce, educators and local supporting industries. This year's event commemorated the 40th anniversary of the Kennedy Space Center and the Centennial of Flight. The theme for the Space Congress was "Linking the Past to the Future: A Celebration of Space."

NASA Image and Video Library

2003-04-30

KENNEDY SPACE CENTER, FLA. - Dennis Tito, the first private citizen to visit the International Space Station, shares his experiences with visitors at the 40th Space Congress. Held April 29-May 2, 2003, in Cape Canaveral, Fla., the Space Congress is an international conference that gathers attendees from the scientific community, the space industry workforce, educators and local supporting industries. This year's event commemorated the 40th anniversary of the Kennedy Space Center and the Centennial of Flight. The theme for the Space Congress was "Linking the Past to the Future: A Celebration of Space."

KENNEDY SPACE CENTER, FLA. - Dennis Tito, the first private citizen to visit the International Space Station, shares his experiences during the Space Congress Gala. Held April 29-May 2, 2003, in Cape Canaveral, Fla., the Space Congress is an international conference that gathers attendees from the scientific community, the space industry workforce, educators and local supporting industries. This year's event commemorated the 40th anniversary of the Kennedy Space Center and the Centennial of Flight. The theme for the Space Congress was "Linking the Past to the Future: A Celebration of Space."

NASA Image and Video Library

2003-04-30

KENNEDY SPACE CENTER, FLA. - Dennis Tito, the first private citizen to visit the International Space Station, shares his experiences during the Space Congress Gala. Held April 29-May 2, 2003, in Cape Canaveral, Fla., the Space Congress is an international conference that gathers attendees from the scientific community, the space industry workforce, educators and local supporting industries. This year's event commemorated the 40th anniversary of the Kennedy Space Center and the Centennial of Flight. The theme for the Space Congress was "Linking the Past to the Future: A Celebration of Space."

Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective.

PubMed

Winter, Karen; Cree, Viviene E

2016-07-01

The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an 'invisible trade': it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice.

Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective

PubMed Central

Winter, Karen; Cree, Viviene E.

2016-01-01

The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an ‘invisible trade’: it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice. PMID:27559221

Theme Binders: One Size Fits All.

ERIC Educational Resources Information Center

Baskwill, Steve

1996-01-01

Describes theme binders designed by sixth graders as an independent study component that unites the class as a learning community, showcases student work, and illustrates developmental milestones for parents. Details theme binder components: (1) cover page; (2) introductory page outlining the theme and contents; (3) evaluation sections indicating…

Aspects of Theme in the Method and Discussion Sections of Biology Journal Articles in English.

ERIC Educational Resources Information Center

Martinez, Iliana A.

2003-01-01

Analyzes the thematic structure of the method and Discussion section of biology research articles. A corpus of 30 journal articles was analyzed using the categories of systematic functional linguistics and a semantic categorization for unmarked themes realized by subject. Revealed differences in the semantic construction of the sections. (VWL)

Hopping into Economics: First Graders Learn about Economics through an Easter Theme.

ERIC Educational Resources Information Center

Davis, Gaylene

A 3-month study unit introducing first grade students to economics through an Easter theme is outlined in five sections. Sections 1 and 2 describe rationale, goals, and learning objectives. Section 3 provides learning activities. A wide range of instructional strategies is used to teach the basic economic concepts of want, need, scarcity,…

To the Library and Beyond! 2001 Texas Reading Club Manual.

ERIC Educational Resources Information Center

Bonet, Elida Guardia; Coker, Lisa; Cowan, Julie; Green, Kathleen D.; Hager, Tina; Muller-McKinstry, Adelle; McMahon, Dorothy; Meyers, Sally; Parrish, Leila; Schill, Victor Lynn; Travis, Gayle; Vigil, Angel; Waits, Cara A.; Youngblood, Lisa

The Texas Reading Club is designed to encourage youth to read for pleasure and to promote library usage.The theme for 2001 is "To the Library and Beyond!" and emphasizes ways in which a visit to the library leads young minds to explore world geography and cultures, nature and the environment, college and careers, computers, and great…

Puja: Expressions of Hindu Devotion. Guide for Educators.

ERIC Educational Resources Information Center

Ridley, Sarah

This teaching packet serves as a unit by itself or as part of preparation unit for a visit to the Arthur M. Sackler Gallery to see the exhibition "Puja: Expressions of Hindu Devotion." Focusing on Hindu religious objects found in an art museum, the packet suggests connections between art and world studies themes. In addition, these…

Determining Primary Care Physician Information Needs to Inform Ambulatory Visit Note Display

PubMed Central

Clarke, M.A.; Steege, L.M.; Moore, J.L.; Koopman, R.J.; Belden, J.L.; Kim, M.S.

2014-01-01

Summary Background With the increase in the adoption of electronic health records (EHR) across the US, primary care physicians are experiencing information overload. The purpose of this pilot study was to determine the information needs of primary care physicians (PCPs) as they review clinic visit notes to inform EHR display. Method Data collection was conducted with 15 primary care physicians during semi-structured interviews, including a third party observer to control bias. Physicians reviewed major sections of an artificial but typical acute and chronic care visit note to identify the note sections that were relevant to their information needs. Statistical methods used were McNemar-Mosteller’s and Cochran Q. Results Physicians identified History of Present Illness (HPI), Assessment, and Plan (A&P) as the most important sections of a visit note. In contrast, they largely judged the Review of Systems (ROS) to be superfluous. There was also a statistical difference in physicians’ highlighting among all seven major note sections in acute (p = 0.00) and chronic (p = 0.00) care visit notes. Conclusion A&P and HPI sections were most frequently identified as important which suggests that physicians may have to identify a few key sections out of a long, unnecessarily verbose visit note. ROS is viewed by doctors as mostly “not needed,” but can have relevant information. The ROS can contain information needed for patient care when other sections of the Visit note, such as the HPI, lack the relevant information. Future studies should include producing a display that provides only relevant information to increase physician efficiency at the point of care. Also, research on moving A&P to the top of visit notes instead of having A&P at the bottom of the page is needed, since those are usually the first sections physicians refer to and reviewing from top to bottom may cause cognitive load. PMID:24734131

Perception of dental visit pictures in children with autism spectrum disorder and their caretakers: A qualitative study.

PubMed

Wibisono, Witriana L; Suharsini, Margaretha; Wiguna, Tjhin; Sudiroatmodjo, Budiharto; Budiardjo, Sarworini B; Auerkari, Elza I

2016-01-01

One of the most common ways to communicate to children with autism spectrum disorder (ASD) is by using pictures. This study was conducted to identify the easiest perception of dental visit by children with ASD when using pictures as printed photographs. Purposive sampling was used to recruit participants from a school for children with special needs in south Jakarta. Semi-structured interviews were conducted with 10 autistic children aged 13-17 years, 2 parents, and 2 teachers. Open-ended questions were asked to participants regarding pictures of dental clinic personnel and activity. Conversations were noted, tape recorded, and then categorized to extract a theme. The data were analyzed using Dedoose mixed methods software. Most respondents showed a positive perception of the dental visit pictures. Many of the pictures were easily recognized by children with ASD, but some failed to be understood. Caretakers not only gave their perception but also recommendations for improvement of the pictures. Dental visit pictures could be used as useful communication tools for children with ASD. Based on the results, the pictures related to dental visit were generally easy to understand, however, some needed correction to be comprehensible.

Theme-Based Courses Foster Student Learning and Promote Comfort with Learning New Material

ERIC Educational Resources Information Center

Tessier, Lisa; Tessier, Jack

2015-01-01

In this article, we review the literature about theme-based teaching, then report quantitative and qualitative results from surveys from three different courses: one section of a 100-level in-person art course; five sections of 300-level on-line art courses; and one section of a 100-level in-person biology course at SUNY Delhi with applied themes…

An Arts Advocacy Group Performs Community Arts Education: Community Development with Implications for K-12 Arts Education Policymaking

ERIC Educational Resources Information Center

Rademaker, Linnea L.

2007-01-01

In this article, the author revisits a case study presented in "Arts Education Policy Review" 105(1) in September/October 2003. The author discusses Arts Collaborator's Incorporated's (ACI) efforts to educate the community about art and about arts opportunities in River City. Themes visited in the discussion are community development through the…

Reflections and unprompted observations by healthcare students of an interprofessional shadowing visit.

PubMed

Wright, Anna; Hawkes, Gillian; Baker, Becky; Lindqvist, Susanne Marie

2012-07-01

This paper reports work from a Centre for Interprofessional Practice in a higher education institution in the UK that offers four levels of interprofessional learning (IPL) to all healthcare students. The second level (IPL2) integrates professional practice into the learning process, requiring students to shadow a qualified healthcare professional (from a different profession) for half a day. Students complete a reflective statement upon their learning experience on their return. A study was undertaken to analyse students' reflective statements in depth to see their observations and reflections on the shadowing visit. Using frame analysis, 160 reflective statements were analyzed, identifying common words and phrases used by students, which were then grouped together under six themes. Three of these related directly to the assignment: communication styles and techniques; communication between healthcare professionals and comparison of students' own and other healthcare professionals' roles. Three themes emerged from student's own interpretation of observations and reflections made during the shadowing of a different professional: attitudes toward other professions; power structures between professionals and patients and between professionals and impact of communication on patient care. Interprofessional shadowing gives students an opportunity to observe communication between healthcare professionals and patients and to reflect on broader issues surrounding collaborative working.

Targeting the NO/superoxide ratio in adipose tissue: relevance to obesity and diabetes management.

PubMed

Jankovic, Aleksandra; Korac, Aleksandra; Buzadzic, Biljana; Stancic, Ana; Otasevic, Vesna; Ferdinandy, Péter; Daiber, Andreas; Korac, Bato

2017-06-01

Insulin sensitivity and metabolic homeostasis depend on the capacity of adipose tissue to take up and utilize excess glucose and fatty acids. The key aspects that determine the fuel-buffering capacity of adipose tissue depend on the physiological levels of the small redox molecule, nitric oxide (NO). In addition to impairment of NO synthesis, excessive formation of the superoxide anion (О 2 •- ) in adipose tissue may be an important interfering factor diverting the signalling of NO and other reactive oxygen and nitrogen species in obesity, resulting in metabolic dysfunction of adipose tissue over time. Besides its role in relief from superoxide burst, enhanced NO signalling may be responsible for the therapeutic benefits of different superoxide dismutase mimetics, in obesity and experimental diabetes models. This review summarizes the role of NO in adipose tissue and highlights the effects of NO/О 2 •- ratio 'teetering' as a promising pharmacological target in the metabolic syndrome. This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc. © 2016 The British Pharmacological Society.

Plant sterol enriched functional food and atherosclerosis.

PubMed

Köhler, Jürgen; Teupser, Daniel; Elsässer, Albrecht; Weingärtner, Oliver

2017-06-01

Hypercholesterolaemia is a major cardiovascular risk factor. A healthy diet and a healthy lifestyle reduces cardiovascular risk. 'Functional foods' supplemented with phytosterols are recommended for the management of hypercholesterolaemia and have become a widely used non-prescription approach to lower plasma cholesterol levels. Two billion euros are spent world-wide each year on various functional foods, which have regulator-approved health claims for the management of elevated cholesterol levels. While international societies, such as the European Atherosclerosis Society or the National Heart Foundation in Australia, still advise phytosterols as an additional dietary option in the management of hypercholesterolaemia, recently released guidelines such as those from the National Institute of Health and Clinical Excellence in the United Kingdom are more critical of food supplementation with phytosterols and draw attention to significant safety issues. This review challenges whether an intervention with phytosterol supplements is beneficial. We summarize the current evidence from genetic diseases, genetic association studies, clinical trial data and data from animal studies. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2017 The British Pharmacological Society.

Transient receptor potential ion channels in primary sensory neurons as targets for novel analgesics

PubMed Central

Sousa-Valente, J; Andreou, A P; Urban, L; Nagy, I

2014-01-01

The last decade has witnessed an explosion in novel findings relating to the molecules involved in mediating the sensation of pain in humans. Transient receptor potential (TRP) ion channels emerged as the greatest group of molecules involved in the transduction of various physical stimuli into neuronal signals in primary sensory neurons, as well as, in the development of pain. Here, we review the role of TRP ion channels in primary sensory neurons in the development of pain associated with peripheral pathologies and possible strategies to translate preclinical data into the development of effective new analgesics. Based on available evidence, we argue that nociception-related TRP channels on primary sensory neurons provide highly valuable targets for the development of novel analgesics and that, in order to reduce possible undesirable side effects, novel analgesics should prevent the translocation from the cytoplasm to the cell membrane and the sensitization of the channels rather than blocking the channel pore or binding sites for exogenous or endogenous activators. LINKED ARTICLES This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-10 PMID:24283624

Can neuropeptides treat obesity? A review of neuropeptides and their potential role in the treatment of obesity

PubMed Central

Boughton, C K; Murphy, K G

2013-01-01

Obesity is a major worldwide public health issue. The physiological systems that regulate body weight are thus of great interest as targets for anti-obesity agents. Peptidergic systems are critical to the regulation of energy homeostasis by key regions in the hypothalamus and brainstem. A number of neuropeptide systems have therefore been investigated as potential treatments for obesity. Blocking orexigenic peptide signals such as neuropeptide Y, melanin-concentrating hormone, orexins, relaxin-3 and galanin-like peptide or stimulating anorectic signalling pathways used by peptides such as the melanocortins, ciliary neurotrophic factor and brain-derived neurotrophic factor, are approaches that have shown some promise, but which have also highlighted possible concerns. Manipulation of central peptidergic systems poses a number of therapeutic problems, including brain access and side effects. Given that the homeostatic defence of body weight may limit the effectiveness of any single-target therapy developed, a combination therapy approach may offer the best hope for the effective prevention and treatment of obesity. LINKED ARTICLES This article is part of a themed section on Neuropeptides. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.170.issue-7 PMID:23121386

Plant sterol enriched functional food and atherosclerosis

PubMed Central

Köhler, Jürgen; Teupser, Daniel; Elsässer, Albrecht

2017-01-01

Hypercholesterolaemia is a major cardiovascular risk factor. A healthy diet and a healthy lifestyle reduces cardiovascular risk. ‘Functional foods’ supplemented with phytosterols are recommended for the management of hypercholesterolaemia and have become a widely used non‐prescription approach to lower plasma cholesterol levels. Two billion euros are spent world‐wide each year on various functional foods, which have regulator‐approved health claims for the management of elevated cholesterol levels. While international societies, such as the European Atherosclerosis Society or the National Heart Foundation in Australia, still advise phytosterols as an additional dietary option in the management of hypercholesterolaemia, recently released guidelines such as those from the National Institute of Health and Clinical Excellence in the United Kingdom are more critical of food supplementation with phytosterols and draw attention to significant safety issues. This review challenges whether an intervention with phytosterol supplements is beneficial. We summarize the current evidence from genetic diseases, genetic association studies, clinical trial data and data from animal studies. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:28253422

Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver's Perceived Quality of Communication with Paediatric Dental Visits.

PubMed

Wong, Hai Ming; Bridges, Susan Margaret; McGrath, Colman Patrick; Yiu, Cynthia Kar Yung; Zayts, Olga A; Au, Terry Kit Fong

2017-01-01

Patients' perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient's perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver's perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients' demographic information and the caregiver's perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes 'disease / treatment', 'treatment procedure related instructions', 'preparation for examination', 'positive reinforcement / reassurance', and 'family / social history' from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme 'Positive reinforcement / reassurance': 'number of related words' (p = 0.002), 'number of related utterances' (p = 0.001), 'percentage of the related words in total number of words' (p = 0.005), 'percentage of the related utterances in total number of utterances' (p = 0.035) and 'percentage of time spent in total time duration' (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver's involvement, such as clinicians' mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians' communication skills for improving patients' clinical experiences and treatment satisfaction.

Exploring the experiences and implementing strategies for physiotherapy students who perceive they have been bullied or harassed on clinical placements: participatory action research.

PubMed

Thomson, Di; Patterson, David; Chapman, Hannah; Murray, Louise; Toner, Maeve; Hassenkamp, Anne-Marie

2017-03-01

To explore and empower physiotherapy students who reported being bullied or harassed on clinical placements by co-developing, implementing and evaluating strategies that could be adopted by the university. A participatory action research design was employed. Two focus groups were carried out involving 5 final year physiotherapy students. In the first focus group negative experiences were discussed and coping strategies suggested for their penultimate placement. A second focus group was held following the students' final placement when these strategies were evaluated and further ones proposed. A thematic analysis of the data was carried out. Four themes and sub-themes emerged from the analysis. The four themes were negative experiences on placement, coping strategies, the role of the visiting tutor and the assessment. The students' highlighted various degrees of threat to their efficacy and in most cases could draw upon a suggested 'tool box' of coping strategies. They all agreed that serious cases of harassment require wider support from the University senior management team which should be clearly documented. The role of the visiting tutor was deemed to be critical in these situations and recommendations were made regarding this role and the assessment of placements. Students understand that they are going to be assessed before achieving their professional qualification and in essence they will always find themselves in a hierarchical position but equally fairness must prevail and it is important and that there are clear avenues for them to seek support. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Building on the Momentum.... Proceedings from the 10th Anniversary Celebration of the National Education Goals Panel (Washington, DC, December 1-2, 1999).

ERIC Educational Resources Information Center

Tyson-Bernstein, Harriet

These proceedings summarize the themes and events of the 10th anniversary celebration of the National Education Goals Panel (NEGP). The proceedings are divided into three sections. The first section summarizes significant themes and issues raised over the 2-day event. The second section is a synopsis of discussions that took place during the…

Paging “Dr. Google”: Does Technology Fill the Gap Created by the Prenatal Care Visit Structure? Qualitative Focus Group Study With Pregnant Women

PubMed Central

Chuang, Cynthia H; Poole, Erika S; Peyton, Tamara; Blubaugh, Ian; Pauli, Jaimey; Feher, Alyssa; Reddy, Madhu

2014-01-01

Background The prenatal care visit structure has changed little over the past century despite the rapid evolution of technology including Internet and mobile phones. Little is known about how pregnant women engage with technologies and the interface between these tools and medical care, especially for women of lower socioeconomic status. Objective We sought to understand how women use technology during pregnancy through a qualitative study with women enrolled in the Women, Infants, and Children (WIC) program. Methods We recruited pregnant women ages 18 and older who owned a smartphone, at a WIC clinic in central Pennsylvania. The focus group guide included questions about women’s current pregnancy, their sources of information, and whether they used technology for pregnancy-related information. Sessions were audiotaped and transcribed. Three members of the research team independently analyzed each transcript, using a thematic analysis approach. Themes related to the topics discussed were identified, for which there was full agreement. Results Four focus groups were conducted with a total of 17 women. Three major themes emerged as follows. First, the prenatal visit structure is not patient-centered, with the first visit perceived as occurring too late and with too few visits early in pregnancy when women have the most questions for their prenatal care providers. Unfortunately, the educational materials women received during prenatal care were viewed as unhelpful. Second, women turn to technology (eg, Google, smartphone applications) to fill their knowledge gaps. Turning to technology was viewed to be a generational approach. Finally, women reported that technology, although frequently used, has limitations. Conclusions The results of this qualitative research suggest that the current prenatal care visit structure is not patient-centered in that it does not allow women to seek advice when they want it most. A generational shift seems to have occurred, resulting in pregnant women in our study turning to the Internet and smartphones to fill this gap, which requires significant skills to navigate for useful information. Future steps may include developing interventions to help health care providers assist patients early in pregnancy to seek the information they want and to become better consumers of Internet-based pregnancy resources. PMID:24892583

Impact of a Home Hospice Visit Program on Third-Year Medical Students: A qualitative analysis of student reflections.

PubMed

Strano-Paul, Lisa; Lane, Susan; Lu, Wei-Hsin; Chandran, Latha

2015-01-01

This study evaluates the impact of an interprofessional home hospice visit (HHV) on third-year medical students' attitudes toward, and understanding of, end-of-life care and the visit's effect on students' views of their emerging professional roles and identities. All third-year medical students at Stony Brook School of Medicine in Stony Brook, New York, USA, participated in an HHV. A didactic session preceded the HHV. Subsequently, students were required to submit a piece of reflective writing detailing the impact of the visit. We conducted a qualitative analysis of a random sample drawn from the 467 submitted reflections. Six themes emerged from the student reflections: three were related to the students' direct observations during the HHV, and three were related to the reflective learning of the students based on their HHV experience. The qualitative analysis of the reflective writings showed that the students gained a deep appreciation of the human identity of hospice patients and a humanistic understanding of their own role as future physicians.

28 CFR 540.47 - Media visits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media representative...

28 CFR 540.47 - Media visits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media representative...

28 CFR 540.47 - Media visits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media representative...

28 CFR 540.47 - Media visits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media representative...

28 CFR 540.47 - Media visits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Media visits. 540.47 Section 540.47... PERSONS IN THE COMMUNITY Visiting Regulations § 540.47 Media visits. Requirements for media visits are governed by the provisions on contact with news media (see subpart E of this part). A media representative...

Closing remarks: A visit to Dr. Stout's and Dr. Murphy's forest health clinic

Treesearch

Russell T. Graham; Theresa B. Jain

1995-01-01

Two years ago I attended a camp with fellow silviculturists in central North Carolina. Camp Kanuga provided all kinds of fun activities. We described ecosystems and designed silvicultural systems for a variety of objectives; and as our camp scribe (Phil Aune) noted, the central camp theme evolved into ecosystem management. I am not sure exactly how or what happened but...

Reflections on the Reggio Emilia Approach as Inspiration for Early Childhood Teacher Education in Abu Dhabi, UAE

ERIC Educational Resources Information Center

Baker, Fiona S.

2015-01-01

This article discusses a teacher educator's reflections on her participation in an international study group and visits to the infant-toddler and pre-schools of Reggio Emilia, Italy, as inspiration for early childhood teacher education in Abu Dhabi, UAE. The following five themes are reflected on, for teacher education in the context of Abu Dhabi:…

Nursing Philosophy of community mental health nurses in Japan: A qualitative, descriptive study.

PubMed

Tanaka, Koji; Hasegawa, Masami; Nagayama, Yutaka; Oe, Masato

2018-04-01

The present study reports the findings of a qualitative, descriptive study that sought to clarify nursing philosophy for community mental health nurses (CMHN) working at independent psychiatric home-visit nursing agencies in Japan. We carried out participant observation and semistructured interviews with 13 CMHN in rural and urban areas. We identified eight subthemes and three higher-order themes based on these subthemes. CMHN embraced a nursing philosophy in which they: (i) have respect for consumers' ways of life and their self-realization; (ii) find harmony between view of life and work; and (iii) build communities where residents support each other beyond their roles. Together, these themes constitute a valuable nursing philosophy that supports the recovery of people with mental illness. The themes could also help educate professionals about principles and meanings relevant to recovery, which are regarded as key to changing the professional's care paradigm from a biomedical model to a recovery model. © 2017 Australian College of Mental Health Nurses Inc.

Comparison of Abuse Experiences of Rural and Urban African American Women During Perinatal Period

PubMed Central

Bhandari, Shreya; Bullock, Linda F. C.; Richardson, Jeanita W.; Kimeto, Pamela; Campbell, Jacquelyn C.; Sharps, Phyllis W.

2015-01-01

A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed. PMID:25315478

Surveillance of compliance with tobacco regulations in Örebro County, Sweden: a mixed methods study after the ban of test purchases.

PubMed

Schölin, Lisa; Eriksson, Charli

2012-02-15

Tobacco has long been known to be one of the most common reasons for sickness and premature deaths in the world. An important aspect of tobacco use is the youth's access to tobacco, and surveillance visits are one way to make sure how retailers are complying with age limit in the tobacco law. In Örebro County, Sweden, a project to reinforce the tobacco legislation was carried out in 2009-2010. One part of the project was surveillance visits that were done according to three different themes, called thematic surveillance. This study is an evaluation of the results from thematic surveillance and has a mixed methods approach. The quantitative analyses concerns protocols from 217 surveillance visits, where questions were asked about three themes (self-monitoring programs; marketing; labeling of products and pricing). In addition, questionnaires filled out by six tobacco administrators who worked within the project were analyzed qualitatively by content analysis in order to study their perceptions and opinions of the project. This study shows that half of the visited retailers had self-monitoring programs. Lack of self-monitoring programs was significantly more common in smaller stores/kiosks and at restaurants. Further, the tobacco administrators who worked within the project perceived thematic surveillance as a good method for accomplishing better structure in surveillance work, but not as effective as purchase attempts (mystery shopping). Thematic surveillance was perceived as positive and the method was also regarded to be a good way to work with surveillance. However, the method could be developed further for optimal use and better effect at the retailers. It is clear that people who work with tobacco prevention at the local level in Örebro County want to use purchase attempts as a surveillance method, and that they believe that purchase attempts is the best way to make sure if store comply with the tobacco law.

Surveillance of compliance with tobacco regulations in Örebro County, Sweden: a mixed methods study after the ban of test purchases

PubMed Central

2012-01-01

Background Tobacco has long been known to be one of the most common reasons for sickness and premature deaths in the world. An important aspect of tobacco use is the youth's access to tobacco, and surveillance visits are one way to make sure how retailers are complying with age limit in the tobacco law. In Örebro County, Sweden, a project to reinforce the tobacco legislation was carried out in 2009-2010. One part of the project was surveillance visits that were done according to three different themes, called thematic surveillance. Methods This study is an evaluation of the results from thematic surveillance and has a mixed methods approach. The quantitative analyses concerns protocols from 217 surveillance visits, where questions were asked about three themes (self-monitoring programs; marketing; labeling of products and pricing). In addition, questionnaires filled out by six tobacco administrators who worked within the project were analyzed qualitatively by content analysis in order to study their perceptions and opinions of the project. Results This study shows that half of the visited retailers had self-monitoring programs. Lack of self-monitoring programs was significantly more common in smaller stores/kiosks and at restaurants. Further, the tobacco administrators who worked within the project perceived thematic surveillance as a good method for accomplishing better structure in surveillance work, but not as effective as purchase attempts (mystery shopping). Conclusions Thematic surveillance was perceived as positive and the method was also regarded to be a good way to work with surveillance. However, the method could be developed further for optimal use and better effect at the retailers. It is clear that people who work with tobacco prevention at the local level in Örebro County want to use purchase attempts as a surveillance method, and that they believe that purchase attempts is the best way to make sure if store comply with the tobacco law. PMID:22336332

School site visits for community-based participatory research on healthy eating.

PubMed

Patel, Anisha I; Bogart, Laura M; Uyeda, Kimberly E; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W; Schuster, Mark A

2009-12-01

School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and costs were obstacles to policy implementation. Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods.

Celebrating Diversity in Iowa.

ERIC Educational Resources Information Center

Gaines, Ruth Ann

This publication highlights the opportunities to celebrate statewide diversity experienced by the 1998-99 Iowa Teacher of the Year, an African-American woman. Section 1 highlights her visits to 16 colleges around Iowa. Section 2 discusses her visits to 400 classrooms in 93 K-12 schools in 50 districts. Section 3 discusses the conferences and…

Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis.

PubMed

Izquierdo, Adriana; Sarkisian, Catherine; Ryan, Gery; Wells, Kenneth B; Miranda, Jeanne

2014-01-01

To describe salient experiences with a primary care visit (eg, the context leading up to the visit, the experience and/or outcomes of that visit) for emotional, personal and/or mental health problems older Latinos with a history of depression and recent depressive symptoms and/or antidepressant medication use reported 10 years after enrollment into a randomized controlled trial of quality-improvement for depression in primary care. Secondary analysis of existing qualitative data from the second stage of the continuation study of Partners in Care (PIC). Latino ethnicity, aged > or =50 years, recent depressive symptoms and/or antidepressant medication use, and a recent primary care visit for mental health problems. Of 280 second-stage participants, 47 were eligible. Both stages of the continuation study included participants from the PIC parent study control and 2 intervention groups, and all had a history of depression. Data analyzed by a multidisciplinary team using grounded theory methodology. Five themes were identified: beliefs about the nature of depression; prior experiences with mental health disorders/treatments; sociocultural context (eg, social relationships, caregiving, the media); clinic-related features (eg, accessibility of providers, staff continuity, amount of visit time); and provider attributes (eg, interpersonal skills, holistic care approach). Findings emphasize the importance of key features for shaping the context leading up to primary care visits for help-seeking for mental health problems, and the experience and/or outcomes of those visits, among older depressed Latinos at long-term follow-up, and may help tailor chronic depression care for the clinical management of this vulnerable population.

Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients' information needs.

PubMed

Clarke, Martina A; Moore, Joi L; Steege, Linsey M; Koopman, Richelle J; Belden, Jeffery L; Canfield, Shannon M; Kim, Min S

2018-09-01

The purpose of this study was to determine the information needs of primary care patients as they review clinic visit notes to inform information that should be contained in an after-visit summary (AVS). We collected data from 15 patients with an acute illness and 14 patients with a chronic disease using semi-structured interviews. The acute patients reviewed seven major sections, and chronic patients reviewed eight major sections of a simulated, but realistic visit note to identify relevant information needs for their AVS. Patients in the acute illness group identified the Plan, Assessment and History of Present Illness the most as important note sections, while patients in the chronic care group identified Significant Lab Data, Plan, and Assessment the most as important note sections. This study was able to identify primary care patients' information needs after clinic visit. Primary care patients have information needs pertaining to diagnosis and treatment, which may be the reason why both patient groups identified Plan and Assessment as important note sections. Future research should also develop and assess an AVS based on the information gathered in this study and evaluate its usefulness among primary care patients. The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence.

22 CFR 125.5 - Exemptions for plant visits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Exemptions for plant visits. 125.5 Section 125... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... course of a classified plant visit by a foreign person, provided: The classified visit has itself been...

22 CFR 125.5 - Exemptions for plant visits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Exemptions for plant visits. 125.5 Section 125... EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.5 Exemptions for plant visits. (a) A... course of a classified plant visit by a foreign person, provided: The classified visit has itself been...

Perception of dental visit pictures in children with autism spectrum disorder and their caretakers: A qualitative study

PubMed Central

Wibisono, Witriana L.; Suharsini, Margaretha; Wiguna, Tjhin; Sudiroatmodjo, Budiharto; Budiardjo, Sarworini B.; Auerkari, Elza I.

2016-01-01

Objectives: One of the most common ways to communicate to children with autism spectrum disorder (ASD) is by using pictures. This study was conducted to identify the easiest perception of dental visit by children with ASD when using pictures as printed photographs. Materials and Methods: Purposive sampling was used to recruit participants from a school for children with special needs in south Jakarta. Semi-structured interviews were conducted with 10 autistic children aged 13–17 years, 2 parents, and 2 teachers. Open-ended questions were asked to participants regarding pictures of dental clinic personnel and activity. Conversations were noted, tape recorded, and then categorized to extract a theme. The data were analyzed using Dedoose mixed methods software. Results: Most respondents showed a positive perception of the dental visit pictures. Many of the pictures were easily recognized by children with ASD, but some failed to be understood. Caretakers not only gave their perception but also recommendations for improvement of the pictures. Conclusions: Dental visit pictures could be used as useful communication tools for children with ASD. Based on the results, the pictures related to dental visit were generally easy to understand, however, some needed correction to be comprehensible. PMID:27583225

Theme Kits Made Easy.

ERIC Educational Resources Information Center

Eslinger, Leslie Silk

Recognizing the long-lasting impact of young childrens learning through themes as well as the amount of teacher time spent in preparing for this type of teaching, this kit is designed to help teachers avoid the shortcomings of theme-based teaching, while capitalizing on the benefits of this approach. The book is presented in two sections. The…

Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

PubMed

Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

2018-04-09

Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors.

PubMed

Rosenfeld, Lindsay E; Cohen, Juliana Fw; Gorski, Mary T; Lessing, Andrés J; Smith, Lauren; Rimm, Eric B; Hoffman, Jessica A

2017-02-01

In autumn 2012, Massachusetts schools implemented comprehensive competitive food and beverage standards similar to the US Department of Agriculture's Smart Snacks in School standards. We explored major themes raised by food-service directors (FSD) regarding their school-district-wide implementation of the standards. For this qualitative study, part of a larger mixed-methods study, compliance was measured via direct observation of foods and beverages during school site visits in spring 2013 and 2014, calculated to ascertain the percentage of compliant products available to students. Semi-structured interviews with school FSD conducted in each year were analysed for major implementation themes; those raised by more than two-thirds of participating school districts were explored in relationship to compliance. Massachusetts school districts (2013: n 26; 2014: n 21). Data collected from FSD. Seven major themes were raised by more than two-thirds of participating school districts (range 69-100 %): taking measures for successful transition; communicating with vendors/manufacturers; using tools to identify compliant foods and beverages; receiving support from leadership; grappling with issues not covered by the law; anticipating changes in sales of competitive foods and beverages; and anticipating changes in sales of school meals. Each theme was mentioned by the majority of more-compliant school districts (65-81 %), with themes being raised more frequently after the second year of implementation (range increase 4-14 %). FSD in more-compliant districts were more likely to talk about themes than those in less-compliant districts. Identified themes suggest best-practice recommendations likely useful for school districts implementing the final Smart Snacks in School standards, effective July 2016.

28 CFR 543.13 - Visits by attorneys.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Visits by attorneys. 543.13 Section 543.13 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT LEGAL... ordinarily take place during regular visiting hours. Attorney visits shall take place in a private conference...

28 CFR 543.13 - Visits by attorneys.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Visits by attorneys. 543.13 Section 543.13 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT LEGAL... ordinarily take place during regular visiting hours. Attorney visits shall take place in a private conference...

28 CFR 543.13 - Visits by attorneys.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Visits by attorneys. 543.13 Section 543.13 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT LEGAL... ordinarily take place during regular visiting hours. Attorney visits shall take place in a private conference...

28 CFR 540.42 - Visiting times.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish a...

28 CFR 540.42 - Visiting times.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish a...

28 CFR 540.42 - Visiting times.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish a...

28 CFR 540.42 - Visiting times.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Visiting times. 540.42 Section 540.42 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.42 Visiting times. (a) Each Warden shall establish a...

An Exploratory Investigation of the Effect of Working in an Environmentally Themed Facility on the Conservation-Related Knowledge, Attitudes and Behavior of Staff

ERIC Educational Resources Information Center

Groff, Amy; Lockhart, Donna; Ogden, Jacqueline; Dierking, Lynn D.

2005-01-01

In the past decade, we have seen an increased focus on measuring the impact of zoos, aquariums, and other free-choice learning environments on the conservation-related knowledge, attitudes and behavior of the visiting public. However, no such studies have been conducted on the impact of such environments on the staff working in these…

CrossTalk: The Journal of Defense Software Engineering. Volume 19, Number 5

DTIC Science & Technology

2006-05-01

Coming Events Web Sites Call for Articles Visit CrossTalk at the SSTC BackTalk Transforming: Business , Security ,Warfighting CrossTalk 76 SMXG CO-SPONSOR...theme “Transforming: Business , Security , Warfighting.” Transformation is not just the current buzzword: Many industries and the military have...systems. Transforming: Business , Security ,Warfighting Characteristic edocfosenilnoillim001-01eziS Number of external interfaces 30-300 Number of

The HyperMuseum Theme Generator System: Ontology-Based Internet Support for the Active Use of Digital Museum Data for Teaching and Presentation.

ERIC Educational Resources Information Center

Stuer, Peter; Meersman, Robert; De Bruyne, Steven

Museums have always been, sometimes directly and often indirectly, a key resource of arts and cultural heritage information for the classroom educator. The Web now offers an ideal way of taking this resource beyond the traditional textbook or school visit. While museums around the globe are embracing the web and putting virtual exhibitions,…

Museum spaces as psychological affordances: representations of immigration history and national identity

PubMed Central

Mukherjee, Sahana; Salter, Phia S.; Molina, Ludwin E.

2015-01-01

The present research draws upon a cultural psychological perspective to consider how psychological phenomena are grounded in socio-cultural contexts. Specifically, we examine the association between representations of history at Ellis Island Immigration Museum and identity-relevant concerns. Pilot study participants (N = 13) took a total of 114 photographs of exhibits that they considered as most important in the museum. Results indicate that a majority of the photographs reflected neutral themes (n = 81), followed by nation-glorifying images (n = 24), and then critical themes that highlight injustices and barriers faced by immigrants (n = 9). Study 1 examines whether there is a preference for glorifying images, and if that preference is related to cultural-assimilationist conceptions of national identity (i.e., defining American identity in dominant group standards). We exposed a new sample of participants (N = 119) to photographs reflecting all three themes. Results indicate that participants expressed greater liking for glorifying images, followed by neutral images, and critical images. National identity moderated within-subject variation in liking scores. Study 2 included 35 visitors who completed a survey before engaging with the museum or after their visit. Results indicate that participants who had completed their visit, compared to participants who had not entered the museum, reported (i) higher endorsement of cultural-assimilationist identity, and (ii) increased support for exclusive immigration policies. Study 3 exposed participants (N = 257) to glorifying, critical, or neutral images. Results indicate that participants who were exposed to glorifying images, especially those endorsing cultural-assimilationist identity, demonstrate decreased perception of current-day racial injustice, and increased ethnocentric enforcement bias. We discuss how engagement with privileged narratives may serve dominant group ends and reproduce systems of privilege. PMID:26074846

Using Maslow's hierarchy to highlight power imbalances between visiting health professional student volunteers and the host community: An applied qualitative study.

PubMed

Evans, Tracey; Akporuno, Orezioghene; Owens, Katrina M; Lickers, Brittany; Marlinga, Jazmin; Lin, Henry C; Loh, Lawrence C

2017-01-01

Health professional students from high-income countries increasingly participate in short-term experiences in global health (STEGH) conducted abroad. One common criticism of STEGH is the inherent power differential that exists between visiting learners and the local community. To highlight this power differential, this paper explores perceived benefits as described by volunteer and community respondents and applies Maslow's hierarchy of needs to commonly identified themes in each respondent group. A semistructured survey was used to collect qualitative responses from both volunteers and community members located in a Dominican Republic community, that is, a hotspot for traditionally conducted STEGH. Thematic analysis identified themes of perceived benefits from both respondent groups; each group's common themes were then classified and compared within Maslow's hierarchy of needs. Each respondent group identified resource provision as a perceived benefit of STEGH, but volunteer respondents primarily focused on the provision of highly-skilled, complex resources while community respondents focused on basic necessities (food, water, etc.) Volunteer respondents were also the only group to also mention spiritual/religious/life experiences, personal skills development, and relationships as perceived benefits. Applying Maslow's hierarchy thus demonstrates a difference in needs: community respondents focused on benefits that address deficiency needs at the bottom of the hierarchy while volunteers focused on benefits addressing self-transcendence/actualization needs at the top of the hierarchy. The perceived difference in needs met by STEGH between volunteers and the host community within Maslow's hierarchy may drive an inherent power differential. Refocusing STEGH on the relationship level of the hierarchy (i.e., focusing on partnerships) might help mitigate this imbalance and empower host communities.

The Achilles' heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability.

PubMed

Rodriguez, Violeta J; LaCabe, Richard P; Privette, C Kyle; Douglass, K Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo Willy; Horigian, Viviana; Weiss, Stephen M; Jones, Deborah L

2017-12-01

The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff-patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention.

The Achilles’ heel of prevention to mother-to-child transmission of HIV: Protocol implementation, uptake, and sustainability

PubMed Central

Rodriguez, Violeta J.; LaCabe, Richard P.; Privette, C. Kyle; Douglass, K. Marie; Peltzer, Karl; Matseke, Gladys; Mathebula, Audrey; Ramlagan, Shandir; Sifunda, Sibusiso; Prado, Guillermo “Willy”; Horigian, Viviana; Weiss, Stephen M.; Jones, Deborah L.

2017-01-01

Abstract The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff–patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention. PMID:28922974

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Visiting nurse services. 405.2416 Section 405.2416... Health Center Services § 405.2416 Visiting nurse services. (a) Visiting nurse services are covered if: (1... are furnished by a registered nurse, licensed practical nurse, or licensed vocational nurse who is...

28 CFR 540.43 - Frequency of visits and number of visitors.

Code of Federal Regulations, 2010 CFR

2010-07-01

... visitors. 540.43 Section 540.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.43 Frequency of visits and number of visitors. The Warden shall allow each inmate a minimum of four hours visiting time per...

42 CFR 409.48 - Visits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INSURANCE BENEFITS Home Health Services Under Hospital Insurance § 409.48 Visits. (a) Number of allowable... home health visits. All Medicare home health services are covered under hospital insurance unless there... 42 Public Health 2 2010-10-01 2010-10-01 false Visits. 409.48 Section 409.48 Public Health CENTERS...

Exploring patients' reasons for participation in a medical education home visit program: a qualitative study in Malaysia.

PubMed

Tan, Chai-Eng; Jaffar, Aida; Tohit, Noorlaili; Hamzah, Zuhra; Hashim, Syahnaz Mohd

2017-06-01

Direct contact with patients for medical education is essential in healthcare professional training. Patients who were recruited for a medical education home visit program in Malaysia did so on a voluntary basis without remuneration. This paper aims to explore their reasons for participation in this program. An exploratory qualitative study was conducted on patients who had been visited during the 2012/2013 academic session. Purposive sampling was done to select adult participants from varying ethnicities and ages from the list of patients. In-depth interviews were conducted at the participants' homes and were audio recorded. The transcripts of these interviews were analyzed using thematic analysis. A total of nine in-depth interviews were conducted. Four main themes were identified from thematic analysis: 1) Perceived meaning of the visit; 2) Perceived benefits and risks; 3) Past healthcare experiences; 4) Availability for visits. The home visits meant different things to different participants, including a teaching-learning encounter, a social visit, a charitable deed or a healthcare check-up. The benefits and risks of accepting unknown students to their homes and sharing their health issues with them had been weighed prior to participation. Prior experience with healthcare services such as gratitude to healthcare providers or having a relative in the healthcare profession increased their receptivity for involvement. Lastly, enabling factors such as availability of time would determine their acceptance for home visits. Patients agree to participate in medical education activities on a voluntary basis for various reasons. Providing good healthcare service and sufficient preparation are crucial to increase patient receptivity for such activities.

School Site Visits for Community-Based Participatory Research on Healthy Eating

PubMed Central

Patel, Anisha I.; Bogart, Laura M.; Uyeda, Kimberly E.; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W.; Schuster, Mark A.

2010-01-01

Background School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. Methods In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Results Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and cost were obstacles to policy implementation. Conclusions Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods. PMID:19896033

Role of cues and contexts on drug-seeking behaviour

PubMed Central

Perry, Christina J; Zbukvic, Isabel; Kim, Jee Hyun; Lawrence, Andrew J

2014-01-01

Environmental stimuli are powerful mediators of craving and relapse in substance-abuse disorders. This review examined how animal models have been used to investigate the cognitive mechanisms through which cues are able to affect drug-seeking behaviour. We address how animal models can describe the way drug-associated cues come to facilitate the development and persistence of drug taking, as well as how these cues are critical to the tendency to relapse that characterizes substance-abuse disorders. Drug-associated cues acquire properties of conditioned reinforcement, incentive motivation and discriminative control, which allow them to influence drug-seeking behaviour. Using these models, researchers have been able to investigate the pharmacology subserving the behavioural impact of environmental stimuli, some of which we highlight. Subsequently, we examine whether the impact of drug-associated stimuli can be attenuated via a process of extinction, and how this question is addressed in the laboratory. We discuss how preclinical research has been translated into behavioural therapies targeting substance abuse, as well as highlight potential developments to therapies that might produce more enduring changes in behaviour. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24749941

The p21-activated kinase 1 (Pak1) signalling pathway in cardiac disease: from mechanistic study to therapeutic exploration.

PubMed

Wang, Yanwen; Wang, Shunyao; Lei, Ming; Boyett, Mark; Tsui, Hoyee; Liu, Wei; Wang, Xin

2018-04-01

p21-activated kinase 1 (Pak1) is a member of the highly conserved family of serine/threonine protein kinases regulated by Ras-related small G-proteins, Cdc42/Rac1. It has been previously demonstrated to be involved in cardiac protection. Based on recent studies, this review provides an overview of the role of Pak1 in cardiac diseases including disrupted Ca 2+ homoeostasis-related cardiac arrhythmias, adrenergic stress- and pressure overload-induced hypertrophy, and ischaemia/reperfusion injury. These findings demonstrate the important role of Pak1 mediated through the phosphorylation and transcriptional modification of hypertrophy and/or arrhythmia-related genes. This review also discusses the anti-arrhythmic and anti-hypertrophic, protective function of Pak1 and the beneficial effects of fingolimod (an FDA-approved sphingolipid drug), a Pak1 activator, and its ability to prevent arrhythmias and cardiac hypertrophy. These findings also highlight the therapeutic potential of Pak1 signalling in the treatment and prevention of cardiac diseases. This article is part of a themed section on Spotlight on Small Molecules in Cardiovascular Diseases. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.8/issuetoc. © 2017 The British Pharmacological Society.

Targeting vascular (endothelial) dysfunction

PubMed Central

Steven, Sebastian; Weber, Alina; Shuvaev, Vladimir V.; Muzykantov, Vladimir R.; Laher, Ismail; Li, Huige; Lamas, Santiago

2016-01-01

Abstract Cardiovascular diseases are major contributors to global deaths and disability‐adjusted life years, with hypertension a significant risk factor for all causes of death. The endothelium that lines the inner wall of the vasculature regulates essential haemostatic functions, such as vascular tone, circulation of blood cells, inflammation and platelet activity. Endothelial dysfunction is an early predictor of atherosclerosis and future cardiovascular events. We review the prognostic value of obtaining measurements of endothelial function, the clinical techniques for its determination, the mechanisms leading to endothelial dysfunction and the therapeutic treatment of endothelial dysfunction. Since vascular oxidative stress and inflammation are major determinants of endothelial function, we have also addressed current antioxidant and anti‐inflammatory therapies. In the light of recent data that dispute the prognostic value of endothelial function in healthy human cohorts, we also discuss alternative diagnostic parameters such as vascular stiffness index and intima/media thickness ratio. We also suggest that assessing vascular function, including that of smooth muscle and even perivascular adipose tissue, may be an appropriate parameter for clinical investigations. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc PMID:27187006

Antioxidant effects of resveratrol in the cardiovascular system.

PubMed

Xia, Ning; Daiber, Andreas; Förstermann, Ulrich; Li, Huige

2017-06-01

The antioxidant effects of resveratrol (3,5,4'-trihydroxy-trans-stilbene) contribute substantially to the health benefits of this compound. Resveratrol has been shown to be a scavenger of a number of free radicals. However, the direct scavenging activities of resveratrol are relatively poor. The antioxidant properties of resveratrol in vivo are more likely to be attributable to its effect as a gene regulator. Resveratrol inhibits NADPH oxidase-mediated production of ROS by down-regulating the expression and activity of the oxidase. This polyphenolic compound reduces mitochondrial superoxide generation by stimulating mitochondria biogenesis. Resveratrol prevents superoxide production from uncoupled endothelial nitric oxide synthase by up-regulating the tetrahydrobiopterin-synthesizing enzyme GTP cyclohydrolase I. In addition, resveratrol increases the expression of various antioxidant enzymes. Some of the gene-regulating effects of resveratrol are mediated by the histone/protein deacetylase sirtuin 1 or by the nuclear factor-E2-related factor-2. In this review article, we have also summarized the cardiovascular effects of resveratrol observed in clinical trials. This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc. © 2016 The British Pharmacological Society.

Translating advances in the molecular basis of schizophrenia into novel cognitive treatment strategies.

PubMed

O'Tuathaigh, Colm M P; Moran, Paula M; Zhen, Xuechu C; Waddington, John L

2017-10-01

The presence and severity of cognitive symptoms, including working memory, executive dysfunction and attentional impairment, contributes materially to functional impairment in schizophrenia. Cognitive symptoms have proved to be resistant to both first- and second-generation antipsychotic drugs. Efforts to develop a consensus set of cognitive domains that are both disrupted in schizophrenia and are amenable to cross-species validation (e.g. the National Institute of Mental Health Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia and Research Domain Criteria initiatives) are an important step towards standardization of outcome measures that can be used in preclinical testing of new drugs. While causative genetic mutations have not been identified, new technologies have identified novel genes as well as hitherto candidate genes previously implicated in the pathophysiology of schizophrenia and/or mechanisms of antipsychotic efficacy. This review comprises a selective summary of these developments, particularly phenotypic data arising from preclinical genetic models for cognitive dysfunction in schizophrenia, with the aim of indicating potential new directions for pro-cognitive therapeutics. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc. © 2017 The British Pharmacological Society.

Protease‐activated receptor 4: from structure to function and back again

PubMed Central

French, Shauna L

2016-01-01

Protease‐activated receptors are a family of four GPCRs (PAR1–PAR4) with a number of unique attributes. Nearly two and a half decades after the discovery of the first PAR, an antagonist targeting this receptor has been approved for human use. The first‐in‐class PAR1 antagonist, vorapaxar, was approved for use in the USA in 2014 for the prevention of thrombotic cardiovascular events in patients with a history of myocardial infarction or with peripheral arterial disease. These recent developments indicate the clinical potential of manipulating PAR function. While much work has been aimed at uncovering the function of PAR1 and, to a lesser extent, PAR2, comparatively little is known regarding the pharmacology and physiology of PAR3 and PAR4. Recent studies have begun to develop the pharmacological and genetic tools required to study PAR4 function in detail, and there is now emerging evidence for the function of PAR4 in disease settings. In this review, we detail the discovery, structure, pharmacology, physiological significance and therapeutic potential of PAR4. Linked Articles This article is part of a themed section on Molecular Pharmacology of G Protein‐Coupled Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v173.20/issuetoc PMID:26844674

Bioactive polyphenols and cardiovascular disease: chemical antagonists, pharmacological agents or xenobiotics that drive an adaptive response?

PubMed Central

Goszcz, Katarzyna; Duthie, Garry G; Stewart, Derek; Leslie, Stephen J

2017-01-01

Polyphenols are widely regarded to have a wide range of health‐promoting qualities, including beneficial effects on cardiovascular disease. Historically, the benefits have been linked to their well‐recognized powerful antioxidant activity. However, the concept that the beneficial effects are attributable to direct antioxidant activity in vivo does not pay sufficient heed to the fact that polyphenols degrade rapidly, are poorly absorbed and rapidly metabolized, resulting in very low bioavailability. This review explores alternative mechanisms by which polyphenols, or their metabolites, exert biological activity via mechanisms that can be activated by physiologically relevant concentrations. Evidence is presented to support the action of phenolic derivatives on receptors and signalling pathways to induce adaptive responses that drive changes in endogenous antioxidant, antiplatelet, vasodilatory and anti‐inflammatory effects. The implications are that in vitro antioxidant measures as predictors of polyphenol protective activity in vivo hold little relevance and that closer attention needs to be paid to bioavailable metabolites to understand the mode of action of these diet‐derived components. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:28071785

Proanthocyanidins and hydrolysable tannins: occurrence, dietary intake and pharmacological effects.

PubMed

Smeriglio, Antonella; Barreca, Davide; Bellocco, Ersilia; Trombetta, Domenico

2017-06-01

Tannins are a heterogeneous group of high MW, water-soluble, polyphenolic compounds, naturally present in cereals, leguminous seeds and, predominantly, in many fruits and vegetables, where they provide protection against a wide range of biotic and abiotic stressors. Tannins exert several pharmacological effects, including antioxidant and free radical scavenging activity as well as antimicrobial, anti-cancer, anti-nutritional and cardio-protective properties. They also seem to exert beneficial effects on metabolic disorders and prevent the onset of several oxidative stress-related diseases. Although the bioavailability and pharmacokinetic data for these phytochemicals are still sparse, gut absorption of these compounds seems to be inversely correlated with the degree of polymerization. Further studies are mandatory to better clarify how these molecules and their metabolites are able to cross the intestinal barrier in order to exert their biological properties. This review summarizes the current literature on tannins, focusing on the main, recently proposed mechanisms of action that underlie their pharmacological and disease-prevention properties, as well as their bioavailability, safety and toxicology. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

Proanthocyanidins and hydrolysable tannins: occurrence, dietary intake and pharmacological effects

PubMed Central

Smeriglio, Antonella; Bellocco, Ersilia; Trombetta, Domenico

2016-01-01

Tannins are a heterogeneous group of high MW, water‐soluble, polyphenolic compounds, naturally present in cereals, leguminous seeds and, predominantly, in many fruits and vegetables, where they provide protection against a wide range of biotic and abiotic stressors. Tannins exert several pharmacological effects, including antioxidant and free radical scavenging activity as well as antimicrobial, anti‐cancer, anti‐nutritional and cardio‐protective properties. They also seem to exert beneficial effects on metabolic disorders and prevent the onset of several oxidative stress‐related diseases. Although the bioavailability and pharmacokinetic data for these phytochemicals are still sparse, gut absorption of these compounds seems to be inversely correlated with the degree of polymerization. Further studies are mandatory to better clarify how these molecules and their metabolites are able to cross the intestinal barrier in order to exert their biological properties. This review summarizes the current literature on tannins, focusing on the main, recently proposed mechanisms of action that underlie their pharmacological and disease‐prevention properties, as well as their bioavailability, safety and toxicology. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27646690

Can neuropeptides treat obesity? A review of neuropeptides and their potential role in the treatment of obesity.

PubMed

Boughton, C K; Murphy, K G

2013-12-01

Obesity is a major worldwide public health issue. The physiological systems that regulate body weight are thus of great interest as targets for anti-obesity agents. Peptidergic systems are critical to the regulation of energy homeostasis by key regions in the hypothalamus and brainstem. A number of neuropeptide systems have therefore been investigated as potential treatments for obesity. Blocking orexigenic peptide signals such as neuropeptide Y, melanin-concentrating hormone, orexins, relaxin-3 and galanin-like peptide or stimulating anorectic signalling pathways used by peptides such as the melanocortins, ciliary neurotrophic factor and brain-derived neurotrophic factor, are approaches that have shown some promise, but which have also highlighted possible concerns. Manipulation of central peptidergic systems poses a number of therapeutic problems, including brain access and side effects. Given that the homeostatic defence of body weight may limit the effectiveness of any single-target therapy developed, a combination therapy approach may offer the best hope for the effective prevention and treatment of obesity. This article is part of a themed section on Neuropeptides. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.170.issue-7. © 2012 The Authors. British Journal of Pharmacology © 2012 The British Pharmacological Society.

Pharmacogenomics, pharmacokinetics and pharmacodynamics: interaction with biological differences between men and women

PubMed Central

Franconi, Flavia; Campesi, Ilaria

2014-01-01

Pharmacological response depends on multiple factors and one of them is sex–gender. Data on the specific effects of sex–gender on pharmacokinetics, as well as the safety and efficacy of numerous medications, are beginning to emerge. Nevertheless, the recruitment of women for clinical research is inadequate, especially during the first phases. In general, pharmacokinetic differences between males and females are more numerous and consistent than disparities in pharmacodynamics. However, sex–gender pharmacodynamic differences are now increasingly being identified at the molecular level. It is now even becoming apparent that sex–gender influences pharmacogenomics and pharmacogenetics. Sex-related differences have been reported for several parameters, and it is consistently shown that women have a worse safety profile, with drug adverse reactions being more frequent and severe in women than in men. Overall, the pharmacological status of women is less well studied than that of men and deserves much more attention. The design of clinical and preclinical studies should have a sex–gender-based approach with the aim of tailoring therapies to an individual's needs and concerns. Linked Articles This article is part of a themed section on Biological Sex and Cardiovascular Pharmacology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-3 PMID:23981051

The role of δ-opioid receptors in learning and memory underlying the development of addiction.

PubMed

Klenowski, Paul; Morgan, Michael; Bartlett, Selena E

2015-01-01

Opioids are important endogenous ligands that exist in both invertebrates and vertebrates and signal by activation of opioid receptors to produce analgesia and reward or pleasure. The μ-opioid receptor is the best known of the opioid receptors and mediates the acute analgesic effects of opiates, while the δ-opioid receptor (DOR) has been less well studied and has been linked to effects that follow from chronic use of opiates such as stress, inflammation and anxiety. Recently, DORs have been shown to play an essential role in emotions and increasing evidence points to a role in learning actions and outcomes. The process of learning and memory in addiction has been proposed to involve strengthening of specific brain circuits when a drug is paired with a context or environment. The DOR is highly expressed in the hippocampus, amygdala, striatum and other basal ganglia structures known to participate in learning and memory. In this review, we will focus on the role of the DOR and its potential role in learning and memory underlying the development of addiction. This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2. © 2014 The British Pharmacological Society.

Targeting midkine and pleiotrophin signalling pathways in addiction and neurodegenerative disorders: recent progress and perspectives

PubMed Central

Herradón, G; Pérez-García, C

2014-01-01

Midkine (MK) and pleiotrophin (PTN) are two neurotrophic factors that are highly up-regulated in different brain regions after the administration of various drugs of abuse and in degenerative areas of the brain. A deficiency in both MK and PTN has been suggested to be an important genetic factor, which confers vulnerability to the development of the neurodegenerative disorders associated with drugs of abuse in humans. In this review, evidence demonstrating that MK and PTN limit the rewarding effects of drugs of abuse and, potentially, prevent drug relapse is compiled. There is also convincing evidence that MK and PTN have neuroprotective effects against the neurotoxicity and development of neurodegenerative disorders induced by drugs of abuse. Exogenous administration of MK and/or PTN into the CNS by means of non-invasive methods is proposed as a novel therapeutic strategy for addictive and neurodegenerative diseases. Identification of new molecular targets downstream of the MK and PTN signalling pathways or pharmacological modulation of those already known may also provide a more traditional, but probably effective, therapeutic strategy for treating addictive and neurodegenerative disorders. Linked Articles This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4 PMID:23889475

Antioxidant effects of resveratrol in the cardiovascular system

PubMed Central

Xia, Ning; Daiber, Andreas; Förstermann, Ulrich

2016-01-01

The antioxidant effects of resveratrol (3,5,4'‐trihydroxy‐trans‐stilbene) contribute substantially to the health benefits of this compound. Resveratrol has been shown to be a scavenger of a number of free radicals. However, the direct scavenging activities of resveratrol are relatively poor. The antioxidant properties of resveratrol in vivo are more likely to be attributable to its effect as a gene regulator. Resveratrol inhibits NADPH oxidase‐mediated production of ROS by down‐regulating the expression and activity of the oxidase. This polyphenolic compound reduces mitochondrial superoxide generation by stimulating mitochondria biogenesis. Resveratrol prevents superoxide production from uncoupled endothelial nitric oxide synthase by up‐regulating the tetrahydrobiopterin‐synthesizing enzyme GTP cyclohydrolase I. In addition, resveratrol increases the expression of various antioxidant enzymes. Some of the gene‐regulating effects of resveratrol are mediated by the histone/protein deacetylase sirtuin 1 or by the nuclear factor‐E2‐related factor‐2. In this review article, we have also summarized the cardiovascular effects of resveratrol observed in clinical trials. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc PMID:27058985

What sparks interest in science? A naturalistic inquiry

NASA Astrophysics Data System (ADS)

Jackson, Julie Kay Cropper

This study examined how career scientists became interested in science. Eight practicing scientists were asked a focus question, "What sparked your interest in science?" Their responses recorded during personal interviews and reported in correspondence frame this qualitative study. Analysis of the data revealed a variety of influences. The influences were coded, arranged into lists, and grouped by theme. A total of 18 themes emerged from the data. Five of the emerging themes were common across all of the participants. They were the influence of a family member, the influence of a teacher, being naturally curious, being interested in science, and reading books, magazines, and/or encyclopedias. Five themes were common among 5 to 7 participants. These themes included visiting museums, having broad exposure, enjoyment of mathematics, enjoying being outside, and freedom to play and explore. Eight themes were common among 2 to 4 of the participants. They were financial incentive, influence of religion, participation in science fairs, influence of the manned space program, having a scientist in the family, having the opportunity to teach others, not seeing self as a scientist, and first generation college graduate. The emerging themes were compared and contrasted with historical and contemporary literature. Vocational psychology's leading career choice and development literature was also aligned with the emerging themes. Data from this study supports tenets of Trait and Factor Theory, Developmental Theory, and Social Learning Theory. Reported data also supports the proposed movement toward a unified theory of career choice and development. A combination of personality traits, developmental stages, self-efficacy, and learning experiences influenced the vocational decisions of the scientists who participated in this study. The study concludes with suggestions for sparking and sustaining interest in science that people responsible for preparing future scientists may find useful. Included are methods for fostering natural curiosity and guidelines for parents and teachers.

Providing context to the implementation of health promoting schools: A case study.

PubMed

McIsaac, Jessie-Lee D; Mumtaz, Zubia; Veugelers, Paul J; Kirk, Sara F L

2015-12-01

Issues related to program context are important components of population health interventions and particularly among complex, adaptive initiatives in schools. Health Promoting Schools (HPS) is a global approach to support early development of healthy behaviors among children and youth. The purpose of this study was to explicate the practical and contextual processes that influenced implementation of HPS in schools in Nova Scotia (Canada). Using a case-study approach, data was collected using interviews (n=14) with principals, teachers and parents, observations collected during school visits and document review in five diverse schools. Case study schools reported a variety of HPS practices and three key themes emerged that provided context to the processes that facilitated their implementation. The results suggest that although school characteristics (theme 1), like staff allocation, physical location and resources, are important, these barriers can be mitigated by building organizational capacity (theme 2) and establishing a supportive school community culture (theme 3). The study provided insight to the variability in implementation by describing how contextual barriers were experienced and mitigated by schools. Establishing a broad system to support HPS, with collaboration across health and education sectors, could help to progress adoption, implementation and sustainability of HPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prisons and Kids: Programs for Inmate Parents.

ERIC Educational Resources Information Center

Boudouris, James

This book examines the history and experience of programs for children of inmates. Section 1 discusses parental ties, emphasizing bonding and the father's role. Section 2 describes prison nurseries, day care and children's centers, parenting classes, furloughs, family and conjugal visits, community facilities, visitation policies, support…

Stennis holds Information Technology Expo

NASA Image and Video Library

2010-06-16

Brian Wagner (l to r) with the U.S. Navy, Andrew Hiukenbein with NVision Solutions and Theresa Avoskey with the Naval Oceanographic Office at Stennis Space Center learn about the latest improvements in making flash drives secure during an Information Technology Expo held June 16. Various area companies visited Stennis during the day to offer exhibits for employees on a range of information technology topics. The theme of the daylong expo was 'The Road to Green IT Computing.'

Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver’s Perceived Quality of Communication with Paediatric Dental Visits

PubMed Central

Bridges, Susan Margaret; McGrath, Colman Patrick; Yiu, Cynthia Kar Yung; Zayts, Olga A.; Au, Terry Kit Fong

2017-01-01

Patients’ perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient’s perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver’s perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients’ demographic information and the caregiver’s perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer™) indicated five prominent themes ‘disease / treatment’, ‘treatment procedure related instructions’, ‘preparation for examination’, ‘positive reinforcement / reassurance’, and ‘family / social history’ from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme ‘Positive reinforcement / reassurance’: ‘number of related words’ (p = 0.002), ‘number of related utterances’ (p = 0.001), ‘percentage of the related words in total number of words’ (p = 0.005), ‘percentage of the related utterances in total number of utterances’ (p = 0.035) and ‘percentage of time spent in total time duration’ (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver’s involvement, such as clinicians’ mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians’ communication skills for improving patients’ clinical experiences and treatment satisfaction. PMID:28046044

Modernizing the Soviet Textile Industry: Implications for Perestroika

DTIC Science & Technology

1989-10-01

source material, the study provides four "data" sections that group recurring themes accord - ing to the decisionmaking agents primarily affected. The...sections of this report. They introduce the major themes that recurred in the second- ary sources searched. They are grouped according to categories by...need to increase the quality and quantity of consumer goods supplied by domestic light industry. According to the Materials of the XXVII Party Congress

Visualization of gene expression in the live subject using the Na/I symporter as a reporter gene: applications in biotherapy

PubMed Central

Baril, Patrick; Martin-Duque, Pilar; Vassaux, Georges

2010-01-01

Biotherapies involve the utilization of antibodies, genetically modified viruses, bacteria or cells for therapeutic purposes. Molecular imaging has the potential to provide unique information that will guarantee their biosafety in humans and provide a rationale for the future development of new generations of reagents. In this context, non-invasive imaging of gene expression is an attractive prospect, allowing precise, spacio-temporal measurements of gene expression in longitudinal studies involving gene transfer vectors. With the emergence of cell therapies in regenerative medicine, it is also possible to track cells injected into subjects. In this context, the Na/I symporter (NIS) has been used in preclinical studies. Associated with a relevant radiotracer (123I-, 124I-, 99mTcO4-), NIS can be used to monitor gene transfer and the spread of selectively replicative viruses in tumours as well as in cells with a therapeutic potential. In addition to its imaging potential, NIS can be used as a therapeutic transgene through its ability to concentrate therapeutic doses of radionuclides in target cells. This dual property has applications in cancer treatment and could also be used to eradicate cells with therapeutic potential in the case of adverse events. Through experience acquired in preclinical studies, we can expect that non-invasive molecular imaging using NIS as a transgene will be pivotal for monitoring in vivo the exact distribution and pharmacodynamics of gene expression in a precise and quantitative way. This review highlights the applications of NIS in biotherapy, with a particular emphasis on image-guided radiotherapy, monitoring of gene and vector biodistribution and trafficking of stem cells. This article is part of a themed section on Imaging in Pharmacology. To view the editorial for this themed section visit http://dx.doi.org/10.1111/j.1476-5381.2010.00685.x PMID:19814733

Counselling practices in community pharmacies in Riyadh, Saudi Arabia: a cross-sectional study.

PubMed

Alaqeel, Sinaa; Abanmy, Norah O

2015-12-15

Community pharmacists play a crucial role in optimising medication use and improving patient outcomes, whilst preventing medication misuse and reducing costs. Evidence suggests that pharmacists counselling improves clinical outcomes, quality of life, drug and disease knowledge and reduces health service utilisation. This study aims to investigate the counselling practices of community pharmacists in Riyadh, the capital of Saudi Arabia. The study consisted of two parts: simulated patients (SPs) visits to observe actual counselling practices, and a cross-sectional survey of community pharmacists to assess their reported counselling practices. In the SPs method, there were four scenarios involving four medications. Scenarios 1 and 2 concerned drug-drug interactions, scenario 3 concerned the proper time of administration, and scenario 4 concerned side effects. The simulated visits were conducted between April and May 2012. A four-sections questionnaire was distributed in the same period. We conducted 161 simulated visits. Out of the 161 visits a medicine was dispensed in 150 visits. When SPs requested medications, pharmacists asked questions during 15 visits (10.0%), provided information during 7 visits (4.6%), and both asked questions and provided information, i.e. provided counselling, during 4 visits (2.6%). When the SPs started to be inquisitive and demanded information, pharmacists asked SPs questions during 71 visits (47.3%), provided information during 150 visits (100%), and both asked questions and provided information, i.e. provided counselling, during 65 visits (43.3%). Information regarding dose was the most common type of information provided in 146 visits (97.3%). After the SPs started to be inquisitive and probed for information, only 10% were counselled on precautions. In the cross-sectional survey, four hundred pharmacists were approached and 350 agreed to participate in the questionnaire (87% response rate). Of the respondents, 223 (63.7%) reported that they usually or always tell the patient about the purpose of medicines or the diagnosis, 302 (86.2%) reported that they usually or always give patient information on how to use or apply the medicine; 299 (85.3%) said they were satisfied with their counselling practices. The present study highlights the current deficiencies in appropriate dispensing practices and medication counselling at community pharmacies in Saudi Arabia. Policy makers, stakeholders, and researchers should collaborate to design interventions to improve the current dispensing practices at community pharmacies across the country.

Using Multiple Sources of Data to Gauge Outcome Differences between Academic-Themed and Transition-Themed First-Year Seminars

ERIC Educational Resources Information Center

Zerr, Ryan J.; Bjerke, Elizabeth

2016-01-01

Students in two different types of first-year experience seminar courses at a moderately sized public university were compared using a large variety of measures--both direct and indirect. One of these first-year experience types was a three-credit academic-themed course offered in sections with variable content; the other was a two-credit…

36 CFR 1280.90 - What are the rules of conduct while visiting the Presidential libraries?

Code of Federal Regulations, 2012 CFR

2012-07-01

... while visiting the Presidential libraries? 1280.90 Section 1280.90 Parks, Forests, and Public Property... Apply for Use of Facilities in Presidential Libraries? § 1280.90 What are the rules of conduct while visiting the Presidential libraries? In addition to the rules in Subpart A, when visiting the museums of...

36 CFR 1280.90 - What are the rules of conduct while visiting the Presidential libraries?

Code of Federal Regulations, 2011 CFR

2011-07-01

... while visiting the Presidential libraries? 1280.90 Section 1280.90 Parks, Forests, and Public Property... Apply for Use of Facilities in Presidential Libraries? § 1280.90 What are the rules of conduct while visiting the Presidential libraries? In addition to the rules in Subpart A, when visiting the museums of...

36 CFR 1280.90 - What are the rules of conduct while visiting the Presidential libraries?

Code of Federal Regulations, 2014 CFR

2014-07-01

... while visiting the Presidential libraries? 1280.90 Section 1280.90 Parks, Forests, and Public Property... Apply for Use of Facilities in Presidential Libraries? § 1280.90 What are the rules of conduct while visiting the Presidential libraries? In addition to the rules in Subpart A, when visiting the museums of...

36 CFR 1280.90 - What are the rules of conduct while visiting the Presidential libraries?

Code of Federal Regulations, 2010 CFR

2010-07-01

... while visiting the Presidential libraries? 1280.90 Section 1280.90 Parks, Forests, and Public Property... Apply for Use of Facilities in Presidential Libraries? § 1280.90 What are the rules of conduct while visiting the Presidential libraries? In addition to the rules in Subpart A, when visiting the museums of...

Revalidation and quality assurance: the application of the MUSIQ framework in independent verification visits to healthcare organisations

PubMed Central

Griffin, Ann; Viney, Rowena; Welland, Trevor; Gafson, Irene

2017-01-01

Objectives We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting. Setting The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs). DBs are healthcare organisations that have a statutory responsibility, via the lead clinician, the responsible officer (RO), to implement medical revalidation. Participants All ROs who had undergone an IVV in England in 2014 and 2015 were invited to participate. 46 ROs were interviewed. Ethnographic data were gathered at 18 observations of the IVVs and 20 IVV post visit reports underwent documentary analysis. Primary and secondary outcome measures Primary outcomes were the findings pertaining to the effectiveness of the IVV system in supporting the revalidation processes at the DBs. Secondary outcomes were methodological, relating to the Model for Understanding Success in Quality (MUSIQ) and how its application to the IVV reveals the relevance of contextual factors described in the model. Results The impact of the IVVs varied by DB according to three major themes: the personal context of the RO; the organisational context of the DB; and the visit and its impact. ROs were largely satisfied with visits which raised the status of appraisal within their organisations. Inadequate or untimely feedback was associated with dissatisfaction. Conclusions Influencing teams whose prime responsibility is establishing processes and evaluating progress was crucial for internal quality improvement. Visits acted as a nudge, generating internal quality review, which was reinforced by visit teams with relevant expertise. Diverse team membership, knowledge transfer and timely feedback made visits more impactful. PMID:28196952

Revalidation and quality assurance: the application of the MUSIQ framework in independent verification visits to healthcare organisations.

PubMed

Griffin, Ann; McKeown, Alex; Viney, Rowena; Rich, Antonia; Welland, Trevor; Gafson, Irene; Woolf, Katherine

2017-02-14

We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting. The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs). DBs are healthcare organisations that have a statutory responsibility, via the lead clinician, the responsible officer (RO), to implement medical revalidation. All ROs who had undergone an IVV in England in 2014 and 2015 were invited to participate. 46 ROs were interviewed. Ethnographic data were gathered at 18 observations of the IVVs and 20 IVV post visit reports underwent documentary analysis. Primary outcomes were the findings pertaining to the effectiveness of the IVV system in supporting the revalidation processes at the DBs. Secondary outcomes were methodological, relating to the Model for Understanding Success in Quality (MUSIQ) and how its application to the IVV reveals the relevance of contextual factors described in the model. The impact of the IVVs varied by DB according to three major themes: the personal context of the RO; the organisational context of the DB; and the visit and its impact. ROs were largely satisfied with visits which raised the status of appraisal within their organisations. Inadequate or untimely feedback was associated with dissatisfaction. Influencing teams whose prime responsibility is establishing processes and evaluating progress was crucial for internal quality improvement. Visits acted as a nudge, generating internal quality review, which was reinforced by visit teams with relevant expertise. Diverse team membership, knowledge transfer and timely feedback made visits more impactful. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

28 CFR 548.19 - Pastoral visits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.19 Pastoral visits. If requested by...

28 CFR 548.19 - Pastoral visits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.19 Pastoral visits. If requested by...

28 CFR 548.19 - Pastoral visits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.19 Pastoral visits. If requested by...

28 CFR 548.19 - Pastoral visits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.19 Pastoral visits. If requested by...

28 CFR 548.19 - Pastoral visits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Pastoral visits. 548.19 Section 548.19 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.19 Pastoral visits. If requested by...

28 CFR 540.41 - Visiting facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting facilities. 540.41 Section 540.41 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT... visitors. (a) Institutions of minimum and low security levels may permit visits beyond the security...

Cannabinoids mediate opposing effects on inflammation-induced intestinal permeability

PubMed Central

Alhamoruni, A; Wright, KL; Larvin, M; O'Sullivan, SE

2012-01-01

BACKGROUND AND PURPOSE Activation of cannabinoid receptors decreases emesis, inflammation, gastric acid secretion and intestinal motility. The ability to modulate intestinal permeability in inflammation may be important in therapy aimed at maintaining epithelial barrier integrity. The aim of the present study was to determine whether cannabinoids modulate the increased permeability associated with inflammation in vitro. EXPERIMENTAL APPROACH Confluent Caco-2 cell monolayers were treated for 24 h with IFNγ and TNFα (10 ng·mL−1). Monolayer permeability was measured using transepithelial electrical resistance and flux measurements. Cannabinoids were applied either apically or basolaterally after inflammation was established. Potential mechanisms of action were investigated using antagonists for CB1, CB2, TRPV1, PPARγ and PPARα. A role for the endocannabinoid system was established using inhibitors of the synthesis and degradation of endocannabinoids. KEY RESULTS Δ9-Tetrahydrocannabinol (THC) and cannabidiol accelerated the recovery from cytokine-induced increased permeability; an effect sensitive to CB1 receptor antagonism. Anandamide and 2-arachidonylglycerol further increased permeability in the presence of cytokines; this effect was also sensitive to CB1 antagonism. No role for the CB2 receptor was identified in these studies. Co-application of THC, cannabidiol or a CB1 antagonist with the cytokines ameliorated their effect on permeability. Inhibiting the breakdown of endocannabinoids worsened, whereas inhibiting the synthesis of endocannabinoids attenuated, the increased permeability associated with inflammation. CONCLUSIONS AND IMPLICATIONS These findings suggest that locally produced endocannabinoids, acting via CB1 receptors play a role in mediating changes in permeability with inflammation, and that phytocannabinoids have therapeutic potential for reversing the disordered intestinal permeability associated with inflammation. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21745190

36 CFR § 1280.90 - What are the rules of conduct while visiting the Presidential libraries?

Code of Federal Regulations, 2013 CFR

2013-07-01

... while visiting the Presidential libraries? § 1280.90 Section § 1280.90 Parks, Forests, and Public... Additional Rules Apply for Use of Facilities in Presidential Libraries? § 1280.90 What are the rules of conduct while visiting the Presidential libraries? In addition to the rules in Subpart A, when visiting...

Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study.

PubMed

Brodribb, Wendy; Miller, Yvette

2015-06-01

Although home visiting in the early post partum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of post partum home visiting in the public and private sectors in Queensland. Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1 February and 31 May 2010 at 4 months post partum (n = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable subpopulations in both sectors were more likely to be visited, whereas others were not. Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed.

Oral Health Knowledge and Dental Visits in Community Living Older Adults in Rural Appalachia-West Virginia: A Cross-Sectional Analysis

PubMed Central

Wiener, R. Constance; Shockey, Alcinda Trickett

2014-01-01

Introduction The purpose of this study was to investigate the relationship between oral health knowledge and dental visits of older adults in an Appalachian county. Methods A cross-sectional study design was used. Surveys were returned from 205 older adults (50 years and above) from an Appalachian county. Questions were asked about oral health, last dental visit and sociodemographics. Results The variable of interest, oral health knowledge, was associated with dental visit. Having low oral health knowledge increased odds of having delayed a dental visit beyond a year (unadjusted odds ratio: 2.99; 95% Confidence interval: 1.70, 5.28). Even after considering the number of existing teeth, and controlling for age, sex, education and smoking, the association remained positive and independently significant (adjusted odds ratio: 2.25; 95% Confidence interval: 1.05, 4.82). Education was the only sociodemographic variable associated with last dental visit Conclusion The surveyed older adults have a need for increasing dental visits within the previous year. Increasing dental knowledge was associated with odds of increased dental visits. Improving dental knowledge may be a strategy to improve the number of older adults having a dental visit within the year. PMID:25530938

28 CFR 540.62 - Institutional visits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media...

28 CFR 540.62 - Institutional visits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media...

28 CFR 540.62 - Institutional visits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media...

28 CFR 540.62 - Institutional visits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media...

28 CFR 540.62 - Institutional visits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Institutional visits. 540.62 Section 540.62 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.62 Institutional visits. (a) A media...

Considering culture in physician-- patient communication during colorectal cancer screening.

PubMed

Ge Gao; Burke, Nancy; Somkin, Carol P; Pasick, Rena

2009-06-01

Racial and ethnic disparities exist in both incidence and stage detection of colorectal cancer (CRC). We hypothesized that cultural practices (i.e., communication norms and expectations) influence patients' and their physicians' understanding and talk about CRC screening. We examined 44 videotaped observations of clinic visits that included a CRC screening recommendation and transcripts from semistructured interviews that doctors and patients separately completed following the visit. We found that interpersonal relationship themes such as power distance, trust, directness/ indirectness, and an ability to listen, as well as personal health beliefs, emerged as affecting patients' definitions of provider-patient effective communication. In addition, we found that in discordant physician-patient interactions (when each is from a different ethnic group), physicians did not solicit or address cultural barriers to CRC screening and patients did not volunteer culture-related concerns regarding CRC screening.

Considering Culture in Physician– Patient Communication During Colorectal Cancer Screening

PubMed Central

Gao, Ge; Burke, Nancy; Somkin, Carol P.; Pasick, Rena

2010-01-01

Racial and ethnic disparities exist in both incidence and stage detection of colorectal cancer (CRC). We hypothesized that cultural practices (i.e., communication norms and expectations) influence patients’ and their physicians’ understanding and talk about CRC screening. We examined 44 videotaped observations of clinic visits that included a CRC screening recommendation and transcripts from semistructured interviews that doctors and patients separately completed following the visit. We found that interpersonal relationship themes such as power distance, trust, directness/indirectness, and an ability to listen, as well as personal health beliefs, emerged as affecting patients’ definitions of provider–patient effective communication. In addition, we found that in discordant physician–patient interactions (when each is from a different ethnic group), physicians did not solicit or address cultural barriers to CRC screening and patients did not volunteer culture-related concerns regarding CRC screening. PMID:19363141

The scientific basis of tobacco product regulation.

PubMed

2007-01-01

This report presents the conclusions reached and recommendations made by the members of the WHO Study Group on Tobacco Product Regulation at its third meeting, during which it reviewed four background papers specially commissioned for the meeting and which dealt, respectively, with the following four themes. 1. The contents and design features of tobacco products: their relationship to dependence potential and consumer appeal. 2. Candy-flavoured tobacco products: research needs and regulatory recommendations. 3. Biomarkers of tobacco exposure and of tobacco smoke-induced health effects. 4. Setting maximum limits for toxic constituents in cigarette smoke. The Study Group's recommendations in relation to each theme are set out at the end of the section dealing with that theme; its overall recommendations are summarized in section 6.

50 CFR 25.53 - Establishment of single visit entrance fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fees. 25.53 Section 25.53 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM ADMINISTRATIVE PROVISIONS Fees and Charges § 25.53 Establishment of single visit entrance fees. Entrance fees established for single visit...

Parent and Clinician Perspectives on Sustained Behavior Change after a Prenatal Obesity Program: A Qualitative Study.

PubMed

Gregory, Emily F; Goldshore, Matthew A; Showell, Nakiya N; Genies, Marquita C; Harding, Mariel E; Henderson, Janice L

2017-04-01

Infants of obese women are at a high risk for development of obesity. Prenatal interventions targeting gestational weight gain among obese women have not demonstrated consistent benefits for infant growth trajectories. To better understand why such programs may not influence infant growth, qualitative semi-structured interviews were conducted with 19 mothers who participated in a prenatal nutrition intervention for women with BMI 30 kg/m 2 or greater, and with 19 clinicians (13 pediatric, 6 obstetrical). Interviews were transcribed and coded with themes emerging inductively from the data, using a grounded theory approach. Mothers were interviewed a mean of 18 months postpartum and reported successful postnatal maintenance of behaviors that were relevant to the family food environment (Theme 1). Ambivalence around the importance of postnatal behavior maintenance (Theme 2) and enhanced postnatal healthcare (Theme 3) emerged as explanations for the failure of prenatal interventions to influence child growth. Mothers acknowledged their importance as role models for their children's behavior, but they often believed that body habitus was beyond their control. Though mothers attributed prenatal behavior change, in part, to additional support during pregnancy, clinicians had hesitations about providing children of obese parents with additional services postnatally. Both mothers and clinicians perceived a lack of interest or concern about infant growth during pediatric visits (Theme 4). Prenatal interventions may better influence childhood growth if paired with improved communication regarding long-term modifiable risks for children. The healthcare community should clarify a package of enhanced preventive services for children with increased risk of developing obesity.

Environmental restoration and waste management: Robotics technology development program: Robotics 5-year program plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

In FY 1990 Robotics Technology Development Program (RTDP) planning teams visited five DOE sites. These sites were selected by the Office of Technology Development to provide a needs basis for developing a 5-Year Plan. Visits to five DOE sites provided identification of needs for robotics technology development to support Environmental Restoration and Waste Management (ER WM) projects at those sites. Additional site visits will be conducted in the future to expand the planning basis. This volume summarizes both the results of the site visits and the needs and requirements of the priority ER WM activities at the sites, including potentialmore » needs for robotics and remote systems technology. It also discusses hazards associated with the site activities and any problems or technical uncertainties associated with dealing with the hazards in the performance of the ER WM work. Robotic or remote systems currently under development for remediation projects or waste operations are also discussed. The information in this document is organized principally by site, activity, and priority. Section 2.0, Site Needs, is based on information from the site visit reports and provides a summary which focuses on the site needs and requirements for each priority activity. Section 2.0 also records evaluations and discussions by the RTDP team following the site visit. Section 3.0, Commonality Assessment, documents similar site needs where common, or cross-cutting, robotics technology might be applied to several activities. Section 4.0 contains a summary of the site needs and requirements in tabular form. 1 tab.« less

Health care and social service professionals' perceptions of a home-visit program for young, first-time mothers.

PubMed

Li, S A; Jack, S M; Gonzalez, A; Duku, E; MacMillan, H L

2015-01-01

Little is known about health care and social service professionals' perspective on the acceptability of long-term home-visit programs serving low-income, first-time mothers. This study describes the experiences and perspectives of these community care providers involved with program referrals or service delivery to mothers who participated in the Nurse-Family Partnership (NFP), a targeted nurse home-visit program. The study included two phases. Phase I was a secondary qualitative data analysis used to analyze a purposeful sample of 24 individual interviews of community care providers. This was part of a larger case study examining adaptations required to increase acceptability of the NFP in Hamilton, Ontario, Canada. In Phase II (n = 4), themes identified from Phase I were further explored through individual, semi-structured interviews with community health care and social service providers, giving qualitative description. Overall, the NFP was viewed as addressing an important service gap for first-time mothers. Providers suggested that frequent communication between the NFP and community agencies serving these mothers could help improve the referral process, avoid service duplication, and streamline the flow of service access. The findings can help determine key components required to enhance the success of integrating a home-visit program into an existing network of community services. The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers.

A short walk in quantum probability

NASA Astrophysics Data System (ADS)

Hudson, Robin

2018-04-01

This is a personal survey of aspects of quantum probability related to the Heisenberg commutation relation for canonical pairs. Using the failure, in general, of non-negativity of the Wigner distribution for canonical pairs to motivate a more satisfactory quantum notion of joint distribution, we visit a central limit theorem for such pairs and a resulting family of quantum planar Brownian motions which deform the classical planar Brownian motion, together with a corresponding family of quantum stochastic areas. This article is part of the themed issue `Hilbert's sixth problem'.

Cultural Themes.

ERIC Educational Resources Information Center

Roy, Loriene, Comp.

Part of a larger report on the Four Directions Project, an American Indian technology innovation project, this section includes 10 "pathfinders" to locating information on Native American cultural themes. The pathfinders were designed by students in the Graduate School of Library and Information Science at the University of Texas at…

42 CFR 405.2417 - Visiting nurse services: Determination of shortage of agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Visiting nurse services: Determination of shortage of agencies. 405.2417 Section 405.2417 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Rural Health Clinic and Federally Qualified Health Center Services § 405.2417 Visiting nurse services...

42 CFR 405.2417 - Visiting nurse services: Determination of shortage of agencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Visiting nurse services: Determination of shortage of agencies. 405.2417 Section 405.2417 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Rural Health Clinic and Federally Qualified Health Center Services § 405.2417 Visiting nurse services...

78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home... Maternal, Infant and Early Childhood Home Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2... meeting: Name: Advisory Committee on the Maternal, Infant, and Early Childhood Home Visiting Program...

Energy Division annual progress report for period ending September 30, 1976

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1977-04-01

A summmary of the work in each section of the Energy Division at ORNL is given and can be characterized by two themes: (1) environmental assessment, including social and economic considerations, and (2) fuel conservation and energy conversion efficiency. The first theme encompasses the preparation of environmental statements and assessments for nuclear power plants and other energy facilities (Chap. 2) as well as regional analyses of social, economic, and environmental effects due to energy system development patterns (Chap. 3). The second theme characterizes a broad scope of conservation-related work, including efforts to understand energy demand patterns and to develop technologiesmore » and arrangements for reducing these demands (Chap. 4). This theme also encompasses research directed at improving both high- and low-temperature thermodynamic cycles driven by solar, geothermal, or fossil energy sources (Chaps. 5 and 6). A listing of publications and oral presentations complete the report. A separate abstract was prepared for each major section or program. (MCW)« less

The dignity of servanthood in pastoral care.

PubMed

Sunderland, Ronald H

2003-01-01

Servanthood is a dominant image of ministry in both Jewish and Christian scriptures, and poses a rich source of material from which to address the theme of human dignity from the perspective of pastoral care. The biblical concept of servanthood, which defines the nature of the pastoral relationship and dignifies the personhood of the care recipient, suggests an approach to the issues of vulnerability of both giver and receiver of care, and proposes that the caring relationship is best conceived as a partnership to which each participant brings gifts. The servant theme implies addressing the notion of the kingship of Christ, how control issues affect the ministry of pastoral care, and the realization that being a servant of the Lord entails a concern for the well being of each individual and of the social order; that is, servant ministry mandates both visiting the sick (Matthew 25) and seek justice and righteousness as social norms (Isaiah 16:5).

Incentives as connectors: insights into a breastfeeding incentive intervention in a disadvantaged area of North-West England

PubMed Central

2012-01-01

Background Incentive or reward schemes are becoming increasingly popular to motivate healthy lifestyle behaviours. In this paper, insights from a qualitative and descriptive study to investigate the uptake, impact and meanings of a breastfeeding incentive intervention integrated into an existing peer support programme (Star Buddies) are reported. The Star Buddies service employs breastfeeding peer supporters to support women across the ante-natal, intra-partum and post-partum period. Methods In a disadvantaged area of North West England, women initiating breastfeeding were recruited by peer supporters on the postnatal ward or soon after hospital discharge to participate in an 8 week incentive (gifts and vouchers) and breastfeeding peer supporter intervention. In-depth interviews were conducted with 26 women participants who engaged with the incentive intervention, and a focus group was held with the 4 community peer supporters who delivered the intervention. Descriptive analysis of routinely collected data for peer supporter contacts and breastfeeding outcomes before and after the incentive intervention triangulated and retrospectively provided the context for the qualitative thematic analysis. Results A global theme emerged of 'incentives as connectors', with two sub-themes of 'facilitating connections' and 'facilitating relationships and wellbeing'. The incentives were linked to discussion themes and gift giving facilitated peer supporter access for proactive weekly home visits to support women. Regular face to face contacts enabled meaningful relationships and new connections within and between the women, families, peer supporters and care providers to be formed and sustained. Participants in the incentive scheme received more home visits and total contact time with peer supporters compared to women before the incentive intervention. Full participation levels and breastfeeding rates at 6-8 weeks were similar for women before and after the incentive intervention. Conclusion The findings suggest that whilst the provision of incentives might not influence women's intentions or motivations to breastfeed, the connections forged provided psycho-social benefits for both programme users and peer supporters. PMID:22458841

Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke.

PubMed

Anderson, Jane A; Godwin, Kyler M; Saleem, Jason J; Russell, Scott; Robinson, Joshua J; Kimmel, Barbara

2014-12-01

This article reports redesign strategies identified to create a Web-based user-interface for the Self-management TO Prevent (STOP) Stroke Tool. Members of a Stroke Quality Improvement Network (N = 12) viewed a visualization video of a proposed prototype and provided feedback on implementation barriers/facilitators. Stroke-care providers (N = 10) tested the Web-based prototype in think-aloud sessions of simulated clinic visits. Participants' dialogues were coded into themes. Access to comprehensive information and the automated features/systematized processes were the primary accessibility and usability facilitator themes. The need for training, time to complete the tool, and computer-centric care were identified as possible usability barriers. Patient accountability, reminders for best practice, goal-focused care, and communication/counseling themes indicate that the STOP Stroke Tool supports the paradigm of patient-centered care. The STOP Stroke Tool was found to prompt clinicians on secondary stroke-prevention clinical-practice guidelines, facilitate comprehensive documentation of evidence-based care, and support clinicians in providing patient-centered care through the shared decision-making process that occurred while using the action-planning/goal-setting feature of the tool. © The Author(s) 2013.

[Oral hygiene habits and use of dental services among teenage students in a city in southern Brazil].

PubMed

Freddo, Silvia Letícia; Aerts, Denise Rangel Ganzo de Castro; Abegg, Claídes; Davoglio, Rosane; Vieira, Patrícia Conzatti; Monteiro, Lisiane

2008-09-01

This study evaluated oral hygiene habits and use of dental services among teenage students, and analyzed their association with sociodemographic factors and life styles. This cross-sectional study included a representative sample of 1,170 seventh-graders from municipal public schools of Gravataí, Rio Grande do Sul State, Brazil. The Cox regression model for univariate analysis, modified for cross-sectional studies, was used to analyze the association between variables. Of the adolescents included in the study, 77.8% brushed their teeth three or more times a day, 31.9% flossed daily, 68.9% visited the dentist regularly, and 50% visited the dentist for dental treatment. Tooth brushing was more frequent among female adolescents. Lower socioeconomic status was associated with a lower frequency of daily flossing, fewer annual dental visits, and a greater prevalence of dental treatment visits. Similar results were found for adolescents with a sedentary lifestyle or that had tried smoking. The consumption of candy was associated with lower frequency of annual dental visits, and the consumption of soft drinks, with greater frequency of treatment visits. A healthy life style was associated with better oral hygiene habits and more frequent dental visits.

Neonicotinoid insecticides differently modulate acetycholine-induced currents on mammalian α7 nicotinic acetylcholine receptors.

PubMed

Cartereau, Alison; Martin, Carine; Thany, Steeve H

2018-06-01

Neonicotinoid insecticides are described as poor agonists of mammalian nicotinic ACh receptors. In this paper, we show that their effects on mammalian nicotinic receptors differ between compounds. Two-electrode voltage-clamp electrophysiology was used to characterize the pharmacology of three neonicotinoid insecticides on nicotinic α7 receptors expressed in Xenopus oocytes. Single and combined application of clothianidin, acetamiprid and thiamethoxam were tested. Two neonicotinoid insecticides, clothianidin and acetamiprid, were partial agonists of mammalian neuronal α7 nicotinic receptors, whereas another neonicotinoid insecticide, thiamethoxam, which is converted to clothianidin in insect and plant tissues, had no effect. Pretreatment with clothianidin and acetamiprid (10 μM) ACh significantly enhanced the subsequent currents evoked by ACh (100 μM ) whereas pretreatment with thiamethoxam (10 μM) reduced ACh-induced current amplitudes.A combination of the three neonicotinoids decreased the ACh-evoked currents. The present findings suggest that neonicotinoid insecticides differ markedly in their direct effects on mammalian α7 nicotinic ACh receptors and can also modulate ACh-induced currents. Furthermore, our data indicate a previously unknown modulation of mammalian α7 nicotinic receptors by a combination of clothianidin, acetamiprid and thiamethoxam. This article is part of a themed section on Nicotinic Acetylcholine Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.11/issuetoc. © 2017 The British Pharmacological Society.

Movers and shakers: cell cytoskeleton in cancer metastasis.

PubMed

Fife, C M; McCarroll, J A; Kavallaris, M

2014-12-01

Metastasis is responsible for the greatest number of cancer deaths. Metastatic disease, or the movement of cancer cells from one site to another, is a complex process requiring dramatic remodelling of the cell cytoskeleton. The various components of the cytoskeleton, actin (microfilaments), microtubules (MTs) and intermediate filaments, are highly integrated and their functions are well orchestrated in normal cells. In contrast, mutations and abnormal expression of cytoskeletal and cytoskeletal-associated proteins play an important role in the ability of cancer cells to resist chemotherapy and metastasize. Studies on the role of actin and its interacting partners have highlighted key signalling pathways, such as the Rho GTPases, and downstream effector proteins that, through the cytoskeleton, mediate tumour cell migration, invasion and metastasis. An emerging role for MTs in tumour cell metastasis is being unravelled and there is increasing interest in the crosstalk between key MT interacting proteins and the actin cytoskeleton, which may provide novel treatment avenues for metastatic disease. Improved understanding of how the cytoskeleton and its interacting partners influence tumour cell migration and metastasis has led to the development of novel therapeutics against aggressive and metastatic disease. This article is part of a themed section on Cytoskeleton, Extracellular Matrix, Cell Migration, Wound Healing and Related Topics. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-24. © 2014 The British Pharmacological Society.

Movers and shakers: cell cytoskeleton in cancer metastasis

PubMed Central

Fife, C M; McCarroll, J A; Kavallaris, M

2014-01-01

Metastasis is responsible for the greatest number of cancer deaths. Metastatic disease, or the movement of cancer cells from one site to another, is a complex process requiring dramatic remodelling of the cell cytoskeleton. The various components of the cytoskeleton, actin (microfilaments), microtubules (MTs) and intermediate filaments, are highly integrated and their functions are well orchestrated in normal cells. In contrast, mutations and abnormal expression of cytoskeletal and cytoskeletal-associated proteins play an important role in the ability of cancer cells to resist chemotherapy and metastasize. Studies on the role of actin and its interacting partners have highlighted key signalling pathways, such as the Rho GTPases, and downstream effector proteins that, through the cytoskeleton, mediate tumour cell migration, invasion and metastasis. An emerging role for MTs in tumour cell metastasis is being unravelled and there is increasing interest in the crosstalk between key MT interacting proteins and the actin cytoskeleton, which may provide novel treatment avenues for metastatic disease. Improved understanding of how the cytoskeleton and its interacting partners influence tumour cell migration and metastasis has led to the development of novel therapeutics against aggressive and metastatic disease. Linked Articles This article is part of a themed section on Cytoskeleton, Extracellular Matrix, Cell Migration, Wound Healing and Related Topics. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-24 PMID:24665826

The epigenetic landscape related to reactive oxygen species formation in the cardiovascular system.

PubMed

Kietzmann, Thomas; Petry, Andreas; Shvetsova, Antonina; Gerhold, Joachim M; Görlach, Agnes

2017-06-01

Cardiovascular diseases are among the leading causes of death worldwide. Reactive oxygen species (ROS) can act as damaging molecules but also represent central hubs in cellular signalling networks. Increasing evidence indicates that ROS play an important role in the pathogenesis of cardiovascular diseases, although the underlying mechanisms and consequences of pathophysiologically elevated ROS in the cardiovascular system are still not completely resolved. More recently, alterations of the epigenetic landscape, which can affect DNA methylation, post-translational histone modifications, ATP-dependent alterations to chromatin and non-coding RNA transcripts, have been considered to be of increasing importance in the pathogenesis of cardiovascular diseases. While it has long been accepted that epigenetic changes are imprinted during development or even inherited and are not changed after reaching the lineage-specific expression profile, it becomes more and more clear that epigenetic modifications are highly dynamic. Thus, they might provide an important link between the actions of ROS and cardiovascular diseases. This review will provide an overview of the role of ROS in modulating the epigenetic landscape in the context of the cardiovascular system. This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc. © 2017 The British Pharmacological Society.

The epigenetic landscape related to reactive oxygen species formation in the cardiovascular system

PubMed Central

Kietzmann, Thomas; Petry, Andreas; Shvetsova, Antonina; Gerhold, Joachim M

2017-01-01

Cardiovascular diseases are among the leading causes of death worldwide. Reactive oxygen species (ROS) can act as damaging molecules but also represent central hubs in cellular signalling networks. Increasing evidence indicates that ROS play an important role in the pathogenesis of cardiovascular diseases, although the underlying mechanisms and consequences of pathophysiologically elevated ROS in the cardiovascular system are still not completely resolved. More recently, alterations of the epigenetic landscape, which can affect DNA methylation, post‐translational histone modifications, ATP‐dependent alterations to chromatin and non‐coding RNA transcripts, have been considered to be of increasing importance in the pathogenesis of cardiovascular diseases. While it has long been accepted that epigenetic changes are imprinted during development or even inherited and are not changed after reaching the lineage‐specific expression profile, it becomes more and more clear that epigenetic modifications are highly dynamic. Thus, they might provide an important link between the actions of ROS and cardiovascular diseases. This review will provide an overview of the role of ROS in modulating the epigenetic landscape in the context of the cardiovascular system. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc PMID:28332701

Effect of hypercholesterolaemia on myocardial function, ischaemia–reperfusion injury and cardioprotection by preconditioning, postconditioning and remote conditioning

PubMed Central

Iliodromitis, Efstathios K; Lazou, Antigone; Görbe, Anikó; Giricz, Zoltán; Schulz, Rainer

2017-01-01

Hypercholesterolaemia is considered to be a principle risk factor for cardiovascular disease, having direct negative effects on the myocardium itself, in addition to the development of atherosclerosis. Since hypercholesterolaemia affects the global cardiac gene expression profile, among many other factors, it results in increased myocardial oxidative stress, mitochondrial dysfunction and inflammation triggered apoptosis, all of which may account for myocardial dysfunction and increased susceptibility of the myocardium to infarction. In addition, numerous experimental and clinical studies have revealed that hyperlcholesterolaemia may interfere with the cardioprotective potential of conditioning mechanisms. Although not fully elucidated, the underlying mechanisms for the lost cardioprotection in hypercholesterolaemic animals have been reported to involve dysregulation of the endothelial NOS‐cGMP, reperfusion injury salvage kinase, peroxynitrite‐MMP2 signalling pathways, modulation of ATP‐sensitive potassium channels and apoptotic pathways. In this review article, we summarize the current knowledge on the effect of hypercholesterolaemia on the non‐ischaemic and ischaemic heart as well as on the cardioprotection induced by drugs or ischaemic preconditioning, postconditioning and remote conditioning. Future perspectives concerning the mechanisms and the design of preclinical and clinical trials are highlighted. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc PMID:28060997

36 CFR 71.7 - Entrance fees for single-visit permits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... either Golden Eagle or Golden Age Passports. (1) The fee for a single-visit permit applicable to those.... “Accompanying,” for the purpose of this section, shall mean entering together with the permittee while being...-visit permit applicable to those persons entering by any means other than private, noncommercial vehicle...

28 CFR 0.87 - Representation on committee for visit-exchange.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Representation on committee for visit-exchange. 0.87 Section 0.87 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Federal Bureau of Investigation § 0.87 Representation on committee for visit-exchange. The Director of the Federal Bureau of...

28 CFR 0.107 - Representation on committee for visit-exchange.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Representation on committee for visit-exchange. 0.107 Section 0.107 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Immigration and Naturalization Service § 0.107 Representation on committee for visit-exchange. The Commissioner of Immigration and...

The Little Red Schoolhouse. A Guide for Teachers.

ERIC Educational Resources Information Center

Norton, Mary; Hall, Jean

An elementary school teaching unit uses a visit to a one-room schoolhouse to increase student awareness of what pioneer schools were like. The first section consists of pre-visit activities and teacher preparation suggestions. A description of an early pioneer school is followed by six activities designed to make the visit more authentic.…

Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

PubMed

Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

2017-09-01

To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary collaboration can be a good approach to meeting the complexity of the chronic obstructive pulmonary disease patient's health needs. © 2017 John Wiley & Sons Ltd.

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

Challenger Center's Window on the Universe

NASA Astrophysics Data System (ADS)

Livengood, T. A.; Goldstein, J. J.; Smith, S.; Bobrowsky, M.; Radnofsky, M.; Perelmuter, J.-M.; Jaggar, L.

2001-11-01

Challenger Center for Space Science Education's Window on the Universe program aims to create a network of under-served communities across the nation dedicated to sustained science, math, and technology education. Window communities presently include Broken Arrow, OK; Muncie, IN; Moscow, ID; Nogales, AZ; Tuskegee, AL; Marquette, MI; Altamont, KS; Washington, D.C.; and other emerging sites. Window uses themes of human space flight and the space sciences as interdisciplinary means to inspire entire communities. Practicing scientists and engineers engaged in these disciplines are invited to volunteer to become a part of these communities for a week, each visitor reaching roughly 2000 K-12 students through individual classroom visits and Family Science Night events during an intense Window on the Universe Week. In the same Window Week, Challenger Center scientists and educators present a workshop for local educators to provide training in the use of a K-12 educational module built around a particular space science and exploration theme. Window communities follow a 3-year development: Year 1, join the network, experience Window Week presented by Challenger Center and visiting researchers; Year 2, same as Year 1 plus workshop on partnering with local organizations to develop sources of visiting researchers and to enhance connections with local resources; Year 3 and subsequent, the community stages its own Window Week, with Challenger Center providing new education modules and training workshops for "master educators" from the Window community, after which the master educators return home to conduct training workshops of their own. Challenger Center remains a resource and clearinghouse for Window communities to acquire experience, technical information, and opportunities for distance collaboration with other Window communities. Window on the Universe is dedicated to assessing degree of success vs. failure in each program component and as a whole, using pre- and post-assessment questionnaires to develop a sound basis for continual improvement. Window on the Universe is funded by NASA's Office of Space Flight and the Office of Space Science.

Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

PubMed Central

2012-01-01

Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation. PMID:22953748

General Science, Ninth Grade: Theme III and Theme IV. Experimental.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This document was designed to help teachers provide ninth grade students in New York City with opportunities to learn about scientific processes as well as basic reasoning skills which underlie problem-solving processes in scientific and nonscientific disciplines. The first section of the guide, "The Environment," contains lessons which…

Energy Theme.

ERIC Educational Resources Information Center

Garrahy, Dennis J.

One of a series of social studies units designed to develop the reading and writing skills of low achievers, this student activity book focuses on the theme of energy. The unit can be used for high school classes, individual study in alternative and continuing high schools, and adult education classes. Separate sections cover early sources of…

"Think aloud" and "Near live" usability testing of two complex clinical decision support tools.

PubMed

Richardson, Safiya; Mishuris, Rebecca; O'Connell, Alexander; Feldstein, David; Hess, Rachel; Smith, Paul; McCullagh, Lauren; McGinn, Thomas; Mann, Devin

2017-10-01

Low provider adoption continues to be a significant barrier to realizing the potential of clinical decision support. "Think Aloud" and "Near Live" usability testing were conducted on two clinical decision support tools. Each was composed of an alert, a clinical prediction rule which estimated risk of either group A Streptococcus pharyngitis or pneumonia and an automatic order set based on risk. The objective of this study was to further understanding of the facilitators of usability and to evaluate the types of additional information gained from proceeding to "Near Live" testing after completing "Think Aloud". This was a qualitative observational study conducted at a large academic health care system with 12 primary care providers. During "Think Aloud" testing, participants were provided with written clinical scenarios and asked to verbalize their thought process while interacting with the tool. During "Near Live" testing participants interacted with a mock patient. Morae usability software was used to record full screen capture and audio during every session. Participant comments were placed into coding categories and analyzed for generalizable themes. Themes were compared across usability methods. "Think Aloud" and "Near Live" usability testing generated similar themes under the coding categories visibility, workflow, content, understand-ability and navigation. However, they generated significantly different themes under the coding categories usability, practical usefulness and medical usefulness. During both types of testing participants found the tool easier to use when important text was distinct in its appearance, alerts were passive and appropriately timed, content was up to date, language was clear and simple, and each component of the tool included obvious indicators of next steps. Participant comments reflected higher expectations for usability and usefulness during "Near Live" testing. For example, visit aids, such as automatically generated order sets, were felt to be less useful during "Near-Live" testing because they would not be all inclusive for the visit. These complementary types of usability testing generated unique and generalizable insights. Feedback during "Think Aloud" testing primarily helped to improve the tools' ease of use. The additional feedback from "Near Live" testing, which mimics a real clinical encounter, was helpful for eliciting key barriers and facilitators to provider workflow and adoption. Copyright © 2017 Elsevier B.V. All rights reserved.

Lack of individualized perspective: a qualitative study of diabetes care for immigrants in Sweden.

PubMed

Brämberg, Elisabeth Björk; Dahlborg-Lyckhage, Elisabeth; Määttä, Sylvia

2012-06-01

This study describes the care provided by a diabetes nurse specialist, and the care needs expressed by people with type 2 diabetes mellitus and an immigrant background. Clinical encounters between a diabetes nurse specialist and 10 people diagnosed with type 2 diabetes mellitus were observed and analyzed by means of qualitative content analysis. One theme, "the diabetes nurse specialist as the conductor of the visit", and four categories emerged from the findings, illustrating the power imbalance between the patients and the diabetes nurse specialist, as well as the lack of an individual perspective. Shifting from a medical perspective to one of openness towards the people's experiences provides a possibility for caregivers to empower patients suffering from type 2 diabetes mellitus. The medical perspective seemed to steer the visit towards curative activities. Thus, technique-centered care should be developed by including individualized care. © 2012 Blackwell Publishing Asia Pty Ltd.

Outcomes and provider perspectives on geriatric care by a nurse practitioner-led community paramedicine program.

PubMed

Kant, Rebecca E; Vejar, Maria; Parnes, Bennett; Mulder, Joy; Daddato, Andrea; Matlock, Daniel D; Lum, Hillary D

2018-05-03

This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives. The most commonly treated diagnoses were respiratory conditions, urinary tract infections, and gastrointestinal concerns. Two patients required an immediate transfer to a higher level of care. Six patients had emergency department visits and five patients were hospitalized within two weeks. Geriatric providers identified three themes including: potential benefits to geriatric patients, importance of enhanced care coordination and communication, and considerations for the specific role of nurse practitioner-led community paramedicine programs for geriatric patient care. Published by Elsevier Inc.

Reflexive photography: an alternative method for documenting the learning process of cultural competence.

PubMed

Amerson, Roxanne; Livingston, Wade G

2014-04-01

This qualitative descriptive study used reflexive photography to evaluate the learning process of cultural competence during an international service-learning project in Guatemala. Reflexive photography is an innovative qualitative research technique that examines participants' interactions with their environment through their personal reflections on images that they captured during their experience. A purposive sample of 10 baccalaureate nursing students traveled to Guatemala, where they conducted family and community assessments, engaged in home visits, and provided health education. Data collection involved over 100 photographs and a personal interview with each student. The themes developed from the photographs and interviews provided insight into the activities of an international experience that influence the cognitive, practical, and affective learning of cultural competence. Making home visits and teaching others from a different culture increased students' transcultural self-efficacy. Reflexive photography is a more robust method of self-reflection, especially for visual learners.

Re-visiting the electrophysiology of language.

PubMed

Obleser, Jonas

2015-09-01

This editorial accompanies a special issue of Brain and Language re-visiting old themes and new leads in the electrophysiology of language. The event-related potential (ERP) as a series of characteristic deflections ("components") over time and their distribution on the scalp has been exploited by speech and language researchers over decades to find support for diverse psycholinguistic models. Fortunately, methodological and statistical advances have allowed human neuroscience to move beyond some of the limitations imposed when looking at the ERP only. Most importantly, we currently witness a refined and refreshed look at "event-related" (in the literal sense) brain activity that relates itself more closely to the actual neurobiology of speech and language processes. It is this imminent change in handling and interpreting electrophysiological data of speech and language experiments that this special issue intends to capture. Copyright © 2015 Elsevier Inc. All rights reserved.

Addressing cancer patient and caregiver role transitions during home hospice nursing care.

PubMed

Hudson, Janella; Reblin, Maija; Clayton, Margaret F; Ellington, Lee

2018-05-15

Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life. A secondary, qualitative analysis was conducted on transcripts. Using an iterative process of constant comparison, coders inductively categorized nurse, caregiver, and patient communication behavior into overarching themes. Participants were home hospice nurses and cancer patient/spouse caregiver dyads; participants were >45 years of age, English speaking, and cognitively able to participate. Research took place in the home during nurse visits.ResultNineteen unique home hospice visits were analyzed. Patient-caregiver conflict occurred in two major content themes (1) negotiating transitions in patient independence and (2) navigating caregiver/patient emotions (e.g., frustration, sadness). Nurse responses to transition conflict included problem-solving, mediating, or facilitating discussions about conflicts. Nurse responses to emotional conflict included validation and reassurance.Significance of resultsOur findings provide insight into the topics and processes involved in patient and caregiver transitions in home hospice and the role hospice nursing communication plays in mediating potential conflict. Nurses are often asked to take on the role of mediator, often with little conflict resolution communication education; results can be used for nursing education.

One practice's experiment in refusing detail rep visits.

PubMed

Evans, David V; Hartung, Daniel M; Andeen, Gabriel; Mahler, Jo; Haxby, Dean G; Kraemer, Dale F; Fagnan, Lyle J

2011-08-01

The physician-pharmaceutical industry relationship has come under increasing scrutiny. Little guidance exists concerning how smaller practices should manage this relationship.In 2006, Madras Medical Group, a small family practice in rural Oregon, implemented a policy prohibiting visits from representatives of the pharmaceutical industry and the acceptance of drug samples. This qualitative study documents the attitudes of clinic personnel in response to this policy. Semistructured interviews were conducted using standardized questions related to 4 areas of policy perception: verification of policy decision, impact on clinic operations,influence of pharmaceutical industry, and lessons to share. Common themes were identified. Three physicians and 3 nurses participated in the study. There was consensus on the existence and effectiveness of the clinic policy. Key themes identified from both groups of interviewees included the perception of enhanced clinic operation after eliminating interruptions from pharmaceutical representatives, positive response from the public, and reduced diversion of samples for personal use. Clinicians interviewed agreed that samples were of questionable benefit,that information obtained from industry representatives was incomplete or of questionable veracity or objectivity, and that it was helpful to substitute other drug information sources and clinic-sponsored lunches for past industry offerings. In this case study, a policy prohibiting pharmaceutical representatives from a small family practice was well accepted and a source of pride among physicians and nurses. Other clinics wishing to enact a similar policy may wish to supplement their efforts by proactively using other sources of drug information.

38 CFR 62.63 - Visits to monitor operations and compliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Visits to monitor operations and compliance. 62.63 Section 62.63 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) SUPPORTIVE SERVICES FOR VETERAN FAMILIES PROGRAM § 62.63 Visits to monitor operations and compliance. (a) VA has the right, at...

BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

PubMed

Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

2017-03-01

Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs. © 2017 Michigan Association for Infant Mental Health.

Terra e Arte Project: Soils connecting Art and Education

NASA Astrophysics Data System (ADS)

Muggler, Cristine Carole; Rozenberg, Bianca; de Cássia Francisco, Talita; Gramacho de Oliveira, Elisa

2015-04-01

The "Terra e Arte" project was designed to combine science and art by approaching soil contents in basic education schools in Viçosa, Minas Gerais, Brazil. The project was developed to awake, sensitize and create awareness about soils and their importance to life and environment within school communities. It was proposed and realized by the Earth Sciences Museum Alexis Dorofeef (MCTAD) of the Federal University of Viçosa (UFV), as part of the celebrations of its 20th anniversary. Since all the schools of the town visit the museum at least once a year and most of them have received and carried out pedagogic projects on soil themes in the last 20 years, it was proposed to them to develop a soil subject with any of their groups and combine it with painting using soil materials. Each group interested in joining the project received a basic set of material to produce soil paints. They were expected to develop a soil theme and its contents for a few weeks and to finalize it with a figurative and textual collective creation that synthetized their learning. 16 of the 24 visited schools joined the project and realized it for an average of two months. During this time, the school groups visited the museum and/or borrowed the itinerant exposition on soils from the museum to work with in in the school community. At the end of the projects, the productions were presented at the Knowledge Market (Feira do Conhecimento) that happens every year in the central square of the town, as part of the National Week of Science and Technology. At the event, 58 works were presented by 14 schools, involving directly 700 pupils and their teachers. They approached themes from soil formation and properties to agroecology and urban occupation and impacts on the soils. 30 of the works were selected for a commemorative exposition and 12 were chosen for a table calendar 2014. The movement created around the project mobilized many people and had strong impact on the school communities, especially after the distribution of the calendar to all schools. The result stimulated the museum to propose another project for the 21st anniversary that was intensely sought after by all schools of the town. The mobilization that has been created by those projects contributes to expand and to strengthen the word about soils within the schools and to increase the perception of soils in the town community.

An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan.

PubMed

Khoso, Aneeta; Soomro, Rafiq Ahmed; Quraishy, Ayesha Muquim; Khan, Hammad Ali; Ismail, Saba; Nazaz, Mehrunnisa; Younus, Sana; Zainab, Saima

2018-05-01

Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

Qualitative assessment of the dental health services provided at a dental school in Kerman, Iran.

PubMed

Rad, Maryam; Haghani, Jahangir; Shahravan, Arash; Khosravifar, Ali

2009-01-01

Increasing the quality of the services provided in a Dental School can raise the satisfaction level of patients and consequently increase the level of their oral health. This study was conducted to evaluate the quality of dental care and services provided to patients referred to a Dental School in Kerman, Iran. In this qualitative study, face-to-face, in-depth interviews were conducted with 41 participants [25 patients (P), 5 nurses (N), 6 dental academic staff (AS), and 5 dental students (S)]. Then, the interviews were transcribed and analyzed, using content analysis of data. Data analysis in qualitative research involves breaking down the data and searching for codes and categories that are then reassembled to form themes. Both positive and negative themes emerged. Positive themes included: good infection control, service accessibility, patient appointments and visits were not assigned on merit, precise examinations, and comprehensive treatment plans. Negative themes included: long wait time, lack of options to pass waiting time, such as newspapers and television, an insufficient number of nurses, and not enough professors for supervision. In addition, the results of this study show that the patients and dental staff have high expectations in relation to dental services, and that implementation of these expectations would increase the overall satisfaction with and the quality of the level of services. Finally, some recommendations for improving services in the Kerman Dental School were given to the managing team of the Dental School.

Measuring what matters to patients: Using goal content to inform measure choice and development.

PubMed

Jacob, Jenna; Edbrooke-Childs, Julian; Law, Duncan; Wolpert, Miranda

2017-04-01

Personalised care requires personalised outcomes and ways of feeding back clinically useful information to clinicians and practitioners, but it is not clear how to best personalise outcome measurement and feedback using existing standardised outcome measures. The constant comparison method of grounded theory was used to compare goal themes derived from goals set at the outset of therapy for 180 children aged between 4 and 17 years, visiting eight child and adolescent mental health services, to existing standardised outcome measures used as part of common national datasets. In all, 20 out of 27 goal themes corresponded to items on at least one commonly used outcome measure. Consideration of goal themes helped to identify potential relevant outcome measures. However, there were several goal themes that were not captured by items on standardised outcome measures. These seemed to be related to existential factors such as understanding, thinking about oneself and future planning. This presents a powerful framework for how clinicians can use goals to help select a standardised outcome measure (where this is helpful) in addition to the use of a goal-based outcome measure and personalise choices. There may be areas not captured by standardised outcome measures that may be important for children and young people and which may only be currently captured in goal measurement. There is an indication that we may not be measuring what is important to children and young people. We may need to develop or look for new measures that capture these areas.

Technology Education Symposium II. Program Theme: "Technological Literacy" (Menomonie, Wisconsin, May 1-2, 1981).

ERIC Educational Resources Information Center

Smalley, Lee, Ed.

This monograph summarizes 21 presentations from a symposium whose theme was technological literacy--an understanding of the impact of technological descisions. These presentations are divided into five categories. The six presentations in the section, The Context of Technology Education, focus on technological literacy for living in today's…

General Science, Ninth Grade: Theme I and Theme II. Experimental.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This document was designed to assist teachers who are helping ninth grade students in New York City learn scientific concepts. In addition, the guide emphasizes basic reasoning skills which underlie problem-solving processes in scientific and nonscientific disciplines. The first section of the guide contains lessons on what a scientist does,…

Living with chronic pain: Evaluating patient experiences with a medical group visit focused on mindfulness and non-pharmacological strategies.

PubMed

Lestoquoy, Anna Sophia; Laird, Lance D; Mitchell, Suzanne; Gergen-Barnett, Katherine; Negash, N Lily; McCue, Kelly; Enad, Racquel; Gardiner, Paula

2017-12-01

Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care. Six IMGVs cohorts were held at a safety net hospital and two federally funded community health centres. Data was gathered through focus groups. Transcripts were analysed using both a priori codes and inductive coding. The intervention included ten sessions of Integrative Medical Group Visits with a primary care provider and a meditation instructor. The curriculum uses principles of Mindfulness Based Stress Reduction and evidence based integrative medicine. The visit is structured similarly to other group medical visits. Data was gathered through four focus groups held after the cohorts were completed. Participants (N=20) were largely low income minority adults with chronic pain and comorbid depression. Six themes emerged from the coding including: chronic pain is isolating; group treatment contributes to better coping with pain; loss of control and autonomy because of the unpredictability of pain as well as dependence on medication and frequent medical appointments; groups improve agency and control over one's health condition; navigating the healthcare system and unsatisfactory treatment options; and changes after the IMGV due to non-pharmacological health management. The IMGV is a promising format of delivering integrative care for chronic pain and depression which addresses many of the problems identified by patients in usual care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Achieving community-based postpartum follow up in eastern Uganda: the field experience from the MamaMiso Study on antenatal distribution of misoprostol.

PubMed

Ditai, James; Frye, Laura J; Durocher, Jill; Byrne, Meagan E; Ononge, Sam; Winikoff, Beverly; Weeks, Andrew D

2017-10-26

Advance provision of misoprostol to women during antenatal care aims to achieve broader access to uterotonics for the prevention of postpartum hemorrhage. Studies of this community-based approach usually involve antenatal education as well as timely postpartum follow-up visits to confirm maternal and neonatal outcomes. The MamaMiso study in Mbale, Uganda sought to assess the feasibility of conducting follow-up visits in the postpartum period following advance provision of misoprostol for postpartum hemorrhage prevention. MamaMiso recruited women during antenatal care visits. Participants were asked to contact the research team within 48 h of giving birth so that postpartum follow-up visits could be carried out at their homes. Women's baseline and delivery characteristics were collected and analyzed with respect to follow-up time ('on time' ≤ 7 days, 'late' > 7 days, and 'lost to follow up'). Every woman who was followed up late due to a failure to report the delivery was asked for the underlying reasons for the delay. When attempts at following up participants were unsuccessful, a file note was generated explaining the details of the failure. We abstracted data and identified themes from these notes. Of 748 recruited women, 700 (94%) were successfully followed up during the study period, 465 (62%) within the first week postpartum. The median time to follow up was 4 days and was similar for women who delivered at home or in facilities and for women who had attended or unattended births. Women recruited at the urban hospital site (as opposed to rural health clinics) were more likely to be lost to follow up or followed up late. Of the women followed up late, 202 provided a reason. File notes explaining failed attempts at follow up were generated for 164 participants. Several themes emerged from qualitative analysis of these notes including phone difficulties, inaccurate baseline information, misperceptions, postpartum travel, and the condition of the mother and neonate. Keeping women connected to the health system in the postpartum period is feasible, though reaching them within the first week of their delivery is challenging. Understanding characteristics of women who are harder to reach can help tailor follow-up efforts and elucidate possible biases in postpartum study data. Trial Registration Number ISRCTN70408620 December 28, 2011.

An evaluation of the experiences of guide dog owners visiting Scottish veterinary practices.

PubMed

Fraser, M; Girling, S J

2016-09-10

Guide dogs and their owners will visit a veterinary practice at least twice a year. The aim of this study was to evaluate what guide dog owners thought about these visits, in order to identify areas of good practice which could be incorporated into the undergraduate curriculum. Nine guide dog owners volunteered to take part in the study and were interviewed by the primary researcher. Thematic analysis was carried out and several themes were identified: good experiences were highlighted where staff had an understanding of visual impairment and the work of a guide dog; the importance of good communication skills involving the owner in the consultation; the need for veterinary professionals to understand the bond between an owner and guide dog; how medication and information could be provided in a user-friendly format for someone affected by a visual impairment and concerns about costs and decision making for veterinary treatment. This work highlights the importance for veterinary staff to talk to, empathise with and understand the individual circumstances of their clients and identifies areas that should be included in veterinary education to better prepare students for the workplace. British Veterinary Association.

Peer supporter experiences of home visits for people with HIV infection

PubMed Central

Lee, Han Ju; Moneyham, Linda; Kang, Hee Sun; Kim, Kyung Sun

2015-01-01

Purpose This study’s purpose was to explore the experiences of peer supporters regarding their work in a home visit program for people with HIV infection. Patients and methods A qualitative descriptive study was conducted using focus groups. Participants were 12 HIV-positive peer supporters conducting home visits with people living with HIV/AIDS in South Korea. Thematic analysis was used to analyze the data. Results Six major themes emerged: feeling a sense of belonging; concern about financial support; facing HIV-related stigma and fear of disclosure; reaching out and acting as a bridge of hope; feeling burnout; and need for quality education. The study findings indicate that although peer supporters experience several positive aspects in the role, such as feelings of belonging, they also experience issues that make it difficult to be successful in the role, including the position’s instability, work-related stress, and concerns about the quality of their continuing education. Conclusion The findings suggest that to maintain a stable and effective peer supporter program, such positions require financial support, training in how to prevent and manage stress associated with the role, and a well-developed program of education and training. PMID:26445560

KSC-04PD-2210

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Center Director Jim Kennedy kicks off Spaceport Super Safety and Health Day with opening ceremonies at the KSC Training Auditorium. Guest speakers included Dr. Pamela Peeke, Navy Com. Stephen E. Iwanowicz, NASAs Dr. Kristine Calderon and Olympic-great Bruce Jenner. Later in the day, employees could visit many vendors exhibits featuring safety and health items. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

KSC-04PD-2214

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Olympic champion and motivational speaker Bruce Jenner talks to KSC employees during opening ceremonies for Spaceport Super Safety and Health Day at KSC. Other speakers included Dr. Pamela Peeke, Navy Com. Stephen E. Iwanowicz and NASAs Dr. Kristine Calderon. Later in the day, employees could visit many vendors exhibits featuring safety and health items. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

KSC-04PD-2213

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Guest speaker Dr. Pamela Peeke talks to KSC employees during opening ceremonies for Spaceport Super Safety and Health Day at KSC. Other speakers included Navy Com. Stephen E. Iwanowicz , NASAs Dr. Kristine Calderon and Olympic- great Bruce Jenner. Later in the day, employees could visit many vendors exhibits featuring safety and health items. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

A short walk in quantum probability.

PubMed

Hudson, Robin

2018-04-28

This is a personal survey of aspects of quantum probability related to the Heisenberg commutation relation for canonical pairs. Using the failure, in general, of non-negativity of the Wigner distribution for canonical pairs to motivate a more satisfactory quantum notion of joint distribution, we visit a central limit theorem for such pairs and a resulting family of quantum planar Brownian motions which deform the classical planar Brownian motion, together with a corresponding family of quantum stochastic areas.This article is part of the themed issue 'Hilbert's sixth problem'. © 2018 The Author(s).

Sixth International Limnogeology Congress: field trip guidebook, Reno, Nevada, June 15-19, 2015

USGS Publications Warehouse

Rosen, Michael R.

2015-01-01

The U.S. Geological Survey has sponsored each ILIC that has been held in the United States because of the importance of understanding paleoclimate and contaminant histories of lakes, two main themes of the Congress. This field trip guide provides a permanent record of some of the wide variety of studies that are being conducted in modern lakes and ancient lake deposits in western North America, and it provides a starting point for any one desiring to visit these exceptional sites or begin work in these areas.

36 CFR 1254.22 - Do I need to register when I visit a NARA facility for research?

Code of Federal Regulations, 2011 CFR

2011-07-01

... visit a NARA facility for research? 1254.22 Section 1254.22 Parks, Forests, and Public Property NATIONAL... MATERIALS Research Room Rules General Procedures § 1254.22 Do I need to register when I visit a NARA facility for research? (a) Yes, you must register each day you enter a NARA research facility by furnishing...

36 CFR 1254.22 - Do I need to register when I visit a NARA facility for research?

Code of Federal Regulations, 2014 CFR

2014-07-01

... visit a NARA facility for research? 1254.22 Section 1254.22 Parks, Forests, and Public Property NATIONAL... MATERIALS Research Room Rules General Procedures § 1254.22 Do I need to register when I visit a NARA facility for research? (a) Yes, you must register each day you enter a NARA research facility by furnishing...

36 CFR 1254.22 - Do I need to register when I visit a NARA facility for research?

Code of Federal Regulations, 2010 CFR

2010-07-01

... visit a NARA facility for research? 1254.22 Section 1254.22 Parks, Forests, and Public Property NATIONAL... MATERIALS Research Room Rules General Procedures § 1254.22 Do I need to register when I visit a NARA facility for research? (a) Yes, you must register each day you enter a NARA research facility by furnishing...

36 CFR 1254.22 - Do I need to register when I visit a NARA facility for research?

Code of Federal Regulations, 2012 CFR

2012-07-01

... visit a NARA facility for research? 1254.22 Section 1254.22 Parks, Forests, and Public Property NATIONAL... MATERIALS Research Room Rules General Procedures § 1254.22 Do I need to register when I visit a NARA facility for research? (a) Yes, you must register each day you enter a NARA research facility by furnishing...

Interpreting carnivore scent-station surveys

USGS Publications Warehouse

Sargeant, G.A.; Johnson, D.H.; Berg, W.E.

1998-01-01

The scent-station survey method has been widely used to estimate trends in carnivore abundance. However, statistical properties of scent-station data are poorly understood, and the relation between scent-station indices and carnivore abundance has not been adequately evaluated. We assessed properties of scent-station indices by analyzing data collected in Minnesota during 1986-03. Visits to stations separated by <2 km were correlated for all species because individual carnivores sometimes visited several stations in succession. Thus, visits to stations had an intractable statistical distribution. Dichotomizing results for lines of 10 stations (0 or 21 visits) produced binomially distributed data that were robust to multiple visits by individuals. We abandoned 2-way comparisons among years in favor of tests for population trend, which are less susceptible to bias, and analyzed results separately for biogeographic sections of Minnesota because trends differed among sections. Before drawing inferences about carnivore population trends, we reevaluated published validation experiments. Results implicated low statistical power and confounding as possible explanations for equivocal or conflicting results of validation efforts. Long-term trends in visitation rates probably reflect real changes in populations, but poor spatial and temporal resolution, susceptibility to confounding, and low statistical power limit the usefulness of this survey method.

Parental Concerns about the Health of Adolescents with Intellectual Disability: A Brief Report

PubMed Central

Tucker, Madonna; Taylor Gomez, Miriam; Rey-Conde, Therese; Lennox, Nicholas

2011-01-01

Background. Parents of adolescents with intellectual disability are concerned about the future health and well-being needs of their children. Method. Qualitative data was collected as part of a cross-sectional descriptive study and semi-structured interviews were conducted with 32 parents. The results were themed. Results. Most parents discussed areas of their children's health which made them anxious about the future. These concerns were collated into five themes. Conclusion. The health and well-being themes were dependency, general health, challenging behaviours, and increasing support needs. PMID:22295180

Epilepsy and AED-induced decreased libido - The unasked psychosocial comorbidity.

PubMed

Kaufman, Kenneth R; Wong, Stephen; Sivaraaman, Kartik; Anim, Candy; Delatte, David

2015-11-01

Therapeutic treatment for persons with epilepsy (PWE) should address seizure control and the broad spectrum of associated comorbidities. Since both epilepsy and antiepileptic drugs (AEDs) can induce decreased libido, sexual health assessment is an important aspect of quality care in PWE as well as other patients receiving AEDs. This paper presents findings from a pilot quality initiative conducted in the ambulatory care epilepsy, pain management, and psychiatric services (N=15 clinicians) which addressed two themes: 1) whether libido is routinely questioned with/without the electronic medical record (EMR) and 2) clinicians' knowledge that both epilepsy and AEDs can induce decreased libido. All clinicians used the EMR, 40% used the GU-ROS section, but only 1 clinician (6.67%) questioned patients regarding libido. Of the clinicians, 26.7% demonstrated knowledge that both AEDs and epilepsy can cause decreased libido. Our results suggest that a treatment gap for epilepsy-induced and AED-induced decreased libido may be related to systems issues (duration of clinical visit, billing codes, EMR template) and physician barriers including decreased knowledge. Further research in this field and replication of this pilot quality initiative are indicated. Copyright © 2015 Elsevier Inc. All rights reserved.

a week in space

NASA Astrophysics Data System (ADS)

collette, christian

2016-04-01

COLLETTE Christian Institut Saint Laurent Liège Belgium. I am a science teacher at a technical high school. Generally, my students don't come from a privileged social background and are not particularly motivated for studies. For 10 years, I organize, for one of my sections, a spatial (and special) school year that ends in a spatial week. Throughout this year, with the help of my colleagues, I will introduce into all themes a lot of concepts relating to space. French, history, geography, English, mathematics, technical courses, sciences, and even gymnastics will be training actors in space culture. In spring, I will accompany my class in the Euro Space Center (Redu- Belgium) where we will live one week 24 hours on "like astronauts" One third of the time is dedicated to astronaut training (moonwalk, remote manipulator system, mission simulation, weightless wall, building rockets, satellites, etc.), One third to more intellectual activities on space (lectures, research, discovery of the outside run) the last one third of time in outside visits (museums, site of ESA-Redu) or in movies about space (October sky, Apollo 13, etc.) During this year, the profits, so educational as human, are considerable!

ACHP | Citizen's Guide to Section 106 Review

Science.gov Websites

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Community Strikes Back? Belonging and Exclusion in Rural English Villages in Networked Times

ERIC Educational Resources Information Center

Hillyard, Sam; Bagley, Carl

2015-01-01

The paper draws upon ethnographic research of two contrasting English primary schools and their villages to explore the themes of belonging and exclusion in contemporary rural contexts. The paper first describes the schools and the villages. A second, conceptual section explores the meaning of rurality in relation to the themes of class, belonging…

Dental utilization of active duty/previous active duty US military: a cross-sectional analysis of the 2010 Behavior and Risk Surveillance Survey

PubMed Central

Sambamoorthi, Usha; Jurevic, Richard J

2015-01-01

Introduction The purpose of this study is to understand dental utilization of 1) individuals serving/having served in active duty in the U.S. military as compared with the general public and 2) individuals who are currently serving as compared with individuals who are no longer active duty, but have been in active duty within the previous year. Methods The Behavior and Risk Surveillance Survey, 2010, was used in cross-sectional analyses to determine the comparisons. Chi square and multivariable logistic regression analyses were applied. Results 70.7% of participants who had served/currently serving had a dental visit within the previous 12 months; 69.9% of the general public reported a dental visit (p = 0.0265). 69.8% of participants who had served/currently serving had a dental hygiene visit within the previous 12 months and 68.1% of the general public reported a dental hygiene visit (p <0.0001). The adjusted odds ratio (AOR) for participants who had served/currently serving vs. the general public was 1.10 (95% Confidence Interval [CI] 1.05, 1.16; p<0.0001) for dental visits and 1.11 (95%CI 1.05, 1.17; p<0.0001) for dental hygiene visits. Conclusion Participants who are serving or have served were more likely to have any dental visit and dental hygiene visit than the general public; but the results were not substantively important. PMID:26086028

Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.

PubMed

Shakespeare, Judy; Blake, Fiona; Garcia, Jo

2004-09-01

to explore how women experience breast-feeding difficulties. This theme emerged unexpectedly during a study of women's experiences of screening with the Edinburgh postnatal depression scale (EPDS) and subsequent care from primary health-care professionals. qualitative in-depth interview study. postnatal women of 22 general practices within Oxford City Primary Care Group area. 39 postnatal women from a purposeful sample were interviewed at an average of 15 months postnatal. They were chosen from different general practices and with a range of emotional difficulties after birth, judged using EPDS results at eight weeks and eight months postnatal, and whether they received 'listening visits' from health visitors. a qualitative thematic analysis was used, including searches for anticipated and emergent themes. Fifteen women had breast-feeding difficulties. Five themes emerged which explore the difficulties. Firstly, commitment to breast feeding and high expectations of success; secondly, unexpected difficulties; thirdly, seeking professional support for difficulties; fourthly, finding a way to cope; and fifthly, guilt. in this study breast-feeding difficulties were common, caused emotional distress and interactions with professionals could be difficult. Current breast-feeding policy, such as the 'Baby Friendly Initiative', may be a contributing factor. This needs to be explored in a further study.

Patients' Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas

PubMed Central

Johansson, Annette M.; Lindberg, Inger; Söderberg, Siv

2014-01-01

Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter. PMID:25243009

Patients' Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas.

PubMed

Johansson, Annette M; Lindberg, Inger; Söderberg, Siv

2014-01-01

Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme "confident with the technology" was constructed from the categories "possibilities and obstacles in using VC encounters" and "advantages and disadvantages of the technology." The theme "personal satisfaction with the VC encounters" was constructed from the categories "support from the healthcare personnel," "perceived security," and "satisfaction with the specialist consultation." Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter.

The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

PubMed Central

Moyer, Lindsay J.; Carbone, Elena T.; Anliker, Jean A.; Goff, Sarah L.

2015-01-01

Objectives Massachusetts (MA) public schools conduct mandated body-mass index (BMI) screening and until recently, communicated results in a letter to parents/caregivers, to encourage primary care visits and provide aggregate data to the state Department of Public Health. This study assessed the letter's readability and qualitatively explored parents’ responses to it. Methods Readability of the BMI letter was calculated. Audio-taped 1-h focus groups were conducted with parents/caregivers of 8- to 14-year-old obese (≥95th BMI-for-age percentile) children. A semistructured interview guide was used to elicit responses. Qualitative content analysis was conducted on transcripts to identify emergent themes. Results Readability analysis showed higher grade levels than recommended. Eight focus groups consisting of two to six parents each were conducted (n = 29); 83% were female, mean age 41 ± 9 years, and 65% self-identified as Hispanic/Latino. Key themes identified included usefulness of the BMI letter, concerns about utility of BMI for screening, concerns about impacting self-esteem, and failure to understand the letter. Conclusions The MA BMI letter may not have been achieving its desired goal with some parents. Practice implications: Emergent themes from this study could be used to test effectiveness of similar BMI letters nationwide and develop strategies to improve communication to parents. PMID:24290240

Children visiting family and friends on adult intensive care units: the nurses' perspective.

PubMed

Clarke, C M

2000-02-01

Recent surveys show that children are still restricted from visiting their critically ill family and friends on many adult intensive care units throughout the country. The purpose of this small-scale exploratory pilot study was to examine and describe the experiences and perceptions of trained nurses towards children visiting within this setting. The aim of the study was to gain greater insight and understanding into the reason why, despite evidence to support the benefits to children of visiting their critically ill family and friends, they remain discouraged and restricted. It is hoped that the study will act as an initial enquiry to generate themes and further research questions. A qualitative research approach was adopted and in-depth focused interviews used as a method of data collection. The participants of the study were trained nurses working on an adult intensive care unit in a district general hospital in England. A total of 12 individual interviews were conducted which were audiotaped in full and analysed using a method of thematic content analysis. The value of the research is to promote family-centred care within an adult intensive care environment to meet the neglected needs of the well children of the critically ill person. The findings suggest that the participants in the study attempted to offer valuable support to children visiting their critically ill family and friends, but, despite an open visiting policy, children rarely visited within this setting. The desire of the well parent to protect and shield the child from the crisis of critical illness was perceived by the participants to be the main reason why they did not visit. To provide family-centred care within an adult intensive care setting has many implications for practice and several of these important issues are discussed. These include the educational and training needs of nursing staff and the importance of adopting a collaborative team approach to providing care for the critically ill person and their family. The need to generate research and literature from within the United Kingdom's health care system has also been identified and recommendations for further studies are proposed.

Multimodal Perception and Multicriterion Control of Nested Systems. 1; Coordination of Postural Control and Vehicular Control

NASA Technical Reports Server (NTRS)

Riccio, Gary E.; McDonald, P. Vernon

1998-01-01

The purpose of this report is to identify the essential characteristics of goal-directed whole-body motion. The report is organized into three major sections (Sections 2, 3, and 4). Section 2 reviews general themes from ecological psychology and control-systems engineering that are relevant to the perception and control of whole-body motion. These themes provide an organizational framework for analyzing the complex and interrelated phenomena that are the defining characteristics of whole-body motion. Section 3 of this report applies the organization framework from the first section to the problem of perception and control of aircraft motion. This is a familiar problem in control-systems engineering and ecological psychology. Section 4 examines an essential but generally neglected aspect of vehicular control: coordination of postural control and vehicular control. To facilitate presentation of this new idea, postural control and its coordination with vehicular control are analyzed in terms of conceptual categories that are familiar in the analysis of vehicular control.

Delivery style moderates study habits in an online nutrition class.

PubMed

Connors, Priscilla

2013-03-01

To report how the design of an online class affected student ability to stay on task, find critical resources, and communicate with the instructor via e-mail. Audiorecorded focus group meetings at a United States university featured a structured approach to discussions among undergraduate students enrolled in an Internet nutrition class. Meeting transcripts were read and reread by a trained investigator, who coded concepts until themes coalesced, which were authenticated by college students taking online classes. Three themes emerged that described factors moderating study habits in an Internet nutrition course: keeping up, e-mail fatigue, and wayfinding. A well-designed online course plans for productive study habits by posting a schedule of events and maintaining a predictable pattern, supporting navigation that stimulates exploration and return visits to critical information, and constructing e-mail messages that convey a concise message and maximize "open and read." Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Informed Strangers: Witnessing and Responding to Unethical Care as Student Nurses.

PubMed

Engel, Joyce; Salfi, Jenn; Micsinszki, Samantha; Bodnar, Andrea

2017-01-01

Nursing students occupy a unique perspective in clinical settings because they are informed, through education, about how patient care ought to happen. Given the brevity of placements and their "visiting status" in clinical sites, students are less invested in the ethos of specific sites. Subsequently, their perspectives of quality care are informed by what should happen, which might differ from that of nurses and patients. The purpose of this study was to identify predominant themes in patient care, as experienced by students, and the influence that these observations have on the development of their ethical reasoning. Using a qualitative descriptive approach in which 27 nursing student papers and three follow-up in-depth interviews were analyzed, three main themes emerged: Good employee, poor nurse; damaged care; and negotiating the gap. The analysis of the ethical situations in these papers suggests that students sometimes observe care that lacks concern for the dignity, autonomy, and safety of patients. For these student nurses, this tension led to uncertainty about patient care and their eventual profession.

Situation Awareness and Interruption Handling During Medication Administration.

PubMed

Sitterding, Mary Cathryn; Ebright, Patricia; Broome, Marion; Patterson, Emily S; Wuchner, Staci

2014-08-01

Medication administration error remains a leading cause of preventable death. A gap exists in understanding attentional dynamics, such as nurse situation awareness (SA) while managing interruptions during medication administration. The aim was to describe SA during medication administration and interruption handling strategies. A cross-sectional, descriptive design was used. Cognitive task analysis (CTA) methods informed analysis of 230 interruptions. Themes were analyzed by SA level. The nature of the stimuli noticed emerged as a Level 1 theme, in contrast to themes of uncertainty, relevance, and expectations (Level 2 themes). Projected or anticipated interventions (Level 3 themes) reflected workload balance between team and patient foregrounds. The prevalence of cognitive time-sharing during the medication administration process was remarkable. Findings substantiated the importance of the concept of SA within nursing as well as the contribution of CTA in understanding the cognitive work of nursing during medication administration. © The Author(s) 2014.

Selectively willing and conditionally able: HIV vaccine trial participation among women at "high risk" of HIV infection.

PubMed

Voytek, Chelsea D; Jones, Kevin T; Metzger, David S

2011-08-18

Efficacy studies of investigational HIV vaccines require enrollment of individuals at 'high risk' for HIV. This paper examines participation in HIV vaccine trials among women at 'high risk' for HIV acquisition. In-depth interviews were conducted with 17 African-American women who use crack cocaine and/or exchange sex for money/drugs to elicit attitudes toward medical research and motivators and deterrents to HIV vaccine trial participation. Interviews were digitally recorded and transcribed; data were coded and compiled into themes. Most women expressed favorable attitudes toward medical research in general. Motivators for trial participation included compensation; personal benefits including information, social services, and the possibility that the trial vaccine could prevent HIV; and altruism. Deterrents included: dislike of needles; distrust; concern about future consequences of participating. In addition, contingencies, care-giving responsibilities, and convenience issues constituted barriers which could impede participation. Respondents described varied, complex perspectives, and individual cases illustrate how these themes played out as women contemplated trial participation. Understanding factors which influence vaccine research participation among women at 'high risk' can aid sites to tailor recruitment procedures to local contexts. Concerns about future reactions can be addressed through sustained community education. Convenience barriers can be ameliorated by providing rides to study visits when necessary, and/or conducting study visits in accessible neighborhood locations. Women in this sample thought carefully about enrolling in HIV vaccine trials given the structural constraints within which they lived. Further research is needed regarding structural factors which influence personal agency and individuals' thinking about research participation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Combined effects of THC and caffeine on working memory in rats

PubMed Central

Panlilio, Leigh V; Ferré, Sergi; Yasar, Sevil; Thorndike, Eric B; Schindler, Charles W; Goldberg, Steven R

2012-01-01

BACKGROUND AND PURPOSE Cannabis and caffeine are two of the most widely used psychoactive substances. Δ9-Tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, induces deficits in short-term memory. Caffeine, a non-selective adenosine receptor antagonist, attenuates some memory deficits, but there have been few studies addressing the effects of caffeine and THC in combination. Here, we evaluate the effects of these drugs using a rodent model of working memory. EXPERIMENTAL APPROACH Rats were given THC (0, 1 and 3 mg·kg−1, i.p.) along with caffeine (0, 1, 3 and 10 mg·kg−1, i.p.), the selective adenosine A1-receptor antagonist CPT (0, 3 and 10 mg·kg−1) or the selective adenosine A2A-receptor antagonist SCH58261 (0 and 5 mg·kg−1) and were tested with a delayed non-matching-to-position procedure in which behaviour during the delay was automatically recorded as a model of memory rehearsal. KEY RESULTS THC alone produced memory deficits at 3 mg·kg−1. The initial exposure to caffeine (10 mg·kg−1) disrupted the established pattern of rehearsal-like behaviour, but tolerance developed rapidly to this effect. CPT and SCH58261 alone had no significant effects on rehearsal or memory. When a subthreshold dose of THC (1 mg·kg−1) was combined with caffeine (10 mg·kg−1) or CPT (10 mg·kg−1), memory performance was significantly impaired, even though performance of the rehearsal-like pattern was not significantly altered. CONCLUSION AND IMPLICATIONS Caffeine did not counteract memory deficits induced by THC but actually exacerbated them. These results are consistent with recent findings that adenosine A1 receptors modulate cannabinoid signalling in the hippocampus. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21699509

Inhibition of monoacylglycerol lipase attenuates vomiting in Suncus murinus and 2-arachidonoyl glycerol attenuates nausea in rats.

PubMed

Sticht, Martin A; Long, Jonathan Z; Rock, Erin M; Limebeer, Cheryl L; Mechoulam, Raphael; Cravatt, Benjamin F; Parker, Linda A

2012-04-01

To evaluate the role of 2-arachidonoyl glycerol (2AG) in the regulation of nausea and vomiting using animal models of vomiting and of nausea-like behaviour (conditioned gaping). Vomiting was assessed in shrews (Suncus murinus), pretreated with JZL184, a selective monoacylglycerol lipase (MAGL) inhibitor which elevates endogenous 2AG levels, 1 h before administering the emetogenic compound, LiCl. Regulation of nausea-like behaviour in rats by exogenous 2AG or its metabolite arachidonic acid (AA) was assessed, using the conditioned gaping model. The role of cannabinoid CB(1) receptors, CB(2) receptors and cyclooxygenase (COX) inhibition in suppression of vomiting or nausea-like behaviour was assessed. JZL184 dose-dependently suppressed vomiting in shrews, an effect prevented by pretreatment with the CB(1) receptor inverse agonist/antagonist, AM251. In shrew brain tissue, JZL184 inhibited MAGL activity in vivo. In rats, 2AG suppressed LiCl-induced conditioned gaping but this effect was not prevented by AM251 or the CB(2) receptor antagonist, AM630. Instead, the COX inhibitor, indomethacin, prevented suppression of conditioned gaping by 2AG or AA. However, when rats were pretreated with a high dose of JZL184 (40 mg·kg(-1) ), suppression of gaping by 2AG was partially reversed by AM251. Suppression of conditioned gaping was not due to interference with learning because the same dose of 2AG did not modify the strength of conditioned freezing to a shock-paired tone. Our results suggest that manipulations that elevate 2AG may have anti-emetic or anti-nausea potential. This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

Differential transcriptional profiles mediated by exposure to the cannabinoids cannabidiol and Δ9-tetrahydrocannabinol in BV-2 microglial cells

PubMed Central

Juknat, Ana; Pietr, Maciej; Kozela, Ewa; Rimmerman, Neta; Levy, Rivka; Coppola, Giovanni; Geschwind, Daniel; Vogel, Zvi

2012-01-01

BACKGROUND AND PURPOSE Apart from their effects on mood and reward, cannabinoids exert beneficial actions such as neuroprotection and attenuation of inflammation. The immunosuppressive activity of cannabinoids has been well established. However, the underlying mechanisms are largely unknown. We previously showed that the psychoactive cannabinoid Δ9-tetrahydrocannabinol (THC) and the non-psychoactive cannabidiol (CBD) differ in their anti-inflammatory signalling pathways. EXPERIMENTAL APPROACH To characterize the transcriptional effects of CBD and THC, we treated BV-2 microglial cells with these compounds and performed comparative microarray analysis using the Illumina MouseRef-8 BeadChip platform. Ingenuity Pathway Analysis was performed to identify functional subsets of genes and networks regulated by CBD and/or THC. KEY RESULTS Overall, CBD altered the expression of many more genes; from the 1298 transcripts found to be differentially regulated by the treatments, 680 gene probe sets were up-regulated by CBD and 58 by THC, and 524 gene products were down-regulated by CBD and only 36 by THC. CBD-specific gene expression profile showed changes associated with oxidative stress and glutathione depletion, normally occurring under nutrient limiting conditions or proteasome inhibition and involving the GCN2/eIF2α/p8/ATF4/CHOP-TRIB3 pathway. Furthermore, CBD-stimulated genes were shown to be controlled by nuclear factors known to be involved in the regulation of stress response and inflammation, mainly via the (EpRE/ARE)-Nrf2/ATF4 system and the Nrf2/Hmox1 axis. CONCLUSIONS AND IMPLICATIONS These observations indicated that CBD, but much less than THC, induced a cellular stress response in microglial cells and suggested that this effect could underlie its anti-inflammatory activity. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21542829

Inhibition of monoacylglycerol lipase attenuates vomiting in Suncus murinus and 2-arachidonoyl glycerol attenuates nausea in rats

PubMed Central

Sticht, Martin A; Long, Jonathan Z; Rock, Erin M; Limebeer, Cheryl L; Mechoulam, Raphael; Cravatt, Benjamin F; Parker, Linda A

2012-01-01

BACKGROUND AND PURPOSE To evaluate the role of 2-arachidonoyl glycerol (2AG) in the regulation of nausea and vomiting using animal models of vomiting and of nausea-like behaviour (conditioned gaping). EXPERIMENTAL APPROACH Vomiting was assessed in shrews (Suncus murinus), pretreated with JZL184, a selective monoacylglycerol lipase (MAGL) inhibitor which elevates endogenous 2AG levels, 1 h before administering the emetogenic compound, LiCl. Regulation of nausea-like behaviour in rats by exogenous 2AG or its metabolite arachidonic acid (AA) was assessed, using the conditioned gaping model. The role of cannabinoid CB1 receptors, CB2 receptors and cyclooxygenase (COX) inhibition in suppression of vomiting or nausea-like behaviour was assessed. KEY RESULTS JZL184 dose-dependently suppressed vomiting in shrews, an effect prevented by pretreatment with the CB1 receptor inverse agonist/antagonist, AM251. In shrew brain tissue, JZL184 inhibited MAGL activity in vivo. In rats, 2AG suppressed LiCl-induced conditioned gaping but this effect was not prevented by AM251 or the CB2 receptor antagonist, AM630. Instead, the COX inhibitor, indomethacin, prevented suppression of conditioned gaping by 2AG or AA. However, when rats were pretreated with a high dose of JZL184 (40 mg·kg−1), suppression of gaping by 2AG was partially reversed by AM251. Suppression of conditioned gaping was not due to interference with learning because the same dose of 2AG did not modify the strength of conditioned freezing to a shock-paired tone. CONCLUSIONS AND IMPLICATIONS Our results suggest that manipulations that elevate 2AG may have anti-emetic or anti-nausea potential. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21470205

Compartmentalization of endocannabinoids into lipid rafts in a microglial cell line devoid of caveorrlin-1

PubMed Central

Rimmerman, Neta; Bradshaw, Heather B; Kozela, Ewa; Levy, Rivka; Juknat, Ana; Vogel, Zvi

2012-01-01

BACKGROUND AND PURPOSE N-acyl ethanolamines (NAEs) and 2-arachidonoyl glycerol (2-AG) are endogenous cannabinoids and along with related lipids are synthesized on demand from membrane phospholipids. Here, we have studied the compartmentalization of NAEs and 2-AG into lipid raft fractions isolated from the caveolin-1-lacking microglial cell line BV-2, following vehicle or cannabidiol (CBD) treatment. Results were compared with those from the caveolin-1-positive F-11 cell line. EXPERIMENTAL APPROACH BV-2 cells were incubated with CBD or vehicle. Cells were fractionated using a detergent-free continuous OptiPrep density gradient. Lipids in fractions were quantified using HPLC/MS/MS. Proteins were measured using Western blot. KEY RESULTS BV-2 cells were devoid of caveolin-1. Lipid rafts were isolated from BV-2 cells as confirmed by co-localization with flotillin-1 and sphingomyelin. Small amounts of cannabinoid CB1 receptors were found in lipid raft fractions. After incubation with CBD, levels and distribution in lipid rafts of 2-AG, N-arachidonoyl ethanolamine (AEA), and N-oleoyl ethanolamine (OEA) were not changed. Conversely, the levels of the saturated N-stearoyl ethanolamine (SEA) and N-palmitoyl ethanolamine (PEA) were elevated in lipid raft fractions. In whole cells with growth medium, CBD treatment increased AEA and OEA time-dependently, while levels of 2-AG, PEA and SEA did not change. CONCLUSIONS AND IMPLICATIONS Whereas levels of 2-AG were not affected by CBD treatment, the distribution and levels of NAEs showed significant changes. Among the NAEs, the degree of acyl chain saturation predicted the compartmentalization after CBD treatment suggesting a shift in cell signalling activity. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21449981

The endocannabinoid system in the rat dorsolateral periaqueductal grey mediates fear-conditioned analgesia and controls fear expression in the presence of nociceptive tone

PubMed Central

Olango, WM; Roche, M; Ford, GK; Harhen, B; Finn, DP

2012-01-01

BACKGROUND AND PURPOSE Endocannabinoids in the midbrain periaqueductal grey (PAG) modulate nociception and unconditioned stress-induced analgesia; however, their role in fear-conditioned analgesia (FCA) has not been examined. The present study examined the role of the endocannabinoid system in the dorsolateral (dl) PAG in formalin-evoked nociceptive behaviour, conditioned fear and FCA in rats. EXPERIMENTAL APPROACH Rats received intra-dlPAG administration of the CB1 receptor antagonist/inverse agonist rimonabant, or vehicle, before re-exposure to a context paired 24 h previously with foot shock. Formalin-evoked nociceptive behaviour and fear-related behaviours (freezing and 22 kHz ultrasonic vocalization) were assessed. In a separate cohort, levels of endocannabinoids [2-arachidonoyl glycerol (2-AG) and N-arachidonoyl ethanolamide (anandamide; AEA)] and the related N-acylethanolamines (NAEs) [N-palmitoyl ethanolamide (PEA) and N-oleoyl ethanolamide (OEA)] were measured in dlPAG tissue following re-exposure to conditioned context in the presence or absence of formalin-evoked nociceptive tone. KEY RESULTS Re-exposure of rats to the context previously associated with foot shock resulted in FCA. Intra-dlPAG administration of rimonabant significantly attenuated FCA and fear-related behaviours expressed in the presence of nociceptive tone. Conditioned fear without formalin-evoked nociceptive tone was associated with increased levels of 2-AG, AEA, PEA and OEA in the dlPAG. FCA was specifically associated with an increase in AEA levels in the dlPAG. CONCLUSIONS AND IMPLICATIONS Conditioned fear to context mobilises endocannabinoids and NAEs in the dlPAG. These data support a role for endocannabinoids in the dlPAG in mediating the potent suppression of pain responding which occurs during exposure to conditioned aversive contexts. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21564082

Metabotropic glutamate receptor subtype 5: molecular pharmacology, allosteric modulation and stimulus bias

PubMed Central

Sengmany, K

2015-01-01

The metabotropic glutamate receptor subtype 5 (mGlu5) is a family C GPCR that has been implicated in various neuronal processes and, consequently, in several CNS disorders. Over the past few decades, GPCR‐based drug discovery, including that for mGlu5 receptors, has turned considerable attention to targeting allosteric binding sites. Modulation of endogenous agonists by allosteric ligands offers the advantages of spatial and temporal fine‐tuning of receptor activity, increased selectivity and reduced adverse effects with the potential to elicit improved clinical outcomes. Further, with greater appreciation of the multifaceted nature of the transduction of mGlu5 receptor signalling, it is increasingly apparent that drug discovery must take into consideration unique receptor conformations and the potential for stimulus‐bias. This novel paradigm proposes that different ligands may differentially modulate distinct signalling pathways arising from the same receptor. We review our current understanding of the complexities of mGlu5 receptor signalling and regulation, and how these relate to allosteric ligands. Ultimately, a deeper appreciation of these relationships will provide the foundation for targeted drug design of compounds with increased selectivity, not only for the desired receptor but also for the desired signalling outcome from the receptor. Linked Articles This article is part of a themed section on Molecular Pharmacology of G Protein‐Coupled Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v173.20/issuetoc PMID:26276909

Transient receptor potential cation channels in visceral sensory pathways

PubMed Central

Blackshaw, L Ashley

2014-01-01

The extensive literature on this subject is in direct contrast to the limited range of clinical uses for ligands of the transient receptor potential cation channels (TRPs) in diseases of the viscera. TRPV1 is the most spectacular example of this imbalance, as it is in other systems, but it is nonetheless the only TRP target that is currently targeted clinically in bladder sensory dysfunction. It is not clear why this discrepancy exists, but a likely answer is in the promiscuity of TRPs as sensors and transducers for environmental mechanical and chemical stimuli. This review first describes the different sensory pathways from the viscera, and on which nociceptive and non-nociceptive neurones within these pathways TRPs are expressed. They not only fulfil roles as both mechano-and chemo-sensors on visceral afferents, but also form an effector mechanism for cell activation after activation of GPCR and cytokine receptors. Their role may be markedly changed in diseased states, including chronic pain and inflammation. Pain presents the most obvious potential for further development of therapeutic interventions targeted at TRPs, but forms of inflammation are emerging as likely to benefit also. However, despite much basic research, we are still at the beginning of exploring such potential in visceral sensory pathways. LINKED ARTICLES This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-10 PMID:24641218

Obesity and risk of vascular disease: importance of endothelium-dependent vasoconstriction

PubMed Central

Barton, Matthias; Baretella, Oliver; Meyer, Matthias R

2012-01-01

Obesity has become a serious global health issue affecting both adults and children. Recent devolopments in world demographics and declining health status of the world's population indicate that the prevalence of obesity will continue to increase in the next decades. As a disease, obesity has deleterious effects on metabolic homeostasis, and affects numerous organ systems including heart, kidney and the vascular system. Thus, obesity is now regarded as an independent risk factor for atherosclerosis-related diseases such as coronary artery disease, myocardial infarction and stroke. In the arterial system, endothelial cells are both the source and target of factors contributing to atherosclerosis. Endothelial vasoactive factors regulate vascular homeostasis under physiological conditions and maintain basal vascular tone. Obesity results in an imbalance between endothelium-derived vasoactive factors favouring vasoconstriction, cell growth and inflammatory activation. Abnormal regulation of these factors due to endothelial cell dysfunction is both a consequence and a cause of vascular disease processes. Finally, because of the similarities of the vascular pathomechanisms activated, obesity can be considered to cause accelerated, ‘premature’ vascular aging. Here, we will review some of the pathomechanisms involved in obesity-related activation of endothelium-dependent vasoconstriction, the clinical relevance of obesity-associated vascular risk, and therapeutic interventions using ‘endothelial therapy’ aiming at maintaining or restoring vascular endothelial health. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3 PMID:21557734

Branched-chain amino acids differently modulate catabolic and anabolic states in mammals: a pharmacological point of view.

PubMed

Bifari, Francesco; Nisoli, Enzo

2017-06-01

Substantial evidence has been accumulated suggesting that branched-chain amino acid (BCAA) supplementation or BCAA-rich diets have a positive effect on the regulation of body weight, muscle protein synthesis, glucose homeostasis, the ageing process and extend healthspan. Despite these beneficial effects, epidemiological studies have shown that BCAA plasma concentrations and BCAA metabolism are altered in several metabolic disorders, including type 2 diabetes mellitus and cardiovascular diseases. In this review article, we present an overview of the current literature on the different effects of BCAAs in health and disease. We also highlight the results showing the most promising therapeutic effects of dietary BCAA supplementation and discuss how BCAAs can trigger different and even opposite effects, depending on the catabolic and anabolic states of the organisms. Moreover, we consider the effects of BCAAs when metabolism is abnormal, in the presence of a mixture of different anabolic and catabolic signals. These unique pharmacodynamic properties may partially explain some of the markedly different effects found in BCAA supplementation studies. To predict accurately these effects, the overall catabolic/anabolic status of patients should be carefully considered. In wider terms, a correct modulation of metabolic disorders would make nutraceutical interventions with BCAAs more effective. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

Stem cell therapy for cardiovascular disease: the demise of alchemy and rise of pharmacology

PubMed Central

Jadczyk, T; Faulkner, A; Madeddu, P

2013-01-01

Regenerative medicine holds great promise as a way of addressing the limitations of current treatments of ischaemic disease. In preclinical models, transplantation of different types of stem cells or progenitor cells results in improved recovery from ischaemia. Furthermore, experimental studies indicate that cell therapy influences a spectrum of processes, including neovascularization and cardiomyogenesis as well as inflammation, apoptosis and interstitial fibrosis. Thus, distinct strategies might be required for specific regenerative needs. Nonetheless, clinical studies have so far investigated a relatively small number of options, focusing mainly on the use of bone marrow-derived cells. Rapid clinical translation resulted in a number of small clinical trials that do not have sufficient power to address the therapeutic potential of the new approach. Moreover, full exploitation has been hindered so far by the absence of a solid theoretical framework and inadequate development plans. This article reviews the current knowledge on cell therapy and proposes a model theory for interpretation of experimental and clinical outcomes from a pharmacological perspective. Eventually, with an increased association between cell therapy and traditional pharmacotherapy, we will soon need to adopt a unified theory for understanding how the two practices additively interact for a patient's benefit. LINKED ARTICLES This article is part of a themed section on Regenerative Medicine and Pharmacology: A Look to the Future. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-2 PMID:22712727

Potential for pharmacological manipulation of human embryonic stem cells

PubMed Central

Atkinson, Stuart P; Lako, Majlinda; Armstrong, Lyle

2013-01-01

The therapeutic potential of human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) is vast, allowing disease modelling, drug discovery and testing and perhaps most importantly regenerative therapies. However, problems abound; techniques for cultivating self-renewing hESCs tend to give a heterogeneous population of self-renewing and partially differentiated cells and general include animal-derived products that can be cost-prohibitive for large-scale production, and effective lineage-specific differentiation protocols also still remain relatively undefined and are inefficient at producing large amounts of cells for therapeutic use. Furthermore, the mechanisms and signalling pathways that mediate pluripotency and differentiation are still to be fully appreciated. However, over the recent years, the development/discovery of a range of effective small molecule inhibitors/activators has had a huge impact in hESC biology. Large-scale screening techniques, coupled with greater knowledge of the pathways involved, have generated pharmacological agents that can boost hESC pluripotency/self-renewal and survival and has greatly increased the efficiency of various differentiation protocols, while also aiding the delineation of several important signalling pathways. Within this review, we hope to describe the current uses of small molecule inhibitors/activators in hESC biology and their potential uses in the future. LINKED ARTICLES This article is part of a themed section on Regenerative Medicine and Pharmacology: A Look to the Future. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-2 PMID:22515554

Convergent pharmacological mechanisms in impulsivity and addiction: insights from rodent models

PubMed Central

Jupp, B; Dalley, J W

2014-01-01

Research over the last two decades has widely demonstrated that impulsivity, in its various forms, is antecedent to the development of drug addiction and an important behavioural trait underlying the inability of addicts to refrain from continued drug use. Impulsivity describes a variety of rapidly and prematurely expressed behaviours that span several domains from impaired response inhibition to an intolerance of delayed rewards, and is a core symptom of attention deficit hyperactivity disorder (ADHD) and other brain disorders. Various theories have been advanced to explain how impulsivity interacts with addiction both causally and as a consequence of chronic drug abuse; these acknowledge the strong overlaps in neural circuitry and mechanisms between impulsivity and addiction and the seemingly paradoxical treatment of ADHD with stimulant drugs with high abuse potential. Recent years have witnessed unprecedented progress in the elucidation of pharmacological mechanisms underpinning impulsivity. Collectively, this work has significantly improved the prospect for new therapies in ADHD as well as our understanding of the neural mechanisms underlying the shift from recreational drug use to addiction. In this review, we consider the extent to which pharmacological interventions that target impulsive behaviour are also effective in animal models of addiction. We highlight several promising examples of convergence based on empirical findings in rodent-based studies. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24866553

Midkine and multiple sclerosis

PubMed Central

Takeuchi, Hideyuki

2014-01-01

Multiple sclerosis (MS) is an autoimmune neurological disease characterized by inflammatory demyelination with subsequent neuronal damage in the CNS. MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have been thought as autoreactive Th1 and Th17 cell-mediated diseases. CD4+CD25+FoxP3+ regulatory T-cell (Treg) plays a pivotal role in autoimmune tolerance, and tolerogenic dendritic cells (DCreg) drive the development of inducible Treg cells. Thus, a dysfunction in the development of Treg and DCreg leads to the development of autoimmune diseases. However, the factors that regulate Treg and DCreg are largely unknown. We recently showed that removal of midkine (MK) suppressed EAE due to an expansion of the Treg cell population as well as a decrease in the numbers of autoreactive Th1 and Th17 cells. MK decreased the Treg cell population by suppressing the phosphorylation of STAT5, which is essential for the expression of Foxp3, the master transcriptional factor of Treg cell differentiation. Furthermore, MK reduces the DCreg cell population by inhibiting the phosphorylation of STAT3, which is critical for DCreg development. Blockade of MK signalling by a specific RNA aptamer significantly elevated the population of DCreg and Treg cells and ameliorated EAE without detectable adverse effects. Therefore, the inhibition of MK may provide an effective therapeutic strategy against autoimmune diseases including MS. Linked Articles This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4 PMID:24460675

Drug repurposing screens and synergistic drug‐combinations for infectious diseases

PubMed Central

Sun, Wei; Simeonov, Anton

2017-01-01

Infectious diseases account for nearly one fifth of the worldwide death toll every year. The continuous increase of drug‐resistant pathogens is a big challenge for treatment of infectious diseases. In addition, outbreaks of infections and new pathogens are potential threats to public health. Lack of effective treatments for drug‐resistant bacteria and recent outbreaks of Ebola and Zika viral infections have become a global public health concern. The number of newly approved antibiotics has decreased significantly in the last two decades compared with previous decades. In parallel with this, is an increase in the number of drug‐resistant bacteria. For these threats and challenges to be countered, new strategies and technology platforms are critically needed. Drug repurposing has emerged as an alternative approach for rapid identification of effective therapeutics to treat the infectious diseases. For treatment of severe infections, synergistic drug combinations using approved drugs identified from drug repurposing screens is a useful option which may overcome the problem of weak activity of individual drugs. Collaborative efforts including government, academic researchers and private drug industry can facilitate the translational research to produce more effective new therapeutic agents such as narrow spectrum antibiotics against drug‐resistant bacteria for these global challenges. Linked Articles This article is part of a themed section on Inventing New Therapies Without Reinventing the Wheel: The Power of Drug Repurposing. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.2/issuetoc PMID:28685814

Branched‐chain amino acids differently modulate catabolic and anabolic states in mammals: a pharmacological point of view

PubMed Central

Bifari, Francesco

2016-01-01

Substantial evidence has been accumulated suggesting that branched‐chain amino acid (BCAA) supplementation or BCAA‐rich diets have a positive effect on the regulation of body weight, muscle protein synthesis, glucose homeostasis, the ageing process and extend healthspan. Despite these beneficial effects, epidemiological studies have shown that BCAA plasma concentrations and BCAA metabolism are altered in several metabolic disorders, including type 2 diabetes mellitus and cardiovascular diseases. In this review article, we present an overview of the current literature on the different effects of BCAAs in health and disease. We also highlight the results showing the most promising therapeutic effects of dietary BCAA supplementation and discuss how BCAAs can trigger different and even opposite effects, depending on the catabolic and anabolic states of the organisms. Moreover, we consider the effects of BCAAs when metabolism is abnormal, in the presence of a mixture of different anabolic and catabolic signals. These unique pharmacodynamic properties may partially explain some of the markedly different effects found in BCAA supplementation studies. To predict accurately these effects, the overall catabolic/anabolic status of patients should be carefully considered. In wider terms, a correct modulation of metabolic disorders would make nutraceutical interventions with BCAAs more effective. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27638647

Understanding organic nitrates – a vein hope?

PubMed Central

Miller, Mark R; Wadsworth, Roger M

2009-01-01

The organic nitrate drugs, such as glyceryl trinitrate (GTN; nitroglycerin), are clinically effective in angina because of their dilator profile in veins and arteries. The exact mechanism of intracellular delivery of nitric oxide (NO), or another NO-containing species, from these compounds is not understood. However, mitochondrial aldehyde dehydrogenase (mtALDH) has recently been identified as an organic nitrate bioactivation enzyme. Nitrate tolerance, the loss of effect of organic nitrates over time, is caused by reduced bioactivation and/or generation of NO-scavenging oxygen-free radicals. In a recent issue of the British Journal of Pharmacology, Wenzl et al. show that guinea-pigs, deficient in ascorbate, also have impaired responsiveness to GTN, but nitrate tolerance was not due to ascorbate deficiency that exhibited divergent changes in mtALDH activity. Thus, the complex function of mtALDH appears to be the key to activation of GTN, the active NO species formed and the induction of tolerance that can limit clinical effectiveness of organic nitrate drugs. British Journal of Pharmacology (2009) 157, 565–567; doi:10.1111/j.1476-5381.2009.00193.x This article is part of a themed section on Endothelium in Pharmacology. For a list of all articles in this section see the end of this paper, or visit: http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009 The paper by Wenzl et al. is available from http://www3.interscience.wiley.com/cgi-bin/fulltext/122221718/PDFSTART PMID:19630835

Chemical genetics and its potential in cardiac stem cell therapy

PubMed Central

Vieira, Joaquim M; Riley, Paul R

2013-01-01

Over the last decade or so, intensive research in cardiac stem cell biology has led to significant discoveries towards a potential therapy for cardiovascular disease; the main cause of morbidity and mortality in humans. The major goal within the field of cardiovascular regenerative medicine is to replace lost or damaged cardiac muscle and coronaries following ischaemic disease. At present, de novo cardiomyocytes can be generated either in vitro, for cell transplantation or disease modelling using directed differentiation of embryonic stem cells or induced pluripotent stem cells, or in vivo via direct reprogramming of resident adult cardiac fibroblast or ectopic stimulation of resident cardiac stem or progenitor cells. A major bottleneck with all of these approaches is the low efficiency of cardiomyocyte differentiation alongside their relative functional immaturity. Chemical genetics, and the application of phenotypic screening with small molecule libraries, represent a means to enhance understanding of the molecular pathways controlling cardiovascular cell differentiation and, moreover, offer the potential for discovery of new drugs to invoke heart repair and regeneration. Here, we review the potential of chemical genetics in cardiac stem cell therapy, highlighting not only the major contributions to the field so far, but also the future challenges. LINKED ARTICLES This article is part of a themed section on Regenerative Medicine and Pharmacology: A Look to the Future. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-2 PMID:22385148

Conference of the Society for Literature and Science. Proceedings (Atlanta, Georgia, October 10-13, 1996).

ERIC Educational Resources Information Center

Perkowitz, Sidney, Ed.

The papers contained in these proceedings from the 1996 Society for Literature and Science Conference are organized into sections based on theme. Some of these themes are: (1) Secularizing Enlightenment; (2) Eugenics and the Politics of Knowledge; (3) Reading the Discourses of Psychology; (4) Women and Medicine; (5) The Rhetoric of Public Health;…

Group medical consultations (GMCs) and tablet-based online support group sessions in the follow-up of breast cancer: A multicenter randomized controlled trial.

PubMed

Visser, Annemiek; Prins, Judith B; Jansen, Lisette; Radema, Sandra A; Schlooz, Margrethe S; van Dalen, Thijs; van Laarhoven, Hanneke W M

2018-06-12

Group medical consultations (GMCs) provide individual medical visits in the presence of ≤7 peer-patients. In the follow-up of breast cancer, we evaluated the efficacy of a new type of blended care My-GMC, a GMC combined with a tablet-based online app, consisting of three online support group sessions (SGS) and additional information. This randomized controlled trial compared the effect of My-GMC (n = 59) with one individual medical visit (n = 50) (care as usual). Between-group differences on the outcomes distress and empowerment were analyzed 1 week, 3 and 6 months after the visit. No between-group differences were found for the primary outcomes distress and empowerment. More themes were discussed in GMCs compared to individual visits. Significantly more patients experienced peer-support in GMCs (78%) than via the online app (29%). Satisfaction with the online app was low. My-GMC did not result in improvements in distress or empowerment, which might partly be explained by low baseline distress levels. This paper provides valuable information concerning factors on organizational level as well as individual level influencing the evaluation of a blended care intervention. My-GMC provided an innovative alternative, combining professional and peer-support in face-to-face and online SGS, resulting in additional information provision and peer-support. Further improvement of the apps is needed to improve user satisfaction. NTR3771. Copyright © 2018 Elsevier Ltd. All rights reserved.

A comparison of communication models of traditional and video-mediated health care delivery.

PubMed

Demiris, George; Edison, Karen; Vijaykumar, Santosh

2005-10-01

While there may be benefits that accrue to the use of telemedicine technology in patient care, such as decreased costs and improved access, it has yet to be determined how telemedicine impacts patients' ability to express themselves and accordingly, how it impacts health care providers' communication of instructions or expressions of empathy. The aim of this study was to examine the effect of telemedicine technology on communication by comparing the style and content of communication between actual (i.e., face to face) and virtual (i.e., non-face to face, telemedical) dermatology visits. The hypothesis was that there is no difference in the content and style of communication between actual and virtual visits in dermatology. Face-to-face and video-mediated dermatology sessions were observed and also audiotaped, timed and transcribed. A content analysis was performed. Average duration of a face-to-face session was 11 min (S.D. 0.08) and of a telemedical session 9 min (S.D. 0.002). Small talk occurred in 20% of all face-to-face and 29.6% of all telemedical visits. Clinical assessment occurred in all sessions. Patient education occurred in 90% of face-to-face and 78% of telemedical visits. Other themes were also identified (e.g., discussion of treatment, promotion of compliance, psychosocial issues). In 14.8% of telemedical sessions technical issues were raised. Findings indicate that communication patterns in the two modes of care delivery are comparable.

Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors.

PubMed

Hughes, Alison; Condon, Louise

2016-11-01

Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

PubMed

Dean, M; Levis, A

2016-12-01

To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Emergency Department Use among Adults with Autism Spectrum Disorders (ASD)

ERIC Educational Resources Information Center

Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha

2016-01-01

A cross-sectional analyses using Nationwide Emergency Department Sample (2006-2011) was conducted to examine the trends, type of ED visits, and mean total ED charges for adults aged 22-64 years with and without ASD (matched 1:3). Around 0.4% ED visits (n = 25,527) were associated with any ASD and rates of such visits more than doubled from 2006 to…

36 CFR § 1254.22 - Do I need to register when I visit a NARA facility for research?

Code of Federal Regulations, 2013 CFR

2013-07-01

... visit a NARA facility for research? § 1254.22 Section § 1254.22 Parks, Forests, and Public Property... HISTORICAL MATERIALS Research Room Rules General Procedures § 1254.22 Do I need to register when I visit a NARA facility for research? (a) Yes, you must register each day you enter a NARA research facility by...

Utilization of Rural Primary Care Physicians' Visit Services for Diabetes Management of Public Health in Southwestern China: A Cross-Sectional Study from Patients' View.

PubMed

Miao, Yudong; Ye, Ting; Qian, Dongfu; Li, Jinlong; Zhang, Liang

2014-06-01

Primary care physicians' visit services for diabetes management are now widely delivered in China's rural public health care. Current studies mainly focus on supply but risk factors from patients' view have not been previously explored. This study aims to present the utilization of rural primary care physicians' visit services for diabetes management in the last 12 months in southwestern China, and to explore risk factors from patients' view. This cross sectional study selected six towns at random and all 385 diabetics managed by primary care physicians were potential participants. Basing on the inclusion and exclusion criteria, 374 diabetics were taken as valid subjects and their survey responses formed the data resource of analyses. Descriptive indicators, χ2 contingency table analyses and Logistic regression were used. 54.8% respondents reported the utilization of visit services. According to the multivariate analysis, the positive factors mainly associated with utilization of visit services include disease duration (OR=1.654), use of diabetic drugs (OR=1.869), consulting diabetes care knowledge (OR=1.602), recognition of diabetic complications (OR=1.662), needs of visit services (OR=2.338). The utilization of rural primary care physicians' visit services still remains unsatisfactory. Mass rural health policy awareness, support, and emphasis are in urgent need and possible risk factors including disease duration, use of diabetic drugs, consulting diabetes care knowledge, recognition of diabetic complications and needs of visit services should be taken into account when making rural health policy of visit services for diabetes management in China and many other low- and middle-income countries.

CMS Annual Report 2004

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rubia, T D; Shang, S P; Rennie, G

2005-07-29

Glance at the articles in this report, and you will sense the transformation that is reshaping the landscape of materials science and chemistry. This transformation is bridging the gaps among chemistry, materials science, and biology--ushering in a wealth of innovative technologies with broad scientific impact. The emergence of this intersection is reinvigorating our strategic investment into areas that build on our strength of interdisciplinary science. It is at the intersection that we position our strategic vision into a future where we will provide radical materials innovations and solutions to our national-security programs and other sponsors. Our 2004 Annual Report describesmore » how our successes and breakthroughs follow a path set forward by our strategic plan and four organizing research themes, each with key scientific accomplishments by our staff and collaborators. We have organized this report into two major sections: research themes and our dynamic teams. The research-theme sections focus on achievements arising from earlier investments while addressing future challenges. The dynamic teams section illustrates the directorate's organizational structure of divisions, centers, and institutes that support a team environment across disciplinary and institutional boundaries. The research presented in this annual report gives substantive examples of how we are proceeding in each of these four theme areas and how they are aligned with our national-security mission. By maintaining an organizational structure that offers an environment of collaborative problem-solving opportunities, we are able to nurture the discoveries and breakthroughs required for future successes.« less

Shrubland ecosystem genetics and biodiversity: proceedings

Treesearch

E. Durant McArthur; Daniel J. Fairbanks

2001-01-01

The 53 papers in this proceedings include a section celebrating the 25-year anniversary of the Shrub Sciences Laboratory (4 papers), three sections devoted to themes, genetics, and biodiversity (12 papers), disturbance ecology and biodiversity (14 papers), ecophysiology (13 papers), community ecology (9 papers), and field trip section (1 paper). The anniversary session...

A framework for measuring self-management effectiveness and health care use among pediatric asthma patients and families

PubMed Central

Rangachari, Pavani

2017-01-01

Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient’s personalized Asthma-Action Plan. It is important to note however that while effective self-management of asthma is known to reduce ED visits and hospitalizations, the relationship between asthma self-management effectiveness and outpatient visit frequency remains ambiguous, reflecting a gap in the literature. For instance, do patients/families who self-manage effectively visit outpatient clinics more frequently for asthma care (compared to those who do not self-manage effectively), after accounting for differences in asthma severity, demographic characteristics, and risk factors? Do patients/families who visit outpatient clinics more frequently for asthma care, in turn have fewer ED and inpatient encounters for asthma? On the other hand, do patients/families who do not revisit outpatient clinics regularly have higher ED visits and hospitalizations? It is important to address these gaps, in order to reduce the costs and public health burden of asthma. This paper provides a foundation for addressing these gaps, by conducting an integrative review of the asthma management literature, to develop a conceptual framework for measuring self-management effectiveness and health care use among pediatric asthma patients/families. In doing so, the paper lays the groundwork for future research seeking to explicate the relationship between asthma self-management effectiveness and health care use, which in turn has potential to engage asthma providers in promoting ideal self-management and optimal health care use for pediatric asthma, in accordance with national evidence-based guidelines for asthma management. PMID:28442924

Junk food seen at pediatric clinic visits: is it a problem?

PubMed

Frazier, Johnnie P; Land, Megan; Hsieh, Pei-Hsuan; Barratt, Michelle S

2014-04-01

To document the prevalence of junk foods seen at clinic visits. A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012. The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston. A convenience sample consisting of 738 families with children from 4 months to 16 years old presenting for visits were included in the study. Children exclusively breast and formula fed was excluded. Junk food was observed 20.9% at the clinic visits. Junk food was often seen at clinic visits. There was a trend toward higher body mass index in patients whose families had junk food at the visit.

The role of family members and close persons in health-care treatment of incompetent patients: a Portuguese approach.

PubMed

André, Pereira

2011-12-01

This article analyses the role of family members and other close persons in the health-care decisions of incompetent patients. It will scrutinize the right to visit a patient in hospital and the importance of the beloved ones in that vulnerable stage of life. It notices a change in society recognized by law in two dimensions: the increasing autonomy of the patient, while nominating the persons who may visit at the hospital or who may participate in the decisions or even appointing a health care proxy; secondly the important role of close persons and friends. This signifies a changing family structure, whereby affections may take supremacy over traditional institutions. There will also be a reference to PVS cases and decisions concerning the collection of organs. Finally the importance of an advance directive that may be binding through procedural control is affirmed. Finally, these themes show the autonomy of medical law in several domains: sources of law, methodology and scope.

Uncovering psychosocial needs: perspectives of Australian child and family health nurses in a sustained home visiting trial.

PubMed

Kardamanidis, Katina; Kemp, Lynn; Schmied, Virginia

2009-08-01

The first Australian trial of sustained nurse home visiting provided an opportunity to explore nurses' understanding of the situations that support mothers of infants to disclose personal and sensitive psychosocial information. Using a qualitative descriptive design, semi-structured interviews were conducted and transcripts were analysed drawing upon aspects of Smith's interpretative phenomenological analysis. Five themes pertaining to the experience of relationship building to foster disclosure of sensitive information emerged: (1) building trust is an ongoing process of giving and giving in return, (2) being 'actively passive' to develop trust, (3) the client is in control of the trust-relationship, (4) the association between disclosure of sensitive issues and a trust-relationship, and (5) empowerment over disclosure. This study provides a deeper understanding of how child and family health nurses develop relationships that lead women to entrust the nurse with personal, sensitive information, and may inform the practice of psychosocial needs assessment in other contexts.

Patient Perspectives on Language Discordance During Healthcare Visits: Findings From the Extremely High-Density Multicultural State of Qatar.

PubMed

Abdelrahim, Huda; Elnashar, Maha; Khidir, Amal; Killawi, Amal; Hammoud, Maya; Al-Khal, Abdul Latif; Fetters, Michael D

2017-04-01

Reducing language and cultural barriers in healthcare are significant factors in resolving health disparities. Qatar's rapidly growing multicultural population presents new challenges to the healthcare system. The purpose of this research was to explore patients' perspectives about language discordance, and the strategies used to overcome language barriers during patients' visits. Participants were recruited and interviewed from four language groups (Arabic = 24, English = 20, Hindi = 20, and Urdu = 20), all of whom were living in Qatar and utilizing Hamad General Hospital-Outpatient Clinics as a source of their healthcare services. Using qualitative analysis procedures, relevant themes and codes were generated and data analyzed using Atlas-ti. As for results, most participants had experienced or witnessed language barriers during their outpatient clinics visits. Participants essentially were unfamiliar with professional medical interpreters and described their adaptive solutions, for example utilizing incidental interpreters, stringing together fragments of multiple languages, and using body language. Those not speaking mainstream languages of Hamad General Hospital (English and Arabic) were more vulnerable to health disparities due to language barriers. Despite the patient impetus to do something, patient-reported adaptive strategies could compromise patients' safety and access to quality healthcare. Polices tackling the language barrier need to be reviewed in Qatar's multicultural healthcare system and similar settings.

Solid Earth and Natural Hazards (SENH) Research and Applications Program and Internation

NASA Technical Reports Server (NTRS)

2001-01-01

This is a final report for grant NAG5-8627 entitled 'Joint UNAVCO and JPL proposal to NASA for support of the Solid Earth and Natural Hazards Research and Applications Program and Internation'. This report consists of the following sections: (1) new installations (with site visits); (2) upgrades (with site visits; (3) upcoming upgrades (with site visits); and (4) data management and archive efforts during the performance period.

KSC-04PD-2211

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. During opening ceremonies for Spaceport Super Safety and Health Day at KSC, members of the astronaut corps and KSC employees enjoy the humor of guest speaker Dr. Pamela Peeke. Other speakers included Navy Com. Stephen E. Iwanowicz, NASAs Dr. Kristine Calderon and Olympic- great Bruce Jenner. Later in the day, employees could visit many vendors exhibits featuring safety and health items. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

KSC-04PD-2223

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Astronaut Mark Polansky (left) visits the Life Sciences Lab at KSC where a demonstration of equipment is underway during Spaceport Super Safety and Health Day. . The event included guest speakers Dr. Pamela Peeke, Navy Com. Stephen E. Iwanowicz, NASAs Dr. Kristine Calderon and Olympic-great Bruce Jenner. In addition, many vendors exhibits were on display for employees. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

Health visitors' needs--national perspectives from the Restorative Clinical Supervision Programme.

PubMed

Wallbank, Sonya

2012-04-01

The restorative clinical supervision programme has been delivering supervision for the last 18 months to over 600 health visitors within trusts across the UK. This opportunity has allowed the supervision team to work with individual organisations to identify the key issues with which health visiting teams are struggling, and provide effective solutions to reduce staff stress, encourage retention and increase job satisfaction. This paper offers an overview of the consistent themes that health visitors are attempting to resolve and of how restorative supervision supports professionals working with complex families to manage these difficulties.

7 CFR 3015.94 - Site visits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Site visits. 3015.94 Section 3015.94 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Monitoring and Reporting Program Performance § 3015.94 Site...

42 CFR 483.40 - Physician services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... may alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner, or clinical nurse specialist in accordance with paragraph (e) of this section. (d) Availability..., nurse practitioner, or clinical nurse specialist who— (i) Meets the applicable definition in § 491.2 of...

42 CFR 483.40 - Physician services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... may alternate between personal visits by the physician and visits by a physician assistant, nurse... 42 Public Health 5 2014-10-01 2014-10-01 false Physician services. 483.40 Section 483.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

42 CFR 483.40 - Physician services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... may alternate between personal visits by the physician and visits by a physician assistant, nurse... 42 Public Health 5 2013-10-01 2013-10-01 false Physician services. 483.40 Section 483.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

42 CFR 483.40 - Physician services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... may alternate between personal visits by the physician and visits by a physician assistant, nurse... 42 Public Health 5 2012-10-01 2012-10-01 false Physician services. 483.40 Section 483.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

42 CFR 483.40 - Physician services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... may alternate between personal visits by the physician and visits by a physician assistant, nurse... 42 Public Health 5 2011-10-01 2011-10-01 false Physician services. 483.40 Section 483.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

26 CFR 521.114 - Visiting professors or teachers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Visiting professors or teachers. 521.114 Section 521.114 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents...

Google Earth Grand Tour Themes

NASA Astrophysics Data System (ADS)

De Paor, D. G.; Whitmeyer, S. J.; Bentley, C.; Dordevic, M. M.

2014-12-01

As part of an NSF TUES Type 3 project entitled "Google Earth for Onsite and Distance Education (GEODE)," we are assembling a "Grand Tour" of locations on Earth and other terrestrial bodies that every geoscience student should know about and visit at least in virtual reality. Based on feedback from colleagues at previous meetings, we have identified nine Grand Tour themes: "Plates and Plumes," "Rocks and Regions," "Geology Through Time," "The Mapping Challenge*," "U.S. National Parks*," "The Magical Mystery Tour*," "Resources and Hazards," "Planets and Moons," and "Top of the Pops." Themes marked with an asterisk are most developed at this stage and will be demonstrated in real time. The Mapping Challenge invites students to trace geological contacts, measure bedding strike and dip and the plunge, trend, and facing of a fold. There is an advanced tool for modeling periclinal folds. The challenge is presented in a game-like format with an emphasis on puzzle-solving that will appeal to students regardless of gender. For the tour of U.S. national parks, we divided the most geologically important parks into four groups—Western Pacific, West Coast, Rockies, and East Coast. We are combining our own team's GigaPan imagery with imagery already available on the Internet. There is a great deal of imagery just waiting to be annotated for geological education purposes. The Magical Mystery Tour takes students to Google Streetview locations selected by instructors. Students are presented with questions or tasks and are given automatic feedback. Other themes are under development. Within each theme, we are crowd-sourcing contributions from colleagues and inviting colleagues to vote for or against proposed locations and student interactions. The GEODE team includes the authors and: Heather Almquist, Stephen Burgin, Cinzia Cervato, Gene Cooper, Paul Karabinos, Terry Pavlis, Jen Piatek, Bill Richards, Jeff Ryan, Ron Schott, Kristen St. John, and Barb Tewksbury.

Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids.

PubMed

Conrardy, Michael; Lank, Patrick; Cameron, Kenzie A; McConnell, Ryan; Chevrier, Alison; Sears, Jill; Ahlstrom, Eric; Wolf, Michael S; Courtney, D Mark; McCarthy, Danielle M

2016-01-01

To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids. Mixed methods analysis of data from a randomized controlled trial. Urban academic ED (>88,000 visits). One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain. The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories. Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction. In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government employees and is in the public domain in the US.

36 CFR 13.1224 - Visiting hours.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Visiting hours. 13.1224 Section 13.1224 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR NATIONAL PARK SYSTEM UNITS IN ALASKA Special Regulations-Katmai National Park and Preserve Brooks Camp...

32 CFR 705.34 - Other special events.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Other special events. 705.34 Section 705.34... AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705.34 Other special events. (a) Ship visits. Requests for visits generally originate with civic groups desiring Navy participation in local events...

32 CFR 705.34 - Other special events.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Other special events. 705.34 Section 705.34... AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705.34 Other special events. (a) Ship visits. Requests for visits generally originate with civic groups desiring Navy participation in local events...

32 CFR 705.34 - Other special events.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Other special events. 705.34 Section 705.34... AND OFFICIAL RECORDS PUBLIC AFFAIRS REGULATIONS § 705.34 Other special events. (a) Ship visits. Requests for visits generally originate with civic groups desiring Navy participation in local events...

42 CFR 405.2463 - What constitutes a visit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

42 CFR 405.2463 - What constitutes a visit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

42 CFR 405.2463 - What constitutes a visit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

42 CFR 405.2463 - What constitutes a visit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false What constitutes a visit. 405.2463 Section 405.2463 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Rural Health Clinic and Federally Qualified...

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2012 CFR

2012-10-01

...; and (2) Personal care services, to the extent covered under Medicare as home health services. These... 42 Public Health 2 2012-10-01 2012-10-01 false Visiting nurse services. 405.2416 Section 405.2416 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; and (2) Personal care services, to the extent covered under Medicare as home health services. These... 42 Public Health 2 2011-10-01 2011-10-01 false Visiting nurse services. 405.2416 Section 405.2416 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2013 CFR

2013-10-01

...; and (2) Personal care services, to the extent covered under Medicare as home health services. These... 42 Public Health 2 2013-10-01 2013-10-01 false Visiting nurse services. 405.2416 Section 405.2416 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... achieved. (2) Personal care services, to the extent covered under Medicare as home health services. These... 42 Public Health 2 2014-10-01 2014-10-01 false Visiting nurse services. 405.2416 Section 405.2416 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

Nonemergent emergency department visits under the National Health Insurance in Taiwan.

PubMed

Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

2011-05-01

To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Someone to talk to: young mothers' experiences of participating in a young parents support programme.

PubMed

Mills, Annie; Schmied, Virginia; Taylor, Christine; Dahlen, Hannah; Shuiringa, Wies; Hudson, Margaret E

2013-09-01

To identify young parents' perceptions and experiences of a parenting support programme, run by a non-government organisation, which provided both community group-based, and one-on-one home visiting, support. A qualitative descriptive study was conducted in one of the most socio-economically disadvantaged areas of Sydney, NSW; this is also an area with one of the highest percentage of births among young parents. Young parents were eligible to participate whether they attended one of the parenting groups and/or received professional home visiting through the young parents programme. Eighteen young women were interviewed, and a further ten participated in a focus group. Thematic analysis of the focus groups and interviews was undertaken. Four themes were identified in the analysis: 'someone I know and trust', 'we just talk about anything and everything', 'doing the personal' and 'getting out and relaxing'. These themes were linked through the common thread of relationships; the relationships between themselves and other young mothers, and with the workers on the programme. The characteristics of the person with whom they had a relationship, the type of relationship, the content of their interactions and the benefits of these relationships were all important. This study is limited by the small sample size and the 'low risk' status of the young parents who engaged in the programme. This study demonstrated not only the importance for young parents of all forms of interaction, whether it is one-on-one, in a group or social networking; but most importantly, the benefits of having someone to talk to. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Intensive procedure preferences at the end of life (EOL) in older Latino adults with end stage renal disease (ESRD) on dialysis.

PubMed

Gonzalez, Karla; Ulloa, Jesus G; Moreno, Gerardo; Echeverría, Oscar; Norris, Keith; Talamantes, Efrain

2017-10-23

Latinos in the U.S. are almost twice as likely to progress to End Stage Renal disease (ESRD) compared to non-Latino whites. Patients with ESRD on dialysis experience high morbidity, pre-mature mortality and receive intensive procedures at the end of life (EOL). This study explores intensive procedure preferences at the EOL in older Latino adults. Seventy-three community-dwelling Spanish- and English-Speaking Latinos over the age of 60 with and without ESRD participated in this study. Those without ESRD (n = 47) participated in one of five focus group sessions, and those with ESRD on dialysis (n = 26) participated in one-on-one semi-structured interviews. Focus group and individual participants answered questions regarding intensive procedures at the EOL. Recurring themes were identified using standard qualitative content-analysis methods. Participants also completed a brief survey that included demographics, language preference, health insurance coverage, co-morbidities, Emergency Department visits and functional limitations. The majority of participants were of Mexican origin with mean age of 70, and there were more female participants in the non-ESRD group, compared to the ESRD dialysis dependent group. The dialysis group reported a higher number of co-morbidities and functional limitations. Nearly 69% of those in the dialysis group reported one or more emergency department visits in the past year, compared to 38% in the non-ESRD group. Primary themes centered on 1) The acceptability of a "natural" versus "invasive" procedure 2) Cultural traditions and family involvement 3) Level of trust in physicians and autonomy in decision-making. Our results highlight the need for improved patient- and family-centered approaches to better understand intensive procedure preferences at the EOL in this underserved population of older adults.

Physician decision-making in the management of work related upper extremity injuries.

PubMed

Szekeres, Mike; Macdermid, Joy C; Katchky, Adam; Grewal, Ruby

2018-05-22

Physicians working in a tertiary care injured worker clinic are faced with clinical decision-making that must balance the needs of patients and society in managing complex clinical problems that are complicated by the work-workplace context. The purpose of this study is to describe and characterize the decision-making process of upper extremity specialized surgeons when managing injured workers within a specialized worker's compensation clinic. Surgeons were interviewed in a semi-structured manner. Following each interview, the surgeon was also observed in a clinic visit during a new patient assessment, allowing observation of the interactional patterns between surgeon and patient, and comparison of the process described in the interview to what actually occurred during clinic visits. The primary central theme emerging from the surgeon interviews and the clinical observation was the focus on the importance of comprehensive assessment to make the first critical decision: an accurate diagnosis. Two subthemes were also found. The first of these involved the decision whether to proceed to management strategies or to continue with further investigation if the correct diagnosis is uncertain. Once the central theme of diagnosis was achieved, a second subtheme was highlighted; selecting appropriate management options, given the complexities of managing the injured worker, the workplace, and the compensation board. This study illustrates that upper extremity surgeons rely on their training and experience with upper extremity conditions to follow a sequential but iterative decision-making process to provide a more definitive diagnosis and treatment plan for workers with injuries that are often complex. The surgeons are challenged by the context which takes them out of their familiar zone of typical clinical practice to deal with the interactions between the injury, worker, work, workplace and insurer.

The Association of Health Literacy With Preventable Emergency Department Visits: A Cross-sectional Study.

PubMed

Balakrishnan, Meenakshi P; Herndon, Jill Boylston; Zhang, Jingnan; Payton, Thomas; Shuster, Jonathan; Carden, Donna L

2017-09-01

Policymakers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor, and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. The objective was to determine the association of health literacy with preventable ED visits. We conducted an observational cross-sectional study of potentially preventable ED visits (outcome) among adults (≥18 years old) in an ED serving an urban community. We assessed health literacy (predictor) through structured interviews with the Rapid Estimate of Adult Literacy in Medicine (REALM). We recorded age, sex, race, employment, payer, marital and health status, and number of comorbidities through structured interviews or electronic record review. We identified potentially preventable ED visits in the 2 years before the index ED visit by applying Agency for Healthcare Research and Quality technical specifications to identify ambulatory care sensitive conditions using ED discharge diagnoses in hospital administrative data. We used Poisson regression to evaluate the number of preventable ED visits among patients with limited (REALM < 61) versus adequate (REALM ≥ 61) health literacy after adjusting for covariates. Of 1,201 participants, 709 (59%) were female, 370 (31%) were African American, mean age was 41.6 years, and 394 (33%) had limited health literacy. Of 4,444 total ED visits, 423 (9.5%) were potentially preventable. Of these, 260 (61%) resulted in hospital admission and 163 (39%) were treat and release. After covariates were adjusted for, patients with limited literacy had 2.3 (95% confidence interval [CI] = 1.7-3.1) times the number of potentially preventable ED visits resulting in hospital admission compared to individuals with adequate health literacy, 1.4 (95% CI = 1.0-2.0) times the number of treat-and-release visits, and 1.9 (95% CI = 1.5-2.4) times the number of total preventable ED visits. Our results suggest that the ED may be an important site to deploy universal literacy-sensitive precautions and to test literacy-sensitive interventions with the goal of reducing the burden of potentially preventable ED visits on patients and the healthcare system. © 2017 by the Society for Academic Emergency Medicine.

Improving Appointment Adherence among Young Adults with HIV in Peru with an mHealth Intervention: a Feasibility Study

PubMed Central

Prochazka, Mateo; Batey, D Scott; Zinski, Anne; Dionne-Odom, Jodie; Otero, Larissa; Rodriguez, J Martin; González, Elsa

2017-01-01

Abstract Background Mobile Health (mHealth) interventions, including short message services (SMS) reminders and motivational messages, are associated with improved HIV appointment adherence, though feasibility is context-dependent. We assessed the feasibility of an mHealth intervention to improve appointment adherence among young adults with HIV in Lima, Peru. Methods Between November 2016 and April 2017, we implemented a one-way mHealth pilot intervention in an outpatient hospital without electronic medical records. We enrolled young adults (age 18–29) entering HIV care in a 3-component intervention: (i) reminder SMS prior to scheduled appointments (provider, laboratory, pharmacy); (ii) motivational SMS after each visit; and (iii) phone call following a missed visit. Feasibility evaluation included enrollment acceptance, visit tracking (information captured in the study database within 3 days of attendance), and proportion of intervention delivery (threshold >90%). We performed a qualitative assessment to identify implementation challenges reviewing staff field notes and meeting minutes. Results We enrolled 80/94 (85.1%) eligible participants. The median age was 25 years and 83% were male. The median time of follow-up after enrollment was 115 [interquartile range (IQR): 84–141] days, and participants had a median of 10 (IQR: 8–14) visits during the study period. Among 850 total participant visits, study personnel tracked 751 (88.4%); most (80.8%) untracked visits were pharmacy pickups. Of all tracked visits, most (78.7%) were scheduled appointments and 160 (21.3%) were unscheduled walk-ins. Intervention delivery reached 556/591 (94.1%) for reminder SMS; 733/751 (97.6%) for motivational messages, and 169/170 (99.4%) phone calls for missed visits, 127 (75.1%) of which were answered. Qualitative assessment revealed 2 major themes: real-time appointment tracking in a paper-based system consumed most staff time and resources, and meticulous in-person coordination between the implementation and hospital staff was essential for tracking. Conclusion An mHealth intervention to improve appointment adherence among young adults with HIV in Peru appears feasible with dedicated staff and a reliable appointment tracking system. Digitalized appointment systems may be needed to address challenges for scale-up. Disclosures All authors: No reported disclosures.

Learning Disabilities, Literacy, and Adult Education.

ERIC Educational Resources Information Center

Vogel, Susan A., Ed.; Reder, Stephen, Ed.

This book deals with the long-neglected problem of learning disabilities (LDs) and the relationship of LDs to difficulties in the acquisition of literacy. Its 17 chapters are divided into 5 sections that begin with an opener to help the reader identify the main themes and content of each chapter in the section. Four chapters in Section I address…

Mixed Methods in Education Research. IES Technical Working Group Meeting. Meeting Summary (Washington, DC, May 29, 2015)

ERIC Educational Resources Information Center

Institute of Education Sciences, 2015

2015-01-01

This meeting summary is organized into two major sections. The first section captures the individual contribution of meeting participants, including both Institute of Education Sciences (IES) staff and the invited technical working group members. The second section captures themes that arose during the group discussions, which were organized…

"The Doctor Needs to Know": Acceptability of Smartphone Location Tracking for Care Coordination.

PubMed

Liss, David T; Serrano, Eloisa; Wakeman, Julie; Nowicki, Christine; Buchanan, David R; Cesan, Ana; Brown, Tiffany

2018-05-04

Care coordination can be highly challenging to carry out. When care is fragmented across health systems and providers, there is an increased likelihood of hospital readmissions and wasteful health care spending. During and after care transitions, smartphones have the potential to bolster information transfer and care coordination. However, little research has examined patients' perceptions of using smartphones to coordinate care. This study's primary objective was to explore patient acceptability of a smartphone app that could facilitate care coordination in a safety net setting. Our secondary objective was to identify how clinicians and other members of primary care teams could use this app to coordinate care. This qualitative study was conducted at a federally qualified health center in metropolitan Chicago, IL. We conducted four focus groups (two in English, two in Spanish) with high-risk adults who owned a smartphone and received services from an organizational care management program. We also conducted structured interviews with clinicians and a group interview with care managers. Focus groups elicited patients' perceptions of a smartphone app designed to: (1) identify emergency department (ED) visits and inpatient stays using real-time location data; (2) send automated notifications (ie, alerts) to users' phones, asking whether they were a patient in the hospital; and (3) send automated messages to primary care teams to notify them about patients' confirmed ED visits and inpatient stays. Focus group transcripts were coded based on emergent themes. Clinicians and care managers were asked about messages they would like to receive from the app. Five main themes emerged in patient focus group discussions. First, participants expressed a high degree of willingness to use the proposed app during inpatient stays. Second, participants expressed varying degrees of willingness to use the app during ED visits, particularly for low acuity ED visits. Third, participants stated their willingness to have their location tracked by the proposed app due to its perceived benefits. Fourth, the most frequently mentioned barriers to acceptability were inconveniences such as "false alarm" notifications and smartphone battery drainage. Finally, there was some tension between how to maximize usability without unnecessarily increasing user burden. Both clinicians and care managers expressed interest in receiving messages from the app at the time of hospital arrival and at discharge. Clinicians were particularly interested in conducting outreach during ED visits and inpatient stays, while care managers expressed more interest in coordinating postdischarge care. High-risk primary care patients in a safety net setting reported a willingness to utilize smartphone location tracking technology to facilitate care coordination. Further research is needed on the development and implementation of new smartphone-based approaches to care coordination. ©David T Liss, Eloisa Serrano, Julie Wakeman, Christine Nowicki, David R Buchanan, Ana Cesan, Tiffany Brown. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.05.2018.

CACD Journal, 1994-95.

ERIC Educational Resources Information Center

Wickwire, Pat Nellor, Ed.

1995-01-01

This issue of the CACD Journal includes theoretical proposals and practical reports of initiatives for innovation and change in the counseling profession. A theme feature section, "Reframing School Guidance and Counseling," examines changes in the state, district, and school. An additional feature section, "The Personal Side of Counseling,"…

Informed Strangers: Witnessing and Responding to Unethical Care as Student Nurses

PubMed Central

Engel, Joyce; Salfi, Jenn; Micsinszki, Samantha; Bodnar, Andrea

2017-01-01

Nursing students occupy a unique perspective in clinical settings because they are informed, through education, about how patient care ought to happen. Given the brevity of placements and their “visiting status” in clinical sites, students are less invested in the ethos of specific sites. Subsequently, their perspectives of quality care are informed by what should happen, which might differ from that of nurses and patients. The purpose of this study was to identify predominant themes in patient care, as experienced by students, and the influence that these observations have on the development of their ethical reasoning. Using a qualitative descriptive approach in which 27 nursing student papers and three follow-up in-depth interviews were analyzed, three main themes emerged: Good employee, poor nurse; damaged care; and negotiating the gap. The analysis of the ethical situations in these papers suggests that students sometimes observe care that lacks concern for the dignity, autonomy, and safety of patients. For these student nurses, this tension led to uncertainty about patient care and their eventual profession. PMID:28932765

Measles outbreak in an unvaccinated family and a possibly associated international traveler - Orange County, Florida, December 2012-January 2013.

PubMed

Slade, Tania A; Klekamp, Benjamin; Rico, Edhelene; Mejia-Echeverry, Alvaro

2014-09-12

The Florida Department of Health in Orange County (DOH-Orange) was notified by a child care facility on January 11, 2013, that a parent had reported that an attendee and three siblings were ill with measles. All four siblings were unvaccinated for measles and had no travel history outside of Orange County during the periods when they likely had been exposed. A fifth, possibly associated case was later reported in a Brazilian citizen who had become ill while vacationing in Florida. The outbreak investigation that was conducted at multiple community settings in Orange County, including at an Orlando-area theme park, identified no additional cases. The genotype sequence was identical for cases 2-5, and visits to the same theme park suggested an unknown, common exposure and link between the cases. Sources of measles exposure can be difficult to identify for every measles case. Measles should be considered in the differential diagnosis of febrile rash illness, especially in unvaccinated persons. Reporting a confirmed or suspected case immediately to public health authorities is critical to limit the spread of measles.

Cannabinoid–dopamine interactions in the physiology and physiopathology of the basal ganglia

PubMed Central

García, Concepción; Palomo‐Garo, Cristina; Gómez‐Gálvez, Yolanda

2015-01-01

Endocannabinoids and their receptors play a modulatory role in the control of dopamine transmission in the basal ganglia. However, this influence is generally indirect and exerted through the modulation of GABA and glutamate inputs received by nigrostriatal dopaminergic neurons, which lack cannabinoid CB1 receptors although they may produce endocannabinoids. Additional evidence suggests that CB2 receptors may be located in nigrostriatal dopaminergic neurons, and that certain eicosanoid‐related cannabinoids may directly activate TRPV1 receptors, which have been found in nigrostriatal dopaminergic neurons, thus allowing in both cases a direct regulation of dopamine transmission by specific cannabinoids. In addition, CB1 receptors form heteromers with dopaminergic receptors which provide another pathway to direct interactions between both systems, in this case at the postsynaptic level. Through these direct mechanisms or through indirect mechanisms involving GABA or glutamate neurons, cannabinoids may interact with dopaminergic transmission in the basal ganglia and this is likely to have important effects on dopamine‐related functions in these structures (i.e. control of movement) and, particularly, on different pathologies affecting these processes, in particular, Parkinson's disease, but also dyskinesia, dystonia and other pathological conditions. The present review will address the current literature supporting these cannabinoid–dopamine interactions at the basal ganglia, with emphasis on aspects dealing with the physiopathological consequences of these interactions. Linked Articles This article is part of a themed section on Updating Neuropathology and Neuropharmacology of Monoaminergic Systems. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v173.13/issuetoc PMID:26059564

Neuroprotective effects of multifaceted hybrid agents targeting MAO, cholinesterase, iron and β-amyloid in ageing and Alzheimer's disease.

PubMed

Weinreb, Orly; Amit, Tamar; Bar-Am, Orit; Youdim, Moussa B H

2016-07-01

Alzheimer's disease (AD) is accepted nowadays as a complex neurodegenerative disorder with multifaceted cerebral pathologies, including extracellular deposition of amyloid β peptide-containing plaques, intracellular neurofibrillary tangles, progressive loss of cholinergic neurons, metal dyshomeostasis, mitochondrial dysfunction, neuroinflammation, glutamate excitoxicity, oxidative stress and increased MAO enzyme activity. This may explain why it is currently widely accepted that a more effective therapy for AD would result from the use of multifunctional drugs, which may affect more than one brain target involved in the disease pathology. The current review will discuss the potential benefits of novel multimodal neuroprotective, brain permeable drugs, recently developed by Youdim and collaborators, as a valuable therapeutic approach for AD treatment. The pharmacological and neuroprotective properties of these multitarget-directed ligands, which target MAO enzymes, the cholinergic system, iron accumulation and amyloid β peptide generation/aggregation are described, with a special emphasis on their potential therapeutic value for ageing and AD-associated cognitive functions. This review is conceived as a tribute to the broad neuropharmacology work of Professor Moussa Youdim, Professor Emeritus in the Faculty of Medicine and Director of Eve Topf Center of Excellence in Technion-Israel Institute of Technology, and Chief Scientific Officer of ABITAL Pharma Pipeline Ltd., at the occasion of his 75th birthday. This article is part of a themed section on Updating Neuropathology and Neuropharmacology of Monoaminergic Systems. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v173.13/issuetoc. © 2015 The British Pharmacological Society.

Carotenoids: biochemistry, pharmacology and treatment.

PubMed

Milani, Alireza; Basirnejad, Marzieh; Shahbazi, Sepideh; Bolhassani, Azam

2017-06-01

Carotenoids and retinoids have several similar biological activities such as antioxidant properties, the inhibition of malignant tumour growth and the induction of apoptosis. Supplementation with carotenoids can affect cell growth and modulate gene expression and immune responses. Epidemiological studies have shown a correlation between a high carotenoid intake in the diet with a reduced risk of breast, cervical, ovarian, colorectal cancers, and cardiovascular and eye diseases. Cancer chemoprevention by dietary carotenoids involves several mechanisms, including effects on gap junctional intercellular communication, growth factor signalling, cell cycle progression, differentiation-related proteins, retinoid-like receptors, antioxidant response element, nuclear receptors, AP-1 transcriptional complex, the Wnt/β-catenin pathway and inflammatory cytokines. Moreover, carotenoids can stimulate the proliferation of B- and T-lymphocytes, the activity of macrophages and cytotoxic T-cells, effector T-cell function and the production of cytokines. Recently, the beneficial effects of carotenoid-rich vegetables and fruits in health and in decreasing the risk of certain diseases has been attributed to the major carotenoids, β-carotene, lycopene, lutein, zeaxanthin, crocin (/crocetin) and curcumin, due to their antioxidant effects. It is thought that carotenoids act in a time- and dose-dependent manner. In this review, we briefly describe the biological and immunological activities of the main carotenoids used for the treatment of various diseases and their possible mechanisms of action. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

Targeting nociceptive transient receptor potential channels to treat chronic pain: current state of the field.

PubMed

Moran, Magdalene M; Szallasi, Arpad

2018-06-01

Control of chronic pain is frequently inadequate and/or associated with intolerable adverse effects, prompting a frantic search for new therapeutics and new therapeutic targets. Nearly two decades of preclinical and clinical research supports the involvement of transient receptor potential (TRP) channels in temperature perception, nociception and sensitization. Although there has been considerable excitement around the therapeutic potential of this channel family since the cloning and identification of TRPV1 cation channels as the capsaicin receptor more than 20 years ago, only modulators of a few channels have been tested clinically. TRPV1 channel antagonists have suffered from side effects related to the channel's role in temperature sensation; however, high dose formulations of capsaicin have reached the market and shown therapeutic utility. A number of potent, small molecule antagonists of TRPA1 channels have recently advanced into clinical trials for the treatment of inflammatory and neuropathic pain, and TRPM8 antagonists are following closely behind for cold allodynia. TRPV3, TRPV4, TRPM2 and TRPM3 channels have also been of significant interest. This review discusses the preclinical promise and status of novel analgesic agents that target TRP channels and the challenges that these compounds may face in development and clinical practice. This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc. © 2017 The British Pharmacological Society.

Reconceptualizing sex, brain and psychopathology: interaction, interaction, interaction

PubMed Central

Joel, D; Yankelevitch-Yahav, R

2014-01-01

In recent years there has been a growing recognition of the influence of sex on brain structure and function, and in relation, on the susceptibility, prevalence and response to treatment of psychiatric disorders. Most theories and descriptions of the effects of sex on the brain are dominated by an analogy to the current interpretation of the effects of sex on the reproductive system, according to which sex is a divergence system that exerts a unitary, overriding and serial effect on the form of other systems. We shortly summarize different lines of evidence that contradict aspects of this analogy. The new view that emerges from these data is of sex as a complex system whose different components interact with one another and with other systems to affect body and brain. The paradigm shift that this understanding calls for is from thinking of sex in terms of sexual dimorphism and sex differences, to thinking of sex in terms of its interactions with other factors and processes. Our review of data obtained from animal models of psychopathology clearly reveals the need for such a paradigmatic shift, because in the field of animal behaviour whether a sex difference exists and its direction depend on the interaction of many factors including, species, strain, age, specific test employed and a multitude of environmental factors. We conclude by explaining how the new conceptualization can account for sex differences in psychopathology. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24758640

Carotenoids: biochemistry, pharmacology and treatment

PubMed Central

Milani, Alireza; Basirnejad, Marzieh; Shahbazi, Sepideh

2016-01-01

Carotenoids and retinoids have several similar biological activities such as antioxidant properties, the inhibition of malignant tumour growth and the induction of apoptosis. Supplementation with carotenoids can affect cell growth and modulate gene expression and immune responses. Epidemiological studies have shown a correlation between a high carotenoid intake in the diet with a reduced risk of breast, cervical, ovarian, colorectal cancers, and cardiovascular and eye diseases. Cancer chemoprevention by dietary carotenoids involves several mechanisms, including effects on gap junctional intercellular communication, growth factor signalling, cell cycle progression, differentiation‐related proteins, retinoid‐like receptors, antioxidant response element, nuclear receptors, AP‐1 transcriptional complex, the Wnt/β‐catenin pathway and inflammatory cytokines. Moreover, carotenoids can stimulate the proliferation of B‐ and T‐lymphocytes, the activity of macrophages and cytotoxic T‐cells, effector T‐cell function and the production of cytokines. Recently, the beneficial effects of carotenoid‐rich vegetables and fruits in health and in decreasing the risk of certain diseases has been attributed to the major carotenoids, β‐carotene, lycopene, lutein, zeaxanthin, crocin (/crocetin) and curcumin, due to their antioxidant effects. It is thought that carotenoids act in a time‐ and dose‐dependent manner. In this review, we briefly describe the biological and immunological activities of the main carotenoids used for the treatment of various diseases and their possible mechanisms of action. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27638711

Obesity and risk of vascular disease: importance of endothelium-dependent vasoconstriction.

PubMed

Barton, Matthias; Baretella, Oliver; Meyer, Matthias R

2012-02-01

Obesity has become a serious global health issue affecting both adults and children. Recent devolopments in world demographics and declining health status of the world's population indicate that the prevalence of obesity will continue to increase in the next decades. As a disease, obesity has deleterious effects on metabolic homeostasis, and affects numerous organ systems including heart, kidney and the vascular system. Thus, obesity is now regarded as an independent risk factor for atherosclerosis-related diseases such as coronary artery disease, myocardial infarction and stroke. In the arterial system, endothelial cells are both the source and target of factors contributing to atherosclerosis. Endothelial vasoactive factors regulate vascular homeostasis under physiological conditions and maintain basal vascular tone. Obesity results in an imbalance between endothelium-derived vasoactive factors favouring vasoconstriction, cell growth and inflammatory activation. Abnormal regulation of these factors due to endothelial cell dysfunction is both a consequence and a cause of vascular disease processes. Finally, because of the similarities of the vascular pathomechanisms activated, obesity can be considered to cause accelerated, 'premature' vascular aging. Here, we will review some of the pathomechanisms involved in obesity-related activation of endothelium-dependent vasoconstriction, the clinical relevance of obesity-associated vascular risk, and therapeutic interventions using 'endothelial therapy' aiming at maintaining or restoring vascular endothelial health. This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3. © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.

The role and contributions of geriatric care managers: care recipients' views.

PubMed

Ortiz, Judith; Horne, Mary Ann

2013-01-01

To assess the value of geriatric care management (GCM) services from the perspective of individuals who receive the care--the "care recipients." The opinions of these older adults-the current users of GCM services--were investigated by means of a cross-sectional mail survey. The study setting was the home of the care recipient of GCM services. This cross-sectional descriptive study applied survey research design. Survey questions were developed related to the following themes about the GCM role and function: (1) overall role, (2) health assistance function, (3) community resources assistance function, (4) advocacy function, and (5) contribution to the care recipients' quality of life. Survey questionnaires were distributed to 179 care recipients of member organizations of the Florida Geriatric Care Management Association. The questionnaires were distributed by mail during the spring of 2012. A second mailing was completed in the fall of 2012. The survey results were analyzed using descriptive statistics. The care recipient survey respondents most frequently described the role of their GCMs as one of a health care professional. The respondents more frequently described the GCM as providing a health assistance and advocacy function. They indicated that the GCM greatly contributed to their quality of life. Geriatric care managers appear to be very valuable in assisting their clients with critical health-related situations, as well as with more routine health care matters. Not only are they called upon to assist with health care emergencies and their clients' hospital stays but they also appear to serve an important role in facilitating physician-patient communications during the care recipient's routine visits to the doctor's office.

Lifestyle use of drugs by healthy people for enhancing cognition, creativity, motivation and pleasure.

PubMed

d'Angelo, L-S Camilla; Savulich, George; Sahakian, Barbara J

2017-10-01

Today, there is continued, and in some cases growing, availability of not only psychoactive substances, including treatments for mental health disorders such as cognitive enhancers, which can enhance or restore brain function, but also 'recreational' drugs such as novel psychoactive substances (NPS). The use of psychoactive drugs has both benefits and risks: whilst new drugs to treat cognitive symptoms in neuropsychiatric or neurodegenerative disorders could have great benefits for many patient groups, the increasing ease of accessibility to recreational NPS and the increasing lifestyle use of cognitive enhancers by healthy people means that the effective management of psychoactive substances will be an issue of increasing importance. Clearly, the potential benefits of cognitive enhancers are large and increasingly relevant, particularly as the population ages, and for this reason, we should continue to devote resources to the development of cognitive enhancers as treatments for neurodegenerative diseases and psychiatric disorders, including Alzheimer's disease, attention deficit hyperactivity disorder and schizophrenia. However, the increasing use of cognitive enhancers by healthy individuals raises safety, ethical and regulatory concerns, which should not be ignored. Similarly, understanding the short- and long-term consequences of the use of NPS, as well as better understanding the motivations and profiles of users could promote more effective prevention and harm reduction measures. Linked Articles This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc. © 2017 The British Pharmacological Society.

Midkine and multiple sclerosis.

PubMed

Takeuchi, Hideyuki

2014-02-01

Multiple sclerosis (MS) is an autoimmune neurological disease characterized by inflammatory demyelination with subsequent neuronal damage in the CNS. MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have been thought as autoreactive Th1 and Th17 cell-mediated diseases. CD4(+) CD25(+) FoxP3(+) regulatory T-cell (Treg) plays a pivotal role in autoimmune tolerance, and tolerogenic dendritic cells (DCreg) drive the development of inducible Treg cells. Thus, a dysfunction in the development of Treg and DCreg leads to the development of autoimmune diseases. However, the factors that regulate Treg and DCreg are largely unknown. We recently showed that removal of midkine (MK) suppressed EAE due to an expansion of the Treg cell population as well as a decrease in the numbers of autoreactive Th1 and Th17 cells. MK decreased the Treg cell population by suppressing the phosphorylation of STAT5, which is essential for the expression of Foxp3, the master transcriptional factor of Treg cell differentiation. Furthermore, MK reduces the DCreg cell population by inhibiting the phosphorylation of STAT3, which is critical for DCreg development. Blockade of MK signalling by a specific RNA aptamer significantly elevated the population of DCreg and Treg cells and ameliorated EAE without detectable adverse effects. Therefore, the inhibition of MK may provide an effective therapeutic strategy against autoimmune diseases including MS. This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4. © 2013 The British Pharmacological Society.

New insights into male (in)fertility: the importance of NO

PubMed Central

Buzadzic, B; Vucetic, M; Jankovic, A; Stancic, A; Korac, A; Korac, B; Otasevic, V

2015-01-01

Infertility is a global problem that is on the rise, especially during the last decade. Currently, infertility affects approximately 10–15% of the population worldwide. The frequency and origin of different forms of infertility varies. It has been shown that reactive oxygen and nitrogen species (ROS and RNS) are involved in the aetiology of infertility, especially male infertility. Various strategies have been designed to remove or decrease the production of ROS and RNS in spermatozoa, in particular during in vitro fertilization. However, in recent years it has been shown that spermatozoa naturally produce a variety of ROS/RNS, including superoxide anion radical (O2⋅−), hydrogen peroxide and NO. These reactive species, in particular NO, are essential in regulating sperm capacitation and the acrosome reaction, two processes that need to be acquired by sperm in order to achieve fertilization potential. In addition, it has recently been shown that mitochondrial function is positively correlated with human sperm fertilization potential and quality and that NO and NO precursors increase sperm motility by increasing energy production in mitochondria. We will review the new link between sperm NO-driven redox regulation and infertility herein. A special emphasis will be placed on the potential implementation of new redox-active substances that modulate the content of NO in spermatozoa to increase fertility and promote conception. Linked Articles This article is part of a themed section on Pharmacology of the Gasotransmitters. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-6 PMID:24601995

Gas what: NO is not the only answer to sexual function

PubMed Central

Yetik-Anacak, G; Sorrentino, R; Linder, A E; Murat, N

2015-01-01

The ability to get and keep an erection is important to men for several reasons and the inability is known as erectile dysfunction (ED). ED has started to be accepted as an early indicator of systemic endothelial dysfunction and subsequently of cardiovascular diseases. The role of NO in endothelial relaxation and erectile function is well accepted. The discovery of NO as a small signalling gasotransmitter led to the investigation of the role of other endogenously derived gases, carbon monoxide (CO) and hydrogen sulphide (H2S) in physiological and pathophysiological conditions. The role of NO and CO in sexual function and dysfunction has been investigated more extensively and, recently, the involvement of H2S in erectile function has also been confirmed. In this review, we focus on the role of these three sister gasotransmitters in the physiology, pharmacology and pathophysiology of sexual function in man, specifically erectile function. We have also reviewed the role of soluble guanylyl cyclase/cGMP pathway as a common target of these gasotransmitters. Several studies have proposed alternative therapies targeting different mechanisms in addition to PDE-5 inhibition for ED treatment, since some patients do not respond to these drugs. This review highlights complementary and possible coordinated roles for these mediators and treatments targeting these gasotransmitters in erectile function/ED. Linked Articles This article is part of a themed section on Pharmacology of the Gasotransmitters. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-6 PMID:24661203

Positive allosteric modulators of the μ-opioid receptor: a novel approach for future pain medications

PubMed Central

Burford, N T; Traynor, J R; Alt, A

2015-01-01

Morphine and other agonists of the μ-opioid receptor are used clinically for acute and chronic pain relief and are considered to be the gold standard for pain medication. However, these opioids also have significant side effects, which are also mediated via activation of the μ-opioid receptor. Since the latter half of the twentieth century, researchers have sought to tease apart the mechanisms underlying analgesia, tolerance and dependence, with the hope of designing drugs with fewer side effects. These efforts have revolved around the design of orthosteric agonists with differing pharmacokinetic properties and/or selectivity profiles for the different opioid receptor types. Recently, μ-opioid receptor-positive allosteric modulators (μ-PAMs) were identified, which bind to a (allosteric) site on the μ-opioid receptor separate from the orthosteric site that binds an endogenous agonist. These allosteric modulators have little or no detectable functional activity when bound to the receptor in the absence of orthosteric agonist, but can potentiate the activity of bound orthosteric agonist, seen as an increase in apparent potency and/or efficacy of the orthosteric agonist. In this review, we describe the potential advantages that a μ-PAM approach might bring to the design of novel therapeutics for pain that may lack the side effects currently associated with opioid therapy. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2 PMID:24460691

Anti‐fibrotic actions of relaxin

PubMed Central

Royce, S G; Hewitson, T D; Denton, K M; Cooney, T E

2016-01-01

Abstract Fibrosis refers to the hardening or scarring of tissues that usually results from aberrant wound healing in response to organ injury, and its manifestations in various organs have collectively been estimated to contribute to around 45–50% of deaths in the Western world. Despite this, there is currently no effective cure for the tissue structural and functional damage induced by fibrosis‐related disorders. Relaxin meets several criteria of an effective anti‐fibrotic based on its specific ability to inhibit pro‐fibrotic cytokine and/or growth factor‐mediated, but not normal/unstimulated, fibroblast proliferation, differentiation and matrix production. Furthermore, relaxin augments matrix degradation through its ability to up‐regulate the release and activation of various matrix‐degrading matrix metalloproteinases and/or being able to down‐regulate tissue inhibitor of metalloproteinase activity. Relaxin can also indirectly suppress fibrosis through its other well‐known (anti‐inflammatory, antioxidant, anti‐hypertrophic, anti‐apoptotic, angiogenic, wound healing and vasodilator) properties. This review will outline the organ‐specific and general anti‐fibrotic significance of exogenously administered relaxin and its mechanisms of action that have been documented in various non‐reproductive organs such as the cardiovascular system, kidney, lung, liver, skin and tendons. In addition, it will outline the influence of sex on relaxin's anti‐fibrotic actions, highlighting its potential as an emerging anti‐fibrotic therapeutic. Linked Articles This article is part of a themed section on Recent Progress in the Understanding of Relaxin Family Peptides and their Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.10/issuetoc PMID:27250825

Curcumin: an orally bioavailable blocker of TNF and other pro-inflammatory biomarkers

PubMed Central

Aggarwal, Bharat B; Gupta, Subash C; Sung, Bokyung

2013-01-01

TNFs are major mediators of inflammation and inflammation-related diseases, hence, the United States Food and Drug Administration (FDA) has approved the use of blockers of the cytokine, TNF-α, for the treatment of osteoarthritis, inflammatory bowel disease, psoriasis and ankylosis. These drugs include the chimeric TNF antibody (infliximab), humanized TNF-α antibody (Humira) and soluble TNF receptor-II (Enbrel) and are associated with a total cumulative market value of more than $20 billion a year. As well as being expensive ($15 000–20 000 per person per year), these drugs have to be injected and have enough adverse effects to be given a black label warning by the FDA. In the current report, we describe an alternative, curcumin (diferuloylmethane), a component of turmeric (Curcuma longa) that is very inexpensive, orally bioavailable and highly safe in humans, yet can block TNF-α action and production in in vitro models, in animal models and in humans. In addition, we provide evidence for curcumin's activities against all of the diseases for which TNF blockers are currently being used. Mechanisms by which curcumin inhibits the production and the cell signalling pathways activated by this cytokine are also discussed. With health-care costs and safety being major issues today, this golden spice may help provide the solution. Linked Articles This article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-8 PMID:23425071

What were the outcomes of home follow-up visits after postpartum hospital discharge?

PubMed

Jirojwong, Sansnee; Rossi, Dolene; Walker, Sandra; Ritchie, Barbara

2005-01-01

To assess health outcomes of home follow-up visits after postpartum discharge and assess relationships between the number of home visits and selected outcomes among women who gave birth at two Queensland, Australia, regional hospitals. A cross sectional study. Services provided during the home visits were responsive to a woman's need rather than having a structured protocol of services. The four measured health outcomes were: 1) postpartum depression; 2) confidence to undertake maternal roles; 3) breastfeeding; and, 4) satisfaction with postpartum care. Of 210 women who were invited to participate in the study, 143 (68.1%) provided information. Women who received a higher number of home visits had significantly lower confidence to undertake maternal roles than those who received fewer home visits. There was a positive correlation between the number of home follow-up visits and postpartum depression among women who gave birth at one hospital (Hospital B), but not at the other (Hospital A). No relationship was found between the home postpartum visits and the other outcomes. These results could be explained in that home follow-up visits were offered to all women at Hospital A while Hospital B only provided home visits to women who had a health risk due to their social, physical and psychological characteristics. The lack of protocol home visits and the characteristics of women receiving the visits were probably the major factors which influenced these limited beneficial outcomes.

42 CFR 410.15 - Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage. 410.15 Section 410.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM...

28 CFR 540.50 - Visits to inmates not in regular population status.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Visits to inmates not in regular population status. 540.50 Section 540.50 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE... not in regular population status. (a) Admission and holdover status. The Warden may limit to the...

28 CFR 540.50 - Visits to inmates not in regular population status.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Visits to inmates not in regular population status. 540.50 Section 540.50 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE... not in regular population status. (a) Admission and holdover status. The Warden may limit to the...

28 CFR 540.50 - Visits to inmates not in regular population status.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Visits to inmates not in regular population status. 540.50 Section 540.50 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE... not in regular population status. (a) Admission and holdover status. The Warden may limit to the...

8 CFR 204.311 - Convention adoption home study requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... individual has one), and date of birth. (3) Include an interview by the preparer of any additional adult... paragraph (f) of this section. (7) State the number of interviews and visits, the participants, date and location of each interview and visit, and the date and location of any other contacts with the applicant...

8 CFR 204.311 - Convention adoption home study requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... individual has one), and date of birth. (3) Include an interview by the preparer of any additional adult... paragraph (f) of this section. (7) State the number of interviews and visits, the participants, date and location of each interview and visit, and the date and location of any other contacts with the applicant...

Business Administration and Management: Current Trends and Future Directions.

ERIC Educational Resources Information Center

Flewellen, William C., Jr.

Drawing from site visits to 39 public and private colleges in Massachusetts, this report presents an evaluation of college programs in business administration and management and recommendations for improvement. Section 1 provides an overview of the statewide study and its findings. After identifying the colleges visited and the members of the…

Reducing medical students' stigmatization of people with chronic mental illness: a field intervention at the "living museum" state hospital art studio.

PubMed

Cutler, Janis L; Harding, Kelli J; Hutner, Lucy A; Cortland, Clarissa; Graham, Mark J

2012-05-01

The authors designed an intervention to reduce beginning medical students' stigmatization of people with chronic mental illness (CMI). Pre-clinical medical students visited a state psychiatric facility's "Living Museum," a combination patient art studio/display space, as the intervention. During the visit, students interacted with artist-guides who showed their work and discussed their experiences creating art. Students completed a self-assessment survey developed to measure attitudes and feelings toward people with CMI after half of the class visited the Living Museum, constituting a Visit/No-Visit cross-sectional comparison. Students who visited the Living Museum (N=64), as compared with those who did not visit (N=110), endorsed more positive attitudes toward people with CMI. Among the students who visited, however, those who reported having spoken individually with a patient-artist (N=44), paradoxically, indicated less-positive feelings toward people with CMI. An intervention in which pre-clinical medical students visited patient-artist guides in an art-studio setting generally improved students' attitudes toward people with CMI. Thus, nontraditional psychiatric settings offer a valuable adjunct to more traditional clinical settings to reduce stigma when introducing medical students to the field of psychiatry.

Observational intensity bias associated with illness adjustment: cross sectional analysis of insurance claims

PubMed Central

Staiger, Douglas O; Sharp, Sandra M; Gottlieb, Daniel J; Bevan, Gwyn; McPherson, Klim; Welch, H Gilbert

2013-01-01

Objective To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases. Setting Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877). Main outcome measures The effect of illness adjustment on regional mortality and spending rates using standard and visit corrected illness methods for adjustment. The standard method adjusts using comorbidity measures based on diagnoses listed in administrative databases; the modified method corrects these measures for the frequency of visits by physicians. Three conventions for measuring comorbidity are used: the Charlson comorbidity index, Iezzoni chronic conditions, and hierarchical condition categories risk scores. Results The visit corrected Charlson comorbidity index explained more of the variation in age, sex, and race mortality across the 306 hospital referral regions than did the standard index (R2=0.21 v 0.11, P<0.001) and, compared with sex and race adjusted mortality, reduced regional variation, whereas adjustment using the standard Charlson comorbidity index increased it. Although visit corrected and age, sex, and race adjusted mortality rates were similar in hospital referral regions with the highest and lowest fifths of visits, adjustment using the standard index resulted in a rate that was 18% lower in the highest fifth (46.4 v 56.3 deaths per 1000, P<0.001). Age, sex, and race adjusted spending as well as visit corrected spending was more than 30% greater in the highest fifth of visits than in the lowest fifth, but only 12% greater after adjustment using the standard index. Similar results were obtained using the Iezzoni and the hierarchical condition categories conventions for measuring comorbidity. Conclusion The rates of visits by physicians introduce substantial bias when regional mortality and spending rates are adjusted for illness using comorbidity measures based on the observed number of diagnoses recorded in Medicare’s administrative database. Adjusting without correction for regional variation in visit rates tends to make regions with high rates of visits seem to have lower mortality and lower costs, and vice versa. Visit corrected comorbidity measures better explain variation in age, sex, and race mortality than observed measures, and reduce observational intensity bias. PMID:23430282

KSC-04PD-2212

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Col.David Nuckles, chief of Safety with the 45th Space Wing, talks to guests and employees during opening ceremonies for Spaceport Super Safety and Health Day at KSC. Guest speakers included Dr. Pamela Peeke, Navy Com. Stephen E. Iwanowicz, NASAs Dr. Kristine Calderon and Olympic-great Bruce Jenner. Later in the day, employees could visit many vendors exhibits featuring safety and health items. Super Safety and Health Day was initiated at KSC in 1998 to increase awareness of the importance of safety and health among the government and contractor workforce. The theme for this years event was Safety and Health: A Winning Combination.

The role of state mental health authorities in managing change for the implementation of evidence-based practices.

PubMed

Isett, Kimberley Roussin; Burnam, M Audrey; Coleman-Beattie, Brenda; Hyde, Pamela S; Morrissey, Joseph P; Magnabosco, Jennifer L; Rapp, Charles; Ganju, Vijay; Goldman, Howard H

2008-06-01

The evidence-based practice demonstration for services to adults with serious mental illness has ended its pilot stage. This paper presents the approaches states employed to combine traditional policy levers with more strategic/institutional efforts (e.g., leadership) to facilitate implementation of these practices. Two rounds of site visits were completed and extensive interview data collected. The data were analyzed to find trends that were consistent across states and across practices. Two themes emerged for understanding implementation of evidence-based practices: the support and influence of the state mental health authority matters and so does the structure of the mental health systems.

Ahtna Athabaskan Dictionary.

ERIC Educational Resources Information Center

Kari, James, Ed.

This dictionary of Ahtna, a dialect of the Athabaskan language family, is the first to integrate all morphemes into a single alphabetically arranged section of main entries, with verbs arranged according to a theory of Ahtna (and Athabascan) verb theme categories. An introductory section details dictionary format conventions used, presents a brief…

Employer-Sponsored Career Development Programs. Information Series No. 231.

ERIC Educational Resources Information Center

Lancaster, Anita Sklare; Berne, Richard R.

This monograph presents an overview of employer-sponsored career development programs. It is divided into four sections. The "Adult Development" and "Adult Career Development" sections review pertinent theories and research (basic concepts, task model, transition model, theme model, adult career stages, career anchors approach, career development…

Job Hunting? It's a Jungle out There! Jungle Survival Guide II.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

This illustrated, jungle-theme book plans a job search. There are three major sections in the book: (1) plan your safari; (2) where to look for jobs; and (3) making contact. Section one includes information on resumes, references, official papers needed for a job, and 11 ideas to help find job openings. Section two suggests finding jobs in state…

Hydrologic Instrumentation Facility of the U.S. Geological Survey, annual report for fiscal year 1993

USGS Publications Warehouse

Latkovich, V.J.; Tracey, Debra C.

1994-01-01

The Hydrologic lnstrumentation Facility (HIF) of the U.S. Geological Survey (USGS) has nationwide responsibility for all aspects of hydrologic field instrumentation in support of Survey data-collection programs. Each year the HIF publishes a report to inform Water Resources Division (WRD) personnel of progress made by the HIF in fulfilling its mission to improve instrumentation services to the Division. The report for fiscal year 1993 (FY93) describes the activities of the HIF, including major accomplish- ments for the year; personnel actions; active projects (reported by section--Technical Services Section, Administrative Services Section, Field Coordination, Applications and Development Section, Test and Evaluation Section, Field Service and Supply Section); and planned activities for the coming year. Also presented in the appendixes are detailed listings of the memberships of the Instrumentation Committee and the Instrumentation Technical Advisory Subcommittee; district, sub- district, and field office visits by HIF personnel; professional and technical meetings attended by HIF personnel; vendor visits; and reports prepared by HIF personnel.

Recreational physical activity in natural environments and implications for health: A population based cross-sectional study in England.

PubMed

White, M P; Elliott, L R; Taylor, T; Wheeler, B W; Spencer, A; Bone, A; Depledge, M H; Fleming, L E

2016-10-01

Building on evidence that natural environments (e.g. parks, woodlands, beaches) are key locations for physical activity, we estimated the total annual amount of adult recreational physical activity in England's natural environments, and assessed implications for population health. A cross-sectional analysis of six waves (2009/10-2014/5) of the nationally representative, Monitor of Engagement with the Natural Environment survey (n=280,790). The survey uses a weekly quota sample, and population weights, to estimate nature visit frequency across England, and provides details on a single, randomly selected visit (n=112,422), including: a) duration; b) activity; and c) environment type. Approximately 8.23 million (95% CIs: 7.93, 8.54) adults (19.5% of the population) made at least one 'active visit' (i.e. ≥30min, ≥3 METs) to natural environments in the previous week, resulting in 1.23 billion (1.14, 1.32) 'active visits' annually. An estimated 3.20 million (3.05, 3.35) of these also reported meeting recommended physical activity guidelines (i.e. ≥5×30min a week) fully, or in part, through such visits. Active visits by this group were associated with an estimated 109,164 (101,736, 116,592) Quality Adjusted Life Years (QALYs) annually. Assuming the social value of a QALY to be £20,000, the annual value of these visits was approximately £2.18 billion (£2.03, £2.33). Results for walking were replicated using WHO's Health Economic Assessment Tool. Natural environments provide the context for a large proportion of England's recreational physical activity and highlight the need to protect and manage such environments for health purposes. Copyright © 2016 Elsevier Inc. All rights reserved.

Vocational Psychology: Agency, Equity, and Well-Being.

PubMed

Brown, Steven D; Lent, Robert W

2016-01-01

The present review organizes the vocational psychology literature published between 2007 and 2014 into three overarching themes: Promoting (a) agency in career development, (b) equity in the work force, and (c) well-being in work and educational settings. Research on career adaptability, self-efficacy beliefs, and work volition is reviewed in the agency section, with the goal of delineating variables that promote or constrain the exercise of personal agency in academic and occupational pursuits. The equity theme covers research on social class and race/ethnicity in career development; entry and retention of women and people of color in science, technology, engineering, and math (STEM) fields; and the career service needs of survivors of domestic violence and of criminal offenders. The goal was to explore how greater equity in the work force could be promoted for these groups. In the well-being section, we review research on hedonic (work, educational, and life satisfaction) and eudaimonic (career calling, meaning, engagement, and commitment) variables, with the goal of understanding how well-being might be promoted at school and at work. Future research needs related to each theme are also discussed.

New Jersey Industrial Arts Education Safety Guide.

ERIC Educational Resources Information Center

Kobylarz, Joseph D.; Olender, Francis B.

This guide was developed to assist the teacher in planning, implementing, revising, or improving safety instruction in industrial arts classes in New Jersey, and has as its theme, "Safety Is Everyone's Responsibility." The guide is organized in seven major sections. The first section explains the purpose of the guide, outlines the…

How to Plan and Implement a Workshop.

ERIC Educational Resources Information Center

Howell, Jacquie

These guidelines were developed to assist school administrators who have the responsibility of organizing a one- to three-day professional development program. The first section outlines the tasks involved in planning and implementing a workshop. The remaining sections cover the following: (1) developing and utilizing the workshop theme; (2)…

Have a Bearable Summer-Read: An Activity Guide.

ERIC Educational Resources Information Center

Jackson, Mary, Ed.

Designed to help librarians plan a summer reading program around the theme of bears called "have a bearable summer," this activity guide presents many activities and organizational suggestions. The first section of the guide deals with publicity and public relations, while the second section covers story time activities. The third…

Identification of Communication and Coordination Issues in the US Air Traffic Control System

NASA Technical Reports Server (NTRS)

Davison, Hayley J.; Hansman, R. John

2001-01-01

Today's air traffic control system is approaching the point of saturation, as evidenced by increasing delays across the National Airspace System (NAS). There exists an opportunity to enhance NAS efficiency and reduce delays by improving strategic communication throughout the ATC system. Although several measures have been taken to improve communication (e.g., Collaborative Decision Making tools), communication issues between ATC facilities remain. It is hypothesized that by identifying the key issues plaguing inter-facility strategic communication, steps can be taken to enhance these communications, and therefore ATC system efficiency. In this report, a series of site visits were performed at Boston and New York ATC facilities as well as at the Air Traffic Control System Command Center. The results from these site visits were used to determine the current communication and coordination structure of Traffic Management Coordinators, who hold a pivotal role in inter-facility communications. Several themes emerged from the study, including: ambiguity of organizational structure in the current ATC system, awkward coordination between ATC facilities, information flow issues, organizational culture issues, and negotiation behaviors used to cope with organizational culture issues.

Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

PubMed

Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

2017-10-01

Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

User-Centered Design of a Tablet Waiting Room Tool for Complex Patients to Prioritize Discussion Topics for Primary Care Visits.

PubMed

Lyles, Courtney R; Altschuler, Andrea; Chawla, Neetu; Kowalski, Christine; McQuillan, Deanna; Bayliss, Elizabeth; Heisler, Michele; Grant, Richard W

2016-09-14

Complex patients with multiple chronic conditions often face significant challenges communicating and coordinating with their primary care physicians. These challenges are exacerbated by the limited time allotted to primary care visits. Our aim was to employ a user-centered design process to create a tablet tool for use by patients for visit discussion prioritization. We employed user-centered design methods to create a tablet-based waiting room tool that enables complex patients to identify and set discussion topic priorities for their primary care visit. In an iterative design process, we completed one-on-one interviews with 40 patients and their 17 primary care providers, followed by three design sessions with a 12-patient group. We audiorecorded and transcribed all discussions and categorized major themes. In addition, we met with 15 key health communication, education, and technology leaders within our health system to further review the design and plan for broader implementation of the tool. In this paper, we present the significant changes made to the tablet tool at each phase of this design work. Patient feedback emphasized the need to make the tablet tool accessible for patients who lacked technical proficiency and to reduce the quantity and complexity of text presentation. Both patients and their providers identified specific content choices based on their personal experiences (eg, the ability to raise private or sensitive concerns) and recommended targeting new patients. Stakeholder groups provided essential input on the need to augment text with video and to create different versions of the videos to match sex and race/ethnicity of the actors with patients. User-centered design in collaboration with patients, providers, and key health stakeholders led to marked evolution in the initial content, layout, and target audience for a tablet waiting room tool intended to assist complex patients with setting visit discussion priorities.

Reflections on a Visit to the Union of the Blind of Croatia, Zagreb, Yugoslavia.

ERIC Educational Resources Information Center

Cylke, Frank Kurt; Hanke, Peter

The paper reports a visit to the Union of the Blind in Croatia, an organization serving the needs of 4,500 blind individuals in this part of Yugoslavia. Briefly considered are personnel, financial support, and services (such as braille and talking book production). A separate section describes the organization's library, recorded and braille…

Correlates of Physician Visits Among Children and Adolescents in West Texas: Effects Of Hyperglycemia Symptoms

ERIC Educational Resources Information Center

Arif, Ahmed A.; Venati, Girikumar; Borders, Tyrone F.; Rohrer, James E.

2004-01-01

Health care services use by children varies tremendously. Because of the increasing prevalence of diabetes in children and adolescents, one of the major concerns is access to physician care among children with diabetes and diabetes symptoms. This population-based cross-sectional study examines correlates of physician visit among children and…

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

45 CFR 303.15 - Agreements to use the Federal Parent Locator Service (PLS) in parental kidnapping and child...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Service (PLS) in parental kidnapping and child custody or visitation cases. 303.15 Section 303.15 Public... parental kidnapping and child custody or visitation cases. (a) Definitions. The following definitions apply... responsibilities require access in connection with child custody and parental kidnapping cases; (ii) Store the...

42 CFR 85.6 - Advance notice of visits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... investigation. Advance notice will not be given when, in the judgment of the NIOSH officer, giving such notice..., advance notice will be given by NIOSH to the employer. Upon the request of the employer, NIOSH will inform... 42 Public Health 1 2010-10-01 2010-10-01 false Advance notice of visits. 85.6 Section 85.6 Public...

Using the Technology Acceptance Model to explore community dwelling older adults' perceptions of a 3D interior design application to facilitate pre-discharge home adaptations.

PubMed

Money, Arthur G; Atwal, Anita; Young, Katherine L; Day, Yasmin; Wilson, Lesley; Money, Kevin G

2015-08-26

In the UK occupational therapy pre-discharge home visits are routinely carried out as a means of facilitating safe transfer from the hospital to home. Whilst they are an integral part of practice, there is little evidence to demonstrate they have a positive outcome on the discharge process. Current issues for patients are around the speed of home visits and the lack of shared decision making in the process, resulting in less than 50 % of the specialist equipment installed actually being used by patients on follow-up. To improve practice there is an urgent need to examine other ways of conducting home visits to facilitate safe discharge. We believe that Computerised 3D Interior Design Applications (CIDAs) could be a means to support more efficient, effective and collaborative practice. A previous study explored practitioners perceptions of using CIDAs; however it is important to ascertain older adult's views about the usability of technology and to compare findings. This study explores the perceptions of community dwelling older adults with regards to adopting and using CIDAs as an assistive tool for the home adaptations process. Ten community dwelling older adults participated in individual interactive task-focused usability sessions with a customised CIDA, utilising the think-aloud protocol and individual semi-structured interviews. Template analysis was used to carry out both deductive and inductive analysis of the think-aloud and interview data. Initially, a deductive stance was adopted, using the three pre-determined high-level themes of the technology acceptance model (TAM): Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Actual Use (AU). Inductive template analysis was then carried out on the data within these themes, from which a number of sub-thmes emerged. Regarding PU, participants believed CIDAs served as a useful visual tool and saw clear potential to facilitate shared understanding and partnership in care delivery. For PEOU, participants were able to create 3D home environments however a number of usability issues must still be addressed. The AU theme revealed the most likely usage scenario would be collaborative involving both patient and practitioner, as many participants did not feel confident or see sufficient value in using the application autonomously. This research found that older adults perceived that CIDAs were likely to serve as a valuable tool which facilitates and enhances levels of patient/practitioner collaboration and empowerment. Older adults also suggested a redesign of the interface so that less sophisticated dexterity and motor functions are required. However, older adults were not confident, or did not see sufficient value in using the application autonomously. Future research is needed to further customise the CIDA software, in line with the outcomes of this study, and to explore the potential of collaborative application patient/practitioner-based deployment.

Take Care of Your Teeth and Gums

MedlinePlus

... This Topic En español Take Care of Your Teeth and Gums Browse Sections The Basics Overview Take ... Brushing Tips 3 of 5 sections Take Action: Dental Checkups Get regular checkups at the dentist. Visit ...

What keeps health professionals working in rural district hospitals in South Africa?

PubMed

Jenkins, Louis S; Gunst, Colette; Blitz, Julia; Coetzee, Johan F

2015-06-26

The theme of the 2014 Southern African Rural Health Conference was 'Building resilience in facing rural realities'. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. CONFERENCE WORKSHOP: The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, 'What is it that keeps you going to work every day?' Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported.

Detecting changes in student teachers' conceptions of teaching science to adolescent English language learners

NASA Astrophysics Data System (ADS)

Pomeroy, Jonathon Richard

2000-10-01

This research study investigated the changes that occurred in six student teachers' conceptions of teaching science to adolescent English language learners over the duration of their participation in a one-year, graduate level, science teacher education program. Cases were created for each of the student teachers based on their concept maps, writing samples, interviews, lesson plans, informal interviews with cooperating teachers, and observation notes collected on biweekly visitations. The cases were divided into three dyads each consisting of two student teachers with similar preprogram and student teaching experiences. Cross case analysis revealed the existence of seven themes related to teaching science to adolescent English language learners. Further analysis suggested that student teachers that worked with experienced cooperating teachers and who had achieved a sense of autonomy over their student teaching demonstrated broad and sophisticated growth across all seven themes. Student teachers who had not achieved a sense of autonomy, demonstrated growth in two to three themes. Student teachers who demonstrated broad and sophisticated growth were able to clearly articulate their conceptions of teaching science to English language learners where as those who demonstrated limited growth were not. This research establishes the use of concept maps as a tool for detecting changes in student teachers' conceptions of teaching science to adolescent English language learners as well as the sensitivity of concept maps to detect the types of changes historically detected by writing samples and interviews. Recommendations based on the implications from are included.

Impact of ITP on physician visits and workplace productivity.

PubMed

Tarantino, Michael D; Mathias, Susan D; Snyder, Claire F; Isitt, John J; Gernsheimer, Terry; Young, Joan

2010-02-01

To assess the impact of immune thrombocytopenic purpura (ITP) on primary care and specialist visits and workplace productivity. This was a cross-sectional, descriptive study comparing ITP patients to age- and gender-matched controls. Subjects completed a one-time web-based survey, which included questions on work loss, work productivity, and physician visits. ITP patients and controls were compared on these outcomes. For ITP patients, the relationship between work-related issues and physician visits with clinical characteristics (time since diagnosis, platelet count, number of treatments received, and an ITP-specific health-related quality of life measure, the ITP-PAQ) was explored. A total of 1002 ITP patients and 1031 controls completed the survey. On average, ITP patients were 46 years old, diagnosed 9 years ago, and had platelet counts of 148 x 10(9)/L; 37% had undergone splenectomy. More ITP patients had primary care (20% vs. 11%) and specialist (28% vs. 11%) visits in the past month versus controls (p < or = 0.001). Higher proportions of ITP patients have ever taken sick leave (56% vs. 30%), and missed chore hours in the past week (18% vs. 13%) (p < or = 0.003). ITP patients scored significantly worse than controls on all six work productivity items. Patients diagnosed within the past year were more likely to have specialist visits and to miss chore hours versus those diagnosed less recently. Worse ITP-PAQ scores and more ITP-related treatments were related to more physician visits and worse work-related and productivity outcomes. Platelet count is not associated with these outcomes. The study is limited by the potential for biased samples due to recruitment approaches, the inherent issues of a cross-sectional study design and recall bias in questionnaire responses. ITP was consistently associated with more physician visits and worse work and productivity outcomes. Future research should build on these findings by calculating a comprehensive cost-of-illness of ITP including both direct and indirect costs.

Revealing teacher agendas: An examination of teacher motivations and strategies for conducting museum fieldtrips

NASA Astrophysics Data System (ADS)

Kisiel, James Francis

The purpose of this investigation was to identify the motivations and strategies that comprise teachers' agendas when leading a student fieldtrip to a museum or similar site. Two data collection methods were used. A survey regarding field trip experiences and rationale was mailed to upper elementary teachers, resulting in a variety of open-ended responses that were analyzed and coded to identify recurring themes. In addition, ten teachers accompanying students during a school trip to a natural history museum were interviewed and observed. Data collected from these in-depth studies were used to verify findings from the survey instrument and to refine and enhance the definitions and descriptions of actual practice. Eight fieldtrip motivations were identified including to connection with the classroom curriculum, to provide a general learning experience, to encourage lifelong learning, to enhance interest and motivation, to provide exposure to new experiences, to provide a change in setting or routine, for enjoyment, and to meet school expectations. Fieldtrip strategies used by teachers could be divided into pre-visit, during-visit or post-visit strategies. The commonly reported pre-visit strategies included familiarization and supervision preparation. During-visit strategies focused on structured student engagement strategies (such as worksheets or guided tours) and unstructured strategies (such as interpretation, connecting, facilitation, label-reading, advance organizers and free exploration), as well as event documentation and supervision tactics (such as keeping track and refocusing). Post-visit strategies included review and discussion, documentation , and assessment. Comparison of stated motivations and observed strategies revealed few links. However, results indicated that connecting to the classroom curriculum was an important consideration, even though teachers had different interpretations of what this meant. Providing hands-on experiences was also critical for many teachers, although the meaning of "hands-on" was more closely related to authentic experience rather than a component of inquiry-based learning. Further examination of the teachers' agendas suggested the influence of contexts, including that of the school (restrictions, curricular pressures), the teacher's personal context (teaching and museum experiences), and the museum site itself. These findings lead to suggestions through which museums might better facilitate school visits by considering the contexts that influence the teachers' fieldtrip perspectives and agendas.

Combined effects of THC and caffeine on working memory in rats.

PubMed

Panlilio, Leigh V; Ferré, Sergi; Yasar, Sevil; Thorndike, Eric B; Schindler, Charles W; Goldberg, Steven R

2012-04-01

Cannabis and caffeine are two of the most widely used psychoactive substances. Δ(9) -Tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, induces deficits in short-term memory. Caffeine, a non-selective adenosine receptor antagonist, attenuates some memory deficits, but there have been few studies addressing the effects of caffeine and THC in combination. Here, we evaluate the effects of these drugs using a rodent model of working memory. Rats were given THC (0, 1 and 3 mg·kg(-1) , i.p.) along with caffeine (0, 1, 3 and 10 mg·kg(-1) , i.p.), the selective adenosine A(1) -receptor antagonist CPT (0, 3 and 10 mg·kg(-1) ) or the selective adenosine A(2A) -receptor antagonist SCH58261 (0 and 5 mg·kg(-1) ) and were tested with a delayed non-matching-to-position procedure in which behaviour during the delay was automatically recorded as a model of memory rehearsal. THC alone produced memory deficits at 3 mg·kg(-1) . The initial exposure to caffeine (10 mg·kg(-1) ) disrupted the established pattern of rehearsal-like behaviour, but tolerance developed rapidly to this effect. CPT and SCH58261 alone had no significant effects on rehearsal or memory. When a subthreshold dose of THC (1 mg·kg(-1) ) was combined with caffeine (10 mg·kg(-1) ) or CPT (10 mg·kg(-1) ), memory performance was significantly impaired, even though performance of the rehearsal-like pattern was not significantly altered. Caffeine did not counteract memory deficits induced by THC but actually exacerbated them. These results are consistent with recent findings that adenosine A(1) receptors modulate cannabinoid signalling in the hippocampus. This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

Cannabidiol, a non-psychotropic component of cannabis, attenuates vomiting and nausea-like behaviour via indirect agonism of 5-HT1A somatodendritic autoreceptors in the dorsal raphe nucleus

PubMed Central

Rock, EM; Bolognini, D; Limebeer, CL; Cascio, MG; Anavi-Goffer, S; Fletcher, PJ; Mechoulam, R; Pertwee, RG; Parker, LA

2012-01-01

BACKGROUND AND PURPOSE To evaluate the hypothesis that activation of somatodendritic 5-HT1A autoreceptors in the dorsal raphe nucleus (DRN) produces the anti-emetic/anti-nausea effects of cannabidiol (CBD), a primary non-psychoactive cannabinoid found in cannabis. EXPERIMENTAL APPROACH The potential of systemic and intra-DRN administration of 5-HT1A receptor antagonists, WAY100135 or WAY100635, to prevent the anti-emetic effect of CBD in shrews (Suncus murinus) and the anti-nausea-like effects of CBD (conditioned gaping) in rats were evaluated. Also, the ability of intra-DRN administration of CBD to produce anti-nausea-like effects (and reversal by systemic WAY100635) was assessed. In vitro studies evaluated the potential of CBD to directly target 5-HT1A receptors and to modify the ability of the 5-HT1A agonist, 8-OH-DPAT, to stimulate [35S]GTPγS binding in rat brainstem membranes. KEY RESULTS CBD suppressed nicotine-, lithium chloride (LiCl)- and cisplatin (20 mg·kg−1, but not 40 mg·kg−1)-induced vomiting in the S. murinus and LiCl-induced conditioned gaping in rats. Anti-emetic and anti-nausea-like effects of CBD were suppressed by WAY100135 and the latter by WAY100635. When administered to the DRN: (i) WAY100635 reversed anti-nausea-like effects of systemic CBD, and (ii) CBD suppressed nausea-like effects, an effect that was reversed by systemic WAY100635. CBD also displayed significant potency (in a bell-shaped dose–response curve) at enhancing the ability of 8-OH-DPAT to stimulate [35S]GTPγS binding to rat brainstem membranes in vitro. Systemically administered CBD and 8-OH-DPAT synergistically suppressed LiCl-induced conditioned gaping. CONCLUSIONS AND IMPLICATIONS These results suggest that CBD produced its anti-emetic/anti-nausea effects by indirect activation of the somatodendritic 5-HT1A autoreceptors in the DRN. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21827451

A new cannabinoid CB2 receptor agonist HU-910 attenuates oxidative stress, inflammation and cell death associated with hepatic ischaemia/reperfusion injury

PubMed Central

Horváth, Bėla; Magid, Lital; Mukhopadhyay, Partha; Bátkai, Sándor; Rajesh, Mohanraj; Park, Ogyi; Tanchian, Galin; Gao, Rachel Y; Goodfellow, Catherine E; Glass, Michelle; Mechoulam, Raphael; Pacher, Pál

2012-01-01

BACKGROUND AND PURPOSE Cannabinoid CB2 receptor activation has been reported to attenuate myocardial, cerebral and hepatic ischaemia-reperfusion (I/R) injury. EXPERIMENTAL APPROACH We have investigated the effects of a novel CB2 receptor agonist ((1S,4R)-2-(2,6-dimethoxy-4-(2-methyloctan-2-yl)phenyl)-7,7-dimethylbicyclo[2.2.1]hept-2-en-1-yl)methanol (HU-910) on liver injury induced by 1 h of ischaemia followed by 2, 6 or 24 h of reperfusion, using a well-established mouse model of segmental hepatic I/R. KEY RESULTS Displacement of [3H]CP55940 by HU-910 from specific binding sites in CHO cell membranes transfected with human CB2 or CB1 receptors (hCB1/2) yielded Ki values of 6 nM and 1.4 µM respectively. HU-910 inhibited forskolin-stimulated cyclic AMP production by hCB2 CHO cells (EC50= 162 nM) and yielded EC50 of 26.4 nM in [35S]GTPγS binding assays using hCB2 expressing CHO membranes. HU-910 given before ischaemia significantly attenuated levels of I/R-induced hepatic pro-inflammatory chemokines (CCL3 and CXCL2), TNF-α, inter-cellular adhesion molecule-1, neutrophil infiltration, oxidative stress and cell death. Some of the beneficial effect of HU-910 also persisted when given at the beginning of the reperfusion or 1 h after the ischaemic episode. Furthermore, HU-910 attenuated the bacterial endotoxin-triggered TNF-α production in isolated Kupffer cells and expression of adhesion molecules in primary human liver sinusoidal endothelial cells stimulated with TNF-α. Pretreatment with a CB2 receptor antagonist attenuated the protective effects of HU-910, while pretreatment with a CB1 antagonist tended to enhance them. CONCLUSION AND IMPLICATIONS HU-910 is a potent CB2 receptor agonist which may exert protective effects in various diseases associated with inflammation and tissue injury. LINKED ARTICLES This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7 PMID:21449982

Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

PubMed Central

2012-01-01

Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and interpersonal care processes emerged as being most essential to quality care. These processes are important as they have a role in mitigating adverse outcomes, promoting involvement of women in their own care, and keeping women engaged in care. The findings suggest key considerations for the planning, delivery, and evaluation of prenatal care. Most notably, care should be woman-centred and embrace shared decision making as an essential element. PMID:22502640

[Effectiveness of a home visit program for adolescent mothers and their children].

PubMed

Aracena, Marcela; Leiva, Loreto; Undurraga, Consuelo; Krause, Mariane; Pérez, Carola; Cuadra, Victoria; Campos, María Silvia; Bedregal, Paula

2011-01-01

Home visiting is effective for the promotion and prevention of mother-child health in other countries, especially in vulnerable populations such as pregnant teenagers. To evaluate the association between receiving a home visiting program during pregnancy and child development during the first year of life, maternal mental health, perception of social support and school attendance. Cross sectional assessment of 132 teenage mother-sibling pairs. Of these, 87 received home visits and 45 were randomly assigned to a control group. The assessed variables were maternal mental health, perception of social support, life satisfaction, incorporation of mothers to school after delivery, child development and frequency of child abuse and neglect. Mothers that received home visits had a better mental health and went back to school in a higher proportion. No significant differences between groups were observed on perception of social support or child development. These results suggest the effectiveness of domiciliary visits performed by non-professionals, to improve mental health and social integration of teenage mothers.

Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study

PubMed Central

2012-01-01

Background Telehealth (TH) and telecare (TC) interventions are increasingly valued for supporting self-care in ageing populations; however, evaluation studies often report high rates of non-participation that are not well understood. This paper reports from a qualitative study nested within a large randomised controlled trial in the UK: the Whole System Demonstrator (WSD) project. It explores barriers to participation and adoption of TH and TC from the perspective of people who declined to participate or withdrew from the trial. Methods Qualitative semi-structured interviews were conducted with 22 people who declined to participate in the trial following explanations of the intervention (n = 19), or who withdrew from the intervention arm (n = 3). Participants were recruited from the four trial groups (with diabetes, chronic obstructive pulmonary disease, heart failure, or social care needs); and all came from the three trial areas (Cornwall, Kent, east London). Observations of home visits where the trial and interventions were first explained were also conducted by shadowing 8 members of health and social care staff visiting 23 people at home. Field notes were made of observational visits and explored alongside interview transcripts to elicit key themes. Results Barriers to adoption of TH and TC associated with non-participation and withdrawal from the trial were identified within the following themes: requirements for technical competence and operation of equipment; threats to identity, independence and self-care; expectations and experiences of disruption to services. Respondents held concerns that special skills were needed to operate equipment but these were often based on misunderstandings. Respondents’ views were often explained in terms of potential threats to identity associated with positive ageing and self-reliance, and views that interventions could undermine self-care and coping. Finally, participants were reluctant to risk potentially disruptive changes to existing services that were often highly valued. Conclusions These findings regarding perceptions of potential disruption of interventions to identity and services go beyond more common expectations that concerns about privacy and dislike of technology deter uptake. These insights have implications for health and social care staff indicating that more detailed information and time for discussion could be valuable especially on introduction. It seems especially important for potential recipients to have the opportunity to discuss their expectations and such views might usefully feed back into design and implementation. PMID:22834978

A qualitative study on coping behaviors and influencing factors among mothers in Japan raising children under three years old while experiencing physical and mental subjective symptoms.

PubMed

Kaso, Misato; Miyazaki, Kikuko; Nakayama, Takeo

2018-01-10

No studies illustrating the coping behaviors of mothers experiencing physical and mental subjective symptoms, or the factors that contribute to these behaviors, have been investigated. Therefore, the present study sought to develop a conceptual framework on the coping behaviors and contributing factors of mothers experiencing physical and mental subjective symptoms. This qualitative study involved theoretical sampling and semi-structured interviews of mothers who were raising children under 3 years of age in Japan and had experienced physical and mental subjective symptoms since giving birth. Women who were pregnant, required regular medical exams, or had difficulty communicating in Japanese were excluded. All mothers were recruited via personal contacts, snowball sampling, and posters at a community center and nursery schools. Analysis was conducted using the constant comparative method. The interview data were extracted in contextual units based on analytical themes, and concepts were generated. Relationships between concepts were investigated and categorized. To confirm theoretical saturation and ensure the validity of the data, a study supervisor was appointed, four qualitative researchers examined the results, and the interview respondents underwent member checking. There were a total of 21 participants. Thirteen categories were created from 29 concepts identified from the analytical theme "What do mothers do when raising children under 3 years of age while experiencing physical and mental subjective symptoms?" While experiencing subjective symptoms, mothers raising children under 3 years of age tended to lead a child-centric lifestyle and were hesitant to visit the doctor, not only because of typical reasons such as time and costs, but also because of factors related to their child. Some circumstances occurring while experiencing physical and mental subjective symptoms led mothers to put their own needs first and attempt to cope on their own as much as possible. As a result, most mothers would only visit a doctor after becoming seriously ill. Mothers raising children under 3 years of age in Japan tend to put their own needs on hold when experiencing subjective symptoms. As a result, they attempt to cope on their own and, at times, only visit a doctor after becoming seriously ill.

Home visits in primary care: contents and organisation in daily practice. Study protocol of a cross-sectional study.

PubMed

Voigt, Karen; Bojanowski, Stefan; Taché, Stephanie; Voigt, Roger; Bergmann, Antje

2016-02-26

Medical care of homebound patients by home visits is an integral part of primary care in Germany and other industrialised countries. Owing to the sociodemography and changes in the health system, the need for home visits is projected to increase rather than decrease. Our study will provide information on content and organisation of home visits. This evidence is needed to assure sufficient medical care for homebound patients. Germany is one of the European nations with highest proportions of elderly age groups, so that our results will be indicative for other European countries with comparable organisation of primary care. This cross-sectional study is conducted over a period of 12 months. All home visits of each participating family practice are documented within a 1-week time period. The anonymous documentation of home visits is carried out by the family practitioner or medical assistant conducting the home visit. All Saxon Family practitioners received study information and were personally invited to participate in our study. Almost 303 (of 2677) family practitioners expressed their interest to participate to generate data on the content and organisational characteristics of home visits. Data analysis of more than 4000 home visits will take into account several patient-related and system-related parameters. Descriptive and multivariate analysis will be carried out by using non-parametric methods. Regarding expected cluster structure of the data, a multilevel analysis will be necessary. The study received ethical approval by the Ethical Commission of the TU Dresden and adheres to the Declaration of Helsinki. Considering that the results of our project will be indicative for ageing societies with comparable organisation of primary care, we will publish them in international open access journals concerned with healthcare and primary care research and disseminate them by a final symposium and at national/international scientific events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Leveraging Collection Structure in Information Retrieval with Applications to Search in Conversational Social Media

ERIC Educational Resources Information Center

Elsas, Jonathan L.

2011-01-01

Social media collections are becoming increasingly important in the everyday life of Internet users. Recent statistics show that sites hosting social media and community-generated content account for five of the top ten most visited websites in the United States [4] are visited regularly by a broad cross-section of Internet users [61, 67, 115] and…

Interpretive Study of Research and Development in Elementary School Mathematics. Volume 3: Developmental Projects.

ERIC Educational Resources Information Center

Suydam, Marilyn N.; Riedesel, C. Alan

To gather the information for this section, visits were made to each of ten major curriculum development projects. These were selected because of the impact which each has had on curriculum reform--past, present, and future. It was not possible to visit every project, and several of the more significant ones, such as the Greater Cleveland…

The Bitterroot Ecosystem Management Research Project: What we have learned

Treesearch

Helen Y. Smith

2000-01-01

The varied topics presented in these symposium proceedings represent the diverse nature of the Bitterroot Ecosystem Management Research Project (BEMRP). Separated into six sections, the papers cover the different themes researched by BEMRP collaborators as well as brief overviews of five other ecosystem management projects. The sections are: Understanding the Ecosystem...

Children's Literature--Passage to the Sea.

ERIC Educational Resources Information Center

Bagnall, Norma

Focusing on books that use the sea as their theme, this booklet provides guidelines for teachers on how to integrate marine-related children's literature into the classroom. The first section of the booklet presents brief synopses of eight sea-related books while the second section contains 39 learning center activities, including knot tying,…

Current Sports: Medicine Issues. Annual Safety Education Review--1973.

ERIC Educational Resources Information Center

Craig, Timothy T., Ed.

This document is a collection of papers whose theme is sports safety. Section one, "Government Interest in Sports Safety," includes an article on Washington, D.C.'s focus on sports safety. Section two, "Medical Aspects of Safety in Sports," includes articles regarding the medical basis of restriction from athletics, orthopaedic restrictions, and…

The Barbarian within and Other Fugitive Essays and Studies.

ERIC Educational Resources Information Center

Ong, Walter J.

The fifteen essays collected here are grouped under three sections, each dealing with a different, but related theme. The first section, exploring the relationship of literature to the human being, includes "The Jinnee in the Well Wrought Urn,""A Dialectic of Aural and Objective Correlatives,""Metaphor and the Twinned Vision," and"Voice as Summons…

Reclaiming Native Education: Activism, Teaching and Leadership.

ERIC Educational Resources Information Center

Stoll, Amy, Ed.

1998-01-01

The bulk of this theme issue of Cultural Survival Quarterly consists of a 41-page "focus" section on indigenous peoples' efforts to regain control of their children's education and on the role of indigenous educators as agents of change. Following an introduction by Nimachia Hernandez and Nicole Thornton, the articles in this section are:…

Celebration: A Planning Guide for Ethnic Heritage and Culture Weeks.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This guide is designed to help teachers and supervisors in planning activities for observing Ethnic Heritage and Culture Weeks in the New York City Board of Education calendar. The first sections discuss goals and general heritage and culture themes, activities, and materials. The following sections each present suggestions for individual ethnic…

Real World Connections Through Videoconferences

NASA Technical Reports Server (NTRS)

Peterson, Ruth; Lytle, John (Technical Monitor)

2002-01-01

The Learning Technologies Project (LTP) is a partner in the National Aeronautics and Space Administration's (NASA's) educational technology program unit, an electronic community center that fosters interaction, collaboration, and sharing among educators, learners, and scientists. The goal of the NASA Glenn Research Center's Learning Technologies Project is to increase students' interest and proficiency in mathematics, science, and technology through the use of computing and communications technology and by using NASA's mission in aerospace technology as a theme. The primary components are: (1) Beginner's Guide to Aeronautics, including interactive simulation packages and teacher-created online activities. (2) NASA Virtual Visits, videoconferences (with online pre-post-conference activities) connecting students and teachers to NASA scientists and researchers.

KSC-2014-4264

NASA Image and Video Library

2014-10-15

CAPE CANAVERAL, Fla. – Michael Kersjes, author and former special education teacher and football coach from Michigan, speaks to workers during the Disability Awareness and Action Working Group, or DAAWG, event at NASA's Kennedy Space Center in Florida. The theme of his presentation was "Power of the Human Spirit." Kersjes is the author of the book, "A Smile as Big as the Moon," which told the true story of how he worked to get special education students into Space Camp, a competitive education program at the U.S. Space and Rocket Center in Huntsville, Alabama. His book was made into a movie in 2012. For information on Kennedy's diversity programs, visit http://odeo.ksc.nasa.gov. Photo credit: NASA/Kim Shiflett

KSC-2014-4263

NASA Image and Video Library

2014-10-15

CAPE CANAVERAL, Fla. – Michael Kersjes, author and former special education teacher and football coach from Michigan, speaks to workers during the Disability Awareness and Action Working Group, or DAAWG, event at NASA's Kennedy Space Center in Florida. The theme of his presentation was "Power of the Human Spirit." Kersjes is the author of the book, "A Smile as Big as the Moon," which told the true story of how he worked to get special education students into Space Camp, a competitive education program at the U.S. Space and Rocket Center in Huntsville, Alabama. His book was made into a movie in 2012. For information on Kennedy's diversity programs, visit http://odeo.ksc.nasa.gov. Photo credit: NASA/Kim Shiflett

KSC-2014-4260

NASA Image and Video Library

2014-10-15

CAPE CANAVERAL, Fla. – Michael Kersjes, author and former special education teacher and football coach from Michigan, speaks to workers during the Disability Awareness and Action Working Group, or DAAWG, event at NASA's Kennedy Space Center in Florida. The theme of his presentation was "Power of the Human Spirit." Kersjes is the author of the book, "A Smile as Big as the Moon," which told the true story of how he worked to get special education students into Space Camp, a competitive education program at the U.S. Space and Rocket Center in Huntsville, Alabama. His book was made into a movie in 2012. For information on Kennedy's diversity programs, visit http://odeo.ksc.nasa.gov. Photo credit: NASA/Kim Shiflett

KSC-2014-4261

NASA Image and Video Library

2014-10-15

CAPE CANAVERAL, Fla. – Michael Kersjes, author and former special education teacher and football coach from Michigan, speaks to workers during the Disability Awareness and Action Working Group, or DAAWG, event at NASA's Kennedy Space Center in Florida. The theme of his presentation was "Power of the Human Spirit." Kersjes is the author of the book, "A Smile as Big as the Moon," which told the true story of how he worked to get special education students into Space Camp, a competitive education program at the U.S. Space and Rocket Center in Huntsville, Alabama. His book was made into a movie in 2012. For information on Kennedy's diversity programs, visit http://odeo.ksc.nasa.gov. Photo credit: NASA/Kim Shiflett

The ED use and non-urgent visits of elderly patients.

PubMed

Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

2016-12-01

To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001). While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001). For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001). The prevalence of upper respiratory tract infection (URTI) was the highest within the elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

National trends in pediatric use of anticonvulsants.

PubMed

Tran, Allen R; Zito, Julie M; Safer, Daniel J; Hundley, Sarah D

2012-11-01

This research study aimed to assess national trends in pediatric use of anticonvulsants for seizures and psychiatric disorders. In a cross-sectional design, data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey were analyzed. Outpatient visit information for youths (ages 0-17 years) was grouped by year for 1996-1997, 2000-2001, 2004-2005, and 2008-2009. Six of the most common anticonvulsant drugs used for psychiatric conditions were examined. Psychiatric diagnoses and seizure or convulsion diagnoses were identified with ICD-9-CM codes. The primary outcome measure was percentage prevalence of visits for anticonvulsants that included a psychiatric diagnosis as a proportion of total youth visits for an anticonvulsant. Total, diagnosis-stratified, and drug-specific visits, as well as visits for concomitant anticonvulsants and psychotropics, were analyzed. As a proportion of total youth visits for anticonvulsants, visits with a psychiatric diagnosis increased 1.7 fold (p<.001), whereas the proportion of seizure-related visits did not change significantly. Regardless of diagnosis, anticonvulsant use significantly increased, from .33% to .68% of total youth visits in the 14-year period. There were significant increases in anticonvulsant use to treat pediatric bipolar disorder and disruptive behavior disorders. Visits noting divalproex decreased while visits noting lamotrigine increased among visits involving a psychiatric diagnosis. The concomitant use of stimulants and anticonvulsants significantly increased in visits noting a psychiatric diagnosis. Whereas anticonvulsant use for seizure disorders across the 14-year period was stable, the use of these drugs for psychiatric conditions rose to a dominant position. The growth of concomitant and off-label use to treat behavioral disorders raises questions about effectiveness and safety in community populations of youths.

Reducing Hispanic children's obesity risk factors in the first 1000 days of life: a qualitative analysis.

PubMed

Woo Baidal, Jennifer A; Criss, Shaniece; Goldman, Roberta E; Perkins, Meghan; Cunningham, Courtney; Taveras, Elsie M

2015-01-01

Modifiable behaviors during the first 1000 days (conception age 24 months) mediate Hispanic children's obesity disparities. We aimed to examine underlying reasons for early life obesity risk factors and identify potential early life intervention strategies. We conducted 7 focus groups with 49 Hispanic women who were pregnant or had children < age 24 months. Domains included influences on childhood obesity risk factors and future intervention ideas. We analyzed data with immersion-crystallization methods until no new themes emerged. Themes included coping with pregnancy may trump healthy eating and physical activity; early life weight gain is unrelated to later life obesity; fear of infant hunger drives bottle and early solids introduction; beliefs about infant taste promote early solids and sugary beverage introduction; and belief that screen time promotes infant development. Mothers identified physicians, nutritionists, and relatives as important health information sources and expressed interest in mobile technology and group or home visits for interventions. Opportunities exist in the first 1000 days to improve Hispanic mothers' understanding of the role of early life weight gain in childhood obesity and other obesity risk factors. Interventions that link health care and public health systems and include extended family may prevent obesity among Hispanic children.

Augmented reality: past, present, future

NASA Astrophysics Data System (ADS)

Inzerillo, Laura

2013-03-01

A great opportunity has permitted to carry out a cultural, historical, architectural and social research with great impact factor on the international cultural interest. We are talking about the realization of a museum whose the main theme is the visit and the discovery of a monument of great prestige: the monumental building the "Steri" in Palermo. The museum is divided into sub themes including the one above all, that has aroused the international interest so much that it has been presented the instance to include the museum in the cultural heritage of UNESCO. It is the realization of a museum path that regards the cells of the Inquisition, which are located just inside of some buildings of the monumental building. The project, as a whole, is faced, in a total view, between the various competences implicated: historic, chemic, architectonic, topographic, drawing, representation, virtual communication, informatics. The birth of the museum will be a sum of the results of all these disciplines involved. Methodology, implementation, fruition, virtual museum, goals, 2D graphic restitution, effects on the cultural heritage and landscape environmental, augmented reality, Surveying 2D and 3D, hi-touch screen, Photogrammetric survey, Photographic survey, representation, drawing 3D and more than this has been dealt with this research.

Lost in translation? Rethinking First Nation education via LUCID insights

NASA Astrophysics Data System (ADS)

Nielsen, Thomas William

2010-10-01

This paper reports on findings from the Learning for Understanding through Culturally-Inclusive Imaginative Development project (LUCID). LUCID has been a 5-year (2004-2009) research and implementation endeavour and a partnership between Simon Fraser University (SFU) and three districts in British Columbia, Canada. Via emotionally engaging pedagogies and a culturally-inclusive curriculum, the project aimed at improving students' educational experience, particularly First Nations learners. Using a combination of Actor Network Theory (Latour, 2005, in: Reassembling the social: an introduction to Actor-Network Theory, Oxford University Press, Oxford) and Hermeneutic Phenomenology (Van Manen, 1990, in: Researching lived experience, The State University of New York, New York), site visits and interview data were examined with reference to the (f)actors influencing project objectives. Although each school district was unique, shared themes included: the importance of creating a community with shared intent; the role of executives as potential "change agents"; the problematic nature of emotionally-engaging teaching; and the complex influences of cultural and historical trauma. The latter theme is explored in particular, presenting the argument that language deficiency and a consequent lack of autonomy might be at the root of many problems experienced in First Nations communities.

The "Spirit of New Orleans": translating a model of intervention with maltreated children and their families for the Glasgow context.

PubMed

Minnis, Helen; Bryce, Graham; Phin, Louise; Wilson, Phil

2010-10-01

Children in care have higher rates of mental health problems than the general population and placement instability contributes to this. Children are both most vulnerable to the effects of poor quality care and most responsive to treatment in the early weeks and months of life yet, in the UK, permanency decisions are generally not in place until around the age of four. We aimed to understand the components of an innovative system for assessing and intervening with maltreated children and their families developed in New Orleans and to consider how it might be implemented in Glasgow, UK. During and after a visit to New Orleans by a team of Glasgow practitioners, eight key interviews and meetings with New Orleans and Glasgow staff were audio-recorded. Qualitative analysis of verbatim transcripts identified key themes. Themes highlighted shared aspects of the context and attitudes of the two teams, identified gaps in the Glasgow service and steps that would be needed to implement a version of the New Orleans model in Glasgow. Our discussions with the New Orleans team have highlighted concrete steps we can take, in Glasgow, to make better decision-making for vulnerable children a reality.

The proportion of work-related emergency department visits not expected to be paid by workers' compensation: implications for occupational health surveillance, research, policy, and health equity.

PubMed

Groenewold, Matthew R; Baron, Sherry L

2013-12-01

To examine trends in the proportion of work-related emergency department visits not expected to be paid by workers' compensation during 2003-2006, and to identify demographic and clinical correlates of such visits. A total of 3,881 work-related emergency department visit records drawn from the 2003-2006 National Hospital Ambulatory Medical Care Surveys. Secondary, cross-sectional analyses of work-related emergency department visit data were performed. Odds ratios and 95 percent confidence intervals were modeled using logistic regression. A substantial and increasing proportion of work-related emergency department visits in the United States were not expected to be paid by workers' compensation. Private insurance, Medicaid, Medicare, and workers themselves were expected to pay for 40 percent of the work-related emergency department visits with this percentage increasing annually. Work-related visits by blacks, in the South, to for-profit hospitals and for work-related illnesses were all more likely not to be paid by workers' compensation. Emergency department-based surveillance and research that determine work-relatedness on the basis of expected payment by workers' compensation systematically underestimate the occurrence of occupational illness and injury. This has important methodological and policy implications. © Health Research and Educational Trust.

Tribal casinos in California: the last vestige of indoor smoking

PubMed Central

2012-01-01

Background High levels of airborne particles from secondhand smoke have been reported in California Indian casinos. Yet, little is known regarding the smoking status of casino patrons, their avoidance of secondhand smoke while visiting, and their views on a hypothetical smoking ban. Methods Predictors of visiting an Indian casino were assessed among participants of the 2008 California Tobacco Survey (n = 10, 397). Exposure to and avoidance of secondhand smoke were subsequently analyzed among a subset of participants who had visited a casino in the year prior to the survey (n = 3, 361). Results Ethnic minorities, older individuals, current smokers and residents of sparsely populated regions of California were more likely than other demographic groups to visit a tribal casino. Avoidance of secondhand smoke was more frequent among the never smokers than former and current smokers, particularly those who last visited a casino lacking physical separation between non-smoking and smoking sections. The never smokers versus current smokers disproportionately expressed a willingness to extend their stay and visit again if smoking were prohibited. Conclusions If casinos became smoke free, then it is anticipated that they would be visited by a significantly larger number of Californians, including both patrons and those who otherwise would not have visited a casino. PMID:22364487

Consequences of the presence and absence of empathy during consultations in primary care: A focus group study with patients.

PubMed

Derksen, Frans; Olde Hartman, Tim C; van Dijk, Annelies; Plouvier, Annette; Bensing, Jozien; Lagro-Janssen, Antoine

2017-05-01

There is general consensus that explicit expression of empathy in patient-GP communication is highly valued. Yet, little is known so far about patients' personal experiences with and expectations of empathy. Insight into these experiences and expectations can help to achieve more person-centeredness in GP practice care. Participants were recruited by a press report in local newspapers. adults, a visit to the GP in the previous year. Exclusion criterion: a formal complaint procedure. Five focus groups were conducted. The discussions were analyzed using constant comparative analysis. In total 28 participants took part in the focus group interviews. Three themes were identified: (1) Personalized care and enablement when empathy is present; (2) Frustrations when empathy is absent; (3) Potential pitfalls of empathy. Participants indicated that empathy helps build a more personal relationship and makes them feel welcome and at ease. Furthermore, empathy makes them feel supported and enabled. A lack of empathy can result in avoiding a visit to the GP. Empathy is perceived as an important attribute of patient-GP communication. Its presence results in feelings of satisfaction, relief and trust. Furthermore, it supports patients, resulting in new coping strategies. A lack of empathy causes feelings of frustration and disappointment and can lead to patients avoiding visiting their GP. More explicit attention should be given to empathy during medical education in general and during vocational GP-training. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Probiotics, fibre and herbal medicinal products for functional and inflammatory bowel disorders

PubMed Central

Ianiro, Gianluca; Pecere, Silvia; Bibbò, Stefano; Cammarota, Giovanni

2016-01-01

Functional bowel disorders (FBD), mainly irritable bowel syndrome (IBS) and functional constipation (FC, also called chronic idiopathic constipation), are very common worldwide. Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, although less common, has a strong impact on patients' quality of life, as well as being highly expensive for our healthcare. A definite cure for those disorders is still yet to come. Over the years, several therapeutic approaches complementary or alternative to traditional pharmacological treatments, including probiotics, prebiotics, synbiotics, fibre and herbal medicinal products, have been investigated for the management of both groups of diseases. However, most available studies are biased by several drawbacks, including small samples and poor methodological quality. Probiotics, in particular Saccharomyces boulardii and Lactobacilli (among which Lactobacillus rhamnosus), synbiotics, psyllium, and some herbal medicinal products, primarily peppermint oil, seem to be effective in ameliorating IBS symptoms. Synbiotics and fibre seem to be beneficial in FC patients. The probiotic combination VSL#3 may be effective in inducing remission in patients with mild‐to‐moderate ulcerative colitis, in whom Escherichia coli Nissle 1917 seems to be as effective as mesalamine in maintaining remission. No definite conclusions can be drawn as to the efficacy of fibre and herbal medicinal products in IBD patients due to the low number of studies and the lack of randomized controlled trials that replicate the results obtained in the individual studies conducted so far. Thus, further, well‐designed studies are needed to address the real role of these therapeutic options in the management of both FBD and IBD. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27696378

Nutraceuticals in hypercholesterolaemia: an overview

PubMed Central

Santini, Antonello

2016-01-01

Growing attention is now being given to the possible preventive/alternative ways to avoid illness onset. Changes in lifestyle and food habits are taking over from the conventional pharmaceutical‐based approach, especially for chronic pathologies. Nutraceuticals have been proposed as key tools for the prevention and cure of some pathological conditions. This is leading research to develop new formulations based on these pharma‐foods addressed in a specific way to prevent and cure health issues, which, in turn, will have an effect on therapy‐related costs sustained by any National Health Organization. According to existing regulations, nutraceuticals cannot be categorized as either food or drugs but, by definition, often inhabit a grey area in between the two, being assimilated into food supplements, notwithstanding the beneficial properties that they can provide for some pathological conditions. A nutraceuticals‐based approach for health management, in particular for some pathological conditions, has resulted in a worldwide growing ‘nutraceutical’ revolution. An outstanding example is the approach to the ‘metabolic syndrome’, which includes overweight, obesity and cardiovascular‐related diseases, causing a sort of cascade of chronic health conditions, which is becoming a norm in modern life. Hypercholesterolaemia is one of these. It represents an example of a pathology that can be linked to both a poor lifestyle and dietary habits. The nutraceutical approach to hypercholesterolaemia is described in the present review as a possible alternative to the conventional drug‐based therapy. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27685833

Crosstalk of mitochondria with NADPH oxidase via reactive oxygen and nitrogen species signalling and its role for vascular function

PubMed Central

Di Lisa, Fabio; Oelze, Matthias; Kröller‐Schön, Swenja; Steven, Sebastian; Schulz, Eberhard; Münzel, Thomas

2016-01-01

Abstract Cardiovascular diseases are associated with and/or caused by oxidative stress. This concept has been proven by using the approach of genetic deletion of reactive species producing (pro‐oxidant) enzymes as well as by the overexpression of reactive species detoxifying (antioxidant) enzymes leading to a marked reduction of reactive oxygen and nitrogen species (RONS) and in parallel to an amelioration of the severity of diseases. Likewise, the development and progression of cardiovascular diseases is aggravated by overexpression of RONS producing enzymes as well as deletion of antioxidant RONS detoxifying enzymes. Thus, the consequences of the interaction (redox crosstalk) of superoxide/hydrogen peroxide produced by mitochondria with other ROS producing enzymes such as NADPH oxidases (Nox) are of outstanding importance and will be discussed including the consequences for endothelial nitric oxide synthase (eNOS) uncoupling as well as the redox regulation of the vascular function/tone in general (soluble guanylyl cyclase, endothelin‐1, prostanoid synthesis). Pathways and potential mechanisms leading to this crosstalk will be analysed in detail and highlighted by selected examples from the current literature including hypoxia, angiotensin II‐induced hypertension, nitrate tolerance, aging and others. The general concept of redox‐based activation of RONS sources via “kindling radicals” and enzyme‐specific “redox switches” will be discussed providing evidence that mitochondria represent key players and amplifiers of the burden of oxidative stress. Linked Articles This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc PMID:26660451

The oxidative stress theory of disease: levels of evidence and epistemological aspects.

PubMed

Ghezzi, Pietro; Jaquet, Vincent; Marcucci, Fabrizio; Schmidt, Harald H H W

2017-06-01

The theory that oxidative stress (OS) is at the root of several diseases is extremely popular. However, so far, no antioxidant has been recommended or offered by healthcare systems neither has any been approved as therapy by regulatory agencies that base their decisions on evidence-based medicine. This is simply because, so far, despite many preclinical and clinical studies indicating a beneficial effect of antioxidants in many disease conditions, randomised clinical trials have failed to provide the evidence of efficacy required for drug approval. In this review, we discuss the levels of evidence required to claim causality in preclinical research on OS, the weakness of the oversimplification associated with OS theory of disease and the importance of the narrative in its popularity. Finally, from a more translational perspective, we discuss the reasons why antioxidants acting by scavenging ROS might not only prevent their detrimental effects but also interfere with essential signalling roles. We propose that ROS have a complex metabolism and are generated by different enzymes at diverse sites and at different times. Aggregating this plurality of systems into a single theory of disease may not be the best way to develop new drugs, and future research may need to focus on specific oxygen-toxifying pathways rather than on non-specific ROS scavengers. Finally, similarly to what is nowadays required for clinical trials, we recommend making unpublished data available in repositories (open data), as this will allow big data approaches or meta-analyses, without the drawbacks of publication bias. This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc. © 2016 The British Pharmacological Society.

The actions of relaxin on the human cardiovascular system.

PubMed

Sarwar, Mohsin; Du, Xiao-Jun; Dschietzig, Thomas B; Summers, Roger J

2017-05-01

The insulin-like peptide relaxin, originally identified as a hormone of pregnancy, is now known to exert a range of pleiotropic effects including vasodilatory, anti-fibrotic, angiogenic, anti-apoptotic and anti-inflammatory effects in both males and females. Relaxin produces these effects by binding to a cognate receptor RXFP1 and activating a variety of signalling pathways including cAMP, cGMP and MAPKs as well as by altering gene expression of TGF-β, MMPs, angiogenic growth factors and endothelin receptors. The peptide has been shown to be effective in halting or reversing many of the adverse effects including fibrosis in animal models of cardiovascular disease including ischaemia/reperfusion injury, myocardial infarction, hypertensive heart disease and cardiomyopathy. Relaxin given to humans is safe and produces favourable haemodynamic changes. Serelaxin, the recombinant form of relaxin, is now in extended phase III clinical trials for the treatment of acute heart failure. Previous clinical studies indicated that a 48 h infusion of relaxin improved 180 day mortality, yet the mechanism underlying this effect is not clear. This article provides an overview of the cellular mechanism of effects of relaxin and summarizes its beneficial actions in animal models and in the clinic. We also hypothesize potential mechanisms for the clinical efficacy of relaxin, identify current knowledge gaps and suggest new ways in which relaxin could be useful therapeutically. This article is part of a themed section on Recent Progress in the Understanding of Relaxin Family Peptides and their Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.10/issuetoc. © 2016 The British Pharmacological Society.

Modelling headache and migraine and its pharmacological manipulation

PubMed Central

Erdener, S E; Dalkara, T

2014-01-01

Similarities between laboratory animals and humans in anatomy and physiology of the cephalic nociceptive pathways have allowed scientists to create successful models that have significantly contributed to our understanding of headache. They have also been instrumental in the development of novel anti-migraine drugs different from classical pain killers. Nevertheless, modelling the mechanisms underlying primary headache disorders like migraine has been challenging due to limitations in testing the postulated hypotheses in humans. Recent developments in imaging techniques have begun to fill this translational gap. The unambiguous demonstration of cortical spreading depolarization (CSD) during migraine aura in patients has reawakened interest in studying CSD in animals as a noxious brain event that can activate the trigeminovascular system. CSD-based models, including transgenics and optogenetics, may more realistically simulate pain generation in migraine, which is thought to originate within the brain. The realization that behavioural correlates of headache and migrainous symptoms like photophobia can be assessed quantitatively in laboratory animals, has created an opportunity to directly study the headache in intact animals without the confounding effects of anaesthetics. Headache and migraine-like episodes induced by administration of glyceryltrinitrate and CGRP to humans and parallel behavioural and biological changes observed in rodents create interesting possibilities for translational research. Not unexpectedly, species differences and model-specific observations have also led to controversies as well as disappointments in clinical trials, which, in return, has helped us improve the models and advance our understanding of headache. Here, we review commonly used headache and migraine models with an emphasis on recent developments. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24611635

Modelling cognitive affective biases in major depressive disorder using rodents

PubMed Central

Hales, Claire A; Stuart, Sarah A; Anderson, Michael H; Robinson, Emma S J

2014-01-01

Major depressive disorder (MDD) affects more than 10% of the population, although our understanding of the underlying aetiology of the disease and how antidepressant drugs act to remediate symptoms is limited. Major obstacles include the lack of availability of good animal models that replicate aspects of the phenotype and tests to assay depression-like behaviour in non-human species. To date, research in rodents has been dominated by two types of assays designed to test for depression-like behaviour: behavioural despair tests, such as the forced swim test, and measures of anhedonia, such as the sucrose preference test. These tests have shown relatively good predictive validity in terms of antidepressant efficacy, but have limited translational validity. Recent developments in clinical research have revealed that cognitive affective biases (CABs) are a key feature of MDD. Through the development of neuropsychological tests to provide objective measures of CAB in humans, we have the opportunity to use ‘reverse translation’ to develop and evaluate whether similar methods are suitable for research into MDD using animals. The first example of this approach was reported in 2004 where rodents in a putative negative affective state were shown to exhibit pessimistic choices in a judgement bias task. Subsequent work in both judgement bias tests and a novel affective bias task suggest that these types of assay may provide translational methods for studying MDD using animals. This review considers recent work in this area and the pharmacological and translational validity of these new animal models of CABs. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24467454

Targeting survival pathways in chronic myeloid leukaemia stem cells

PubMed Central

Sinclair, A; Latif, A L; Holyoake, T L

2013-01-01

Chronic myeloid leukaemia (CML) is a clonal myeloproliferative disorder characterized by the presence of a fusion oncogene BCR-ABL, which encodes a protein with constitutive TK activity. The implementation of tyrosine kinase inhibitors (TKIs) marked a major advance in CML therapy; however, there are problems with current treatment. For example, relapse occurs when these drugs are discontinued in the majority of patients who have achieved a complete molecular response on TKI and these agents are less effective in patients with mutations in the BCR-ABL kinase domain. Importantly, TKI can effectively target proliferating mature cells, but do not eradicate quiescent leukaemic stem cells (LSCs), therefore allowing disease persistence despite treatment. It is essential that alternative strategies are used to target the LSC population. BCR-ABL activation is responsible for the modulation of different signalling pathways, which allows the LSC fraction to evade cell death. Several pathways have been shown to be modulated by BCR-ABL, including PI3K/AKT/mTOR, JAK-STAT and autophagy signalling pathways. Targeting components of these survival pathways, alone or in combination with TKI, therefore represents an attractive potential therapeutic approach for targeting the LSC. However, many pathways are also active in normal stem cells. Therefore, potential targets must be validated to effectively eradicate CML stem cells while sparing normal counterparts. This review summarizes the main pathways modulated in CML stem cells, the recent developments and the use of novel drugs to target components in these pathways which may be used to target the LSC population. Linked Articles This article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-8 PMID:23517124

Nutraceuticals in hypercholesterolaemia: an overview.

PubMed

Santini, Antonello; Novellino, Ettore

2017-06-01

Growing attention is now being given to the possible preventive/alternative ways to avoid illness onset. Changes in lifestyle and food habits are taking over from the conventional pharmaceutical-based approach, especially for chronic pathologies. Nutraceuticals have been proposed as key tools for the prevention and cure of some pathological conditions. This is leading research to develop new formulations based on these pharma-foods addressed in a specific way to prevent and cure health issues, which, in turn, will have an effect on therapy-related costs sustained by any National Health Organization. According to existing regulations, nutraceuticals cannot be categorized as either food or drugs but, by definition, often inhabit a grey area in between the two, being assimilated into food supplements, notwithstanding the beneficial properties that they can provide for some pathological conditions. A nutraceuticals-based approach for health management, in particular for some pathological conditions, has resulted in a worldwide growing 'nutraceutical' revolution. An outstanding example is the approach to the 'metabolic syndrome', which includes overweight, obesity and cardiovascular-related diseases, causing a sort of cascade of chronic health conditions, which is becoming a norm in modern life. Hypercholesterolaemia is one of these. It represents an example of a pathology that can be linked to both a poor lifestyle and dietary habits. The nutraceutical approach to hypercholesterolaemia is described in the present review as a possible alternative to the conventional drug-based therapy. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Cannabimimetic phytochemicals in the diet - an evolutionary link to food selection and metabolic stress adaptation?

PubMed

Gertsch, Jürg

2017-06-01

The endocannabinoid system (ECS) is a major lipid signalling network that plays important pro-homeostatic (allostatic) roles not only in the nervous system but also in peripheral organs. There is increasing evidence that there is a dietary component in the modulation of the ECS. Cannabinoid receptors in hominids co-evolved with diet, and the ECS constitutes a feedback loop for food selection and energy metabolism. Here, it is postulated that the mismatch of ancient lipid genes of hunter-gatherers and pastoralists with the high-carbohydrate diet introduced by agriculture could be compensated for via dietary modulation of the ECS. In addition to the fatty acid precursors of endocannabinoids, the potential role of dietary cannabimimetic phytochemicals in agriculturist nutrition is discussed. Dietary secondary metabolites from vegetables and spices able to enhance the activity of cannabinoid-type 2 (CB 2 ) receptors may provide adaptive metabolic advantages and counteract inflammation. In contrast, chronic CB 1 receptor activation in hedonic obese individuals may enhance pathophysiological processes related to hyperlipidaemia, diabetes, hepatorenal inflammation and cardiometabolic risk. Food able to modulate the CB 1 /CB 2 receptor activation ratio may thus play a role in the nutrition transition of Western high-calorie diets. In this review, the interplay between diet and the ECS is highlighted from an evolutionary perspective. The emerging potential of cannabimimetic food as a nutraceutical strategy is critically discussed. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases.

PubMed

Kunnumakkara, Ajaikumar B; Bordoloi, Devivasha; Padmavathi, Ganesan; Monisha, Javadi; Roy, Nand Kishor; Prasad, Sahdeo; Aggarwal, Bharat B

2017-06-01

Curcumin, a yellow pigment in the Indian spice Turmeric (Curcuma longa), which is chemically known as diferuloylmethane, was first isolated exactly two centuries ago in 1815 by two German Scientists, Vogel and Pelletier. However, according to the pubmed database, the first study on its biological activity as an antibacterial agent was published in 1949 in Nature and the first clinical trial was reported in The Lancet in 1937. Although the current database indicates almost 9000 publications on curcumin, until 1990 there were less than 100 papers published on this nutraceutical. At the molecular level, this multitargeted agent has been shown to exhibit anti-inflammatory activity through the suppression of numerous cell signalling pathways including NF-κB, STAT3, Nrf2, ROS and COX-2. Numerous studies have indicated that curcumin is a highly potent antimicrobial agent and has been shown to be active against various chronic diseases including various types of cancers, diabetes, obesity, cardiovascular, pulmonary, neurological and autoimmune diseases. Furthermore, this compound has also been shown to be synergistic with other nutraceuticals such as resveratrol, piperine, catechins, quercetin and genistein. To date, over 100 different clinical trials have been completed with curcumin, which clearly show its safety, tolerability and its effectiveness against various chronic diseases in humans. However, more clinical trials in different populations are necessary to prove its potential against different chronic diseases in humans. This review's primary focus is on lessons learnt about curcumin from clinical trials. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The British Pharmacological Society.

Dietary salt blunts vasodilation by stimulating epithelial sodium channels in endothelial cells from salt-sensitive Dahl rats.

PubMed

Wang, Zi-Rui; Liu, Hui-Bin; Sun, Ying-Ying; Hu, Qing-Qing; Li, Yu-Xia; Zheng, Wei-Wan; Yu, Chang-Jiang; Li, Xin-Yuan; Wu, Ming-Ming; Song, Bin-Lin; Mu, Jian-Jun; Yuan, Zu-Yi; Zhang, Zhi-Ren; Ma, He-Ping

2018-04-01

Our recent studies show that the reduced activity of epithelial sodium channels (ENaC) in endothelial cells accounts for the adaptation of vasculature to salt in Sprague-Dawley rats. The present study examines a hypothesis that enhanced ENaC activity mediates the loss of vasorelaxation in Dahl salt-sensitive (SS) rats. We used the cell-attached patch-clamp technique to record ENaC activity in split-open mesenteric arteries. Western blot and immunofluorescence staining were used to evaluate the levels of aldosterone, ENaC, eNOS and NO. Blood pressure was measured with the tail-cuff method and the artery relaxation was measured with the wire myograph assay. High-salt (HS) diet significantly increased plasma aldosterone and ENaC activity in the endothelial cells of Dahl SS rats. The endothelium-dependent artery relaxation was blunted by HS challenge in these rats. Amiloride, a potent blocker of ENaC, increased both phosphorylated eNOS and NO and therefore prevented the HS-induced loss of vasorelaxation. As, in SS rats, endogenous aldosterone was already elevated by HS challenge, exogenous aldosterone did not further elevate ENaC activity in the rats fed with HS. Eplerenone, a mineralocorticoid receptor antagonist, attenuated the effects of HS on both ENaC activity and artery relaxation. These data suggest that HS diet blunts artery relaxation and causes hypertension via a pathway associated with aldosterone-dependent activation of ENaC in endothelial cells. This pathway provides one of the mechanisms by which HS causes hypertension in Dahl SS rats. This article is part of a themed section on Spotlight on Small Molecules in Cardiovascular Diseases. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.8/issuetoc. © 2017 The British Pharmacological Society.

Calcium channel modulation as a target in chronic pain control

PubMed Central

Montagut‐Bordas, Carlota; Dickenson, Anthony H

2017-01-01

Neuropathic pain remains poorly treated for large numbers of patients, and little progress has been made in developing novel classes of analgesics. To redress this issue, ziconotide (Prialt™) was developed and approved as a first‐in‐class synthetic version of ω‐conotoxin MVIIA, a peptide blocker of Cav2.2 channels. Unfortunately, the impracticalities of intrathecal delivery, low therapeutic index and severe neurological side effects associated with ziconotide have restricted its use to exceptional circumstances. Ziconotide exhibits no state or use‐dependent block of Cav2.2 channels; activation state‐dependent blockers were hypothesized to circumvent the side effects of state‐independent blockers by selectively targeting high‐frequency firing of nociceptive neurones in chronic pain states, thus alleviating aberrant pain but not affecting normal sensory transduction. Unfortunately, numerous drugs, including state‐dependent calcium channel blockers, have displayed efficacy in preclinical models but have subsequently been disappointing in clinical trials. In recent years, it has become more widely acknowledged that trans‐aetiological sensory profiles exist amongst chronic pain patients and may indicate similar underlying mechanisms and drug sensitivities. Heterogeneity amongst patients, a reliance on stimulus‐evoked endpoints in preclinical studies and a failure to utilize translatable endpoints, all are likely to have contributed to negative clinical trial results. We provide an overview of how electrophysiological and operant‐based assays provide insight into sensory and affective aspects of pain in animal models and how these may relate to chronic pain patients in order to improve the bench‐to‐bedside translation of calcium channel modulators. Linked Articles This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc PMID:28320042

Cannabimimetic phytochemicals in the diet – an evolutionary link to food selection and metabolic stress adaptation?*

PubMed Central

2017-01-01

The endocannabinoid system (ECS) is a major lipid signalling network that plays important pro‐homeostatic (allostatic) roles not only in the nervous system but also in peripheral organs. There is increasing evidence that there is a dietary component in the modulation of the ECS. Cannabinoid receptors in hominids co‐evolved with diet, and the ECS constitutes a feedback loop for food selection and energy metabolism. Here, it is postulated that the mismatch of ancient lipid genes of hunter‐gatherers and pastoralists with the high‐carbohydrate diet introduced by agriculture could be compensated for via dietary modulation of the ECS. In addition to the fatty acid precursors of endocannabinoids, the potential role of dietary cannabimimetic phytochemicals in agriculturist nutrition is discussed. Dietary secondary metabolites from vegetables and spices able to enhance the activity of cannabinoid‐type 2 (CB2) receptors may provide adaptive metabolic advantages and counteract inflammation. In contrast, chronic CB1 receptor activation in hedonic obese individuals may enhance pathophysiological processes related to hyperlipidaemia, diabetes, hepatorenal inflammation and cardiometabolic risk. Food able to modulate the CB1/CB2 receptor activation ratio may thus play a role in the nutrition transition of Western high‐calorie diets. In this review, the interplay between diet and the ECS is highlighted from an evolutionary perspective. The emerging potential of cannabimimetic food as a nutraceutical strategy is critically discussed. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27891602

Sex-dependent long-term effects of adolescent exposure to THC and/or MDMA on neuroinflammation and serotoninergic and cannabinoid systems in rats.

PubMed

Lopez-Rodriguez, Ana Belen; Llorente-Berzal, Alvaro; Garcia-Segura, Luis M; Viveros, Maria-Paz

2014-03-01

Many young people consume ecstasy as a recreational drug and often in combination with cannabis. In this study, we aimed to mimic human consumption patterns and investigated, in male and female animals, the long-term effects of Δ(9) -tetrahydrocannabinol (THC) and 3,4-methylenedioxymethamphetamine (MDMA) on diverse neuroinflammation and neurotoxic markers. Male and female Wistar rats were chronically treated with increasing doses of THC and/or MDMA during adolescence. The effects of THC and/or MDMA on glial reactivity and on serotoninergic and cannabinoid systems were assessed by immunohistochemistry in the hippocampus and parietal cortex. THC increased the area staining for glial fibrilar acidic protein in both sexes. In males, both drugs, either separately or in combination, increased the proportion of reactive microglia cells [ionized calcium binding adaptor molecule 1 (Iba-1)]. In contrast, in females, each drug, administered alone, decreased of this proportion, whereas the combination of both drugs resulted in a 'normalization' to control values. In males, MDMA reduced the number of SERT positive fibres, THC induced the opposite effect and the group receiving both drugs did not significantly differ from the controls. In females, MDMA reduced the number of SERT positive fibres and the combination of both drugs counteracted this effect. THC also reduced immunostaining for CB1 receptors in females and this effect was aggravated by the combination with MDMA. Adolescent exposure of rats to THC and/or MDMA induced long-term, sex-dependent neurochemical and glial alterations, and revealed interactions between the two drugs. This article is part of a themed section on Cannabinoids 2013. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-6. © 2013 The British Pharmacological Society.

Prolonged morphine treatment alters δ opioid receptor post-internalization trafficking

PubMed Central

Ong, E W; Xue, L; Olmstead, M C; Cahill, C M

2015-01-01

BACKGROUND AND PURPOSE The δ opioid receptor (DOP receptor) undergoes internalization both constitutively and in response to agonists. Previous work has shown that DOP receptors traffic from intracellular compartments to neuronal cell membranes following prolonged morphine treatment. Here, we examined the effects of prolonged morphine treatment on the post-internalization trafficking of DOP receptors. EXPERIMENTAL APPROACH Using primary cultures of dorsal root ganglia neurons, we measured the co-localization of endogenous DOP receptors with post-endocytic compartments following both prolonged and acute agonist treatments. KEY RESULTS A departure from the constitutive trafficking pathway was observed following acute DOP receptor agonist-induced internalization by deltorphin II. That is, the DOP receptor underwent distinct agonist-induced post-endocytic sorting. Following prolonged morphine treatment, constitutive DOP receptor trafficking was augmented. SNC80 following prolonged morphine treatment also caused non-constitutive DOP receptor agonist-induced post-endocytic sorting. The μ opioid receptor (MOP receptor) agonist DAMGO induced DOP receptor internalization and trafficking following prolonged morphine treatment. Finally, all of the alterations to DOP receptor trafficking induced by both DOP and MOP receptor agonists were inhibited or absent when those agonists were co-administered with a DOP receptor antagonist, SDM-25N. CONCLUSIONS AND IMPLICATIONS The results support the hypothesis that prolonged morphine treatment induces the formation of MOP–DOP receptor interactions and subsequent augmentation of the available cell surface DOP receptors, at least some of which are in the form of a MOP/DOP receptor species. The pharmacology and trafficking of this species appear to be unique compared to those of its individual constituents. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2 PMID:24819092

Vascular targets for cannabinoids: animal and human studies

PubMed Central

Stanley, Christopher; O'Sullivan, Saoirse E

2014-01-01

Application of cannabinoids and endocannabinoids to perfused vascular beds or individual isolated arteries results in changes in vascular resistance. In most cases, the result is vasorelaxation, although vasoconstrictor responses are also observed. Cannabinoids also modulate the actions of vasoactive compounds including acetylcholine, methoxamine, angiotensin II and U46619 (thromboxane mimetic). Numerous mechanisms of action have been proposed including receptor activation, potassium channel activation, calcium channel inhibition and the production of vasoactive mediators such as calcitonin gene-related peptide, prostanoids, NO, endothelial-derived hyperpolarizing factor and hydrogen peroxide. The purpose of this review is to examine the evidence for the range of receptors now known to be activated by cannabinoids. Direct activation by cannabinoids of CB1, CBe, TRPV1 (and potentially other TRP channels) and PPARs in the vasculature has been observed. A potential role for CB2, GPR55 and 5-HT1A has also been identified in some studies. Indirectly, activation of prostanoid receptors (TP, IP, EP1 and EP4) and the CGRP receptor is involved in the vascular responses to cannabinoids. The majority of this evidence has been obtained through animal research, but recent work has confirmed some of these targets in human arteries. Vascular responses to cannabinoids are enhanced in hypertension and cirrhosis, but are reduced in obesity and diabetes, both due to changes in the target sites of action. Much further work is required to establish the extent of vascular actions of cannabinoids and the application of this research in physiological and pathophysiological situations. Linked ArticlesThis article is part of a themed section on Cannabinoids 2013. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-6 PMID:24329566

Identification of the anti‐mycobacterial functional properties of piperidinol derivatives

PubMed Central

Guy, Collette S; Tichauer, Esther; Kay, Gemma L; Phillips, Daniel J; Bailey, Trisha L; Harrison, James; Furze, Christopher M; Millard, Andrew D; Gibson, Matthew I; Pallen, Mark J

2017-01-01

Background and Purpose Tuberculosis (TB) remains a major global health threat and is now the leading cause of death from a single infectious agent worldwide. The current TB drug regimen is inadequate, and new anti‐tubercular agents are urgently required to be able to successfully combat the increasing prevalence of drug‐resistant TB. The purpose of this study was to investigate a piperidinol compound derivative that is highly active against the Mycobacterium tuberculosis bacillus. Experimental Approach The antibacterial properties of the piperidinol compound and its corresponding bis‐Mannich base analogue were evaluated against M. smegmatis and Gram‐negative organisms. Cytotoxicity studies were undertaken in order to determine the selectivity index for these compounds. Spontaneous resistant mutants of M. smegmatis were generated against the piperidinol and corresponding bis‐Mannich base lead derivatives and whole genome sequencing employed to determine the genetic modifications that lead to selection pressure in the presence of these compounds. Key Results The piperidinol and the bis‐Mannich base analogue were found to be selective for mycobacteria and rapidly kill this organism with a cytotoxicity selectivity index for mycobacteria of >30‐fold. Whole genome sequencing of M. smegmatis strains resistant to the lead compounds led to the identification of a number of single nucleotide polymorphisms indicating multiple targets. Conclusion and Implications Our results indicate that the piperidinol moiety represents an attractive compound class in the pursuit of novel anti‐tubercular agents. Linked Articles This article is part of a themed section on Drug Metabolism and Antibiotic Resistance in Micro‐organisms. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.14/issuetoc PMID:28195652

Pharmacological profiling of the TRPV3 channel in recombinant and native assays

PubMed Central

Grubisha, Olivera; Mogg, Adrian J; Sorge, Jessica L; Ball, Laura-Jayne; Sanger, Helen; Ruble, Cara L A; Folly, Elizabeth A; Ursu, Daniel; Broad, Lisa M

2014-01-01

Background and Purpose Transient receptor potential vanilloid subtype 3 (TRPV3) is implicated in nociception and certain skin conditions. As such, it is an attractive target for pharmaceutical research. Understanding of endogenous TRPV3 function and pharmacology remains elusive as selective compounds and native preparations utilizing higher throughput methodologies are lacking. In this study, we developed medium-throughput recombinant and native cellular assays to assess the detailed pharmacological profile of human, rat and mouse TRPV3 channels. Experimental Approach Medium-throughput cellular assays were developed using a Ca2+-sensitive dye and a fluorescent imaging plate reader. Human and rat TRPV3 pharmacology was examined in recombinant cell lines, while the mouse 308 keratinocyte cell line was used to assess endogenous TRPV3 activity. Key Results A recombinant rat TRPV3 cellular assay was successfully developed after solving a discrepancy in the published rat TRPV3 protein sequence. A medium-throughput, native, mouse TRPV3 keratinocyte assay was also developed and confirmed using genetic approaches. Whereas the recombinant human and rat TRPV3 assays exhibited similar agonist and antagonist profiles, the native mouse assay showed important differences, namely, TRPV3 activity was detected only in the presence of potentiator or during agonist synergy. Furthermore, the native assay was more sensitive to block by some antagonists. Conclusions and Implications Our findings demonstrate similarities but also notable differences in TRPV3 pharmacology between recombinant and native systems. These findings offer insights into TRPV3 function and these assays should aid further research towards developing TRPV3 therapies. Linked Articles This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-10 PMID:23848361

Developmental rodent models of fear and anxiety: from neurobiology to pharmacology

PubMed Central

Ganella, Despina E; Kim, Jee Hyun

2014-01-01

Anxiety disorders pose one of the biggest threats to mental health in the world, and they predominantly emerge early in life. However, research of anxiety disorders and fear-related memories during development has been largely neglected, and existing treatments have been developed based on adult models of anxiety. The present review describes animal models of anxiety disorders across development and what is currently known of their pharmacology. To summarize, the underlying mechanisms of intrinsic ‘unlearned’ fear are poorly understood, especially beyond the period of infancy. Models using ‘learned’ fear reveal that through development, rats exhibit a stress hyporesponsive period before postnatal day 10, where they paradoxically form odour-shock preferences, and then switch to more adult-like conditioned fear responses. Juvenile rats appear to forget these aversive associations more easily, as is observed with the phenomenon of infantile amnesia. Juvenile rats also undergo more robust extinction, until adolescence where they display increased resistance to extinction. Maturation of brain structures, such as the amygdala, prefrontal cortex and hippocampus, along with the different temporal recruitment and involvement of various neurotransmitter systems (including NMDA, GABA, corticosterone and opioids) are responsible for these developmental changes. Taken together, the studies described in this review highlight that there is a period early in development where rats appear to be more robust in overcoming adverse early life experience. We need to understand the fundamental pharmacological processes underlying anxiety early in life in order to take advantage of this period for the treatment of anxiety disorders. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24527726

Sex differences in animal models of psychiatric disorders

PubMed Central

Kokras, N; Dalla, C

2014-01-01

Psychiatric disorders are characterized by sex differences in their prevalence, symptomatology and treatment response. Animal models have been widely employed for the investigation of the neurobiology of such disorders and the discovery of new treatments. However, mostly male animals have been used in preclinical pharmacological studies. In this review, we highlight the need for the inclusion of both male and female animals in experimental studies aiming at gender-oriented prevention, diagnosis and treatment of psychiatric disorders. We present behavioural findings on sex differences from animal models of depression, anxiety, post-traumatic stress disorder, substance-related disorders, obsessive–compulsive disorder, schizophrenia, bipolar disorder and autism. Moreover, when available, we include studies conducted across different stages of the oestrous cycle. By inspection of the relevant literature, it is obvious that robust sex differences exist in models of all psychiatric disorders. However, many times results are conflicting, and no clear conclusion regarding the direction of sex differences and the effect of the oestrous cycle is drawn. Moreover, there is a lack of considerable amount of studies using psychiatric drugs in both male and female animals, in order to evaluate the differential response between the two sexes. Notably, while in most cases animal models successfully mimic drug response in both sexes, test parameters and treatment-sensitive behavioural indices are not always the same for male and female rodents. Thus, there is an increasing need to validate animal models for both sexes and use standard procedures across different laboratories. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24697577

Pharmacological manipulations in animal models of anorexia and binge eating in relation to humans

PubMed Central

van Gestel, M A; Kostrzewa, E; Adan, R A H; Janhunen, S K

2014-01-01

Eating disorders, such as anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorders (BED), are described as abnormal eating habits that usually involve insufficient or excessive food intake. Animal models have been developed that provide insight into certain aspects of eating disorders. Several drugs have been found efficacious in these animal models and some of them have eventually proven useful in the treatment of eating disorders. This review will cover the role of monoaminergic neurotransmitters in eating disorders and their pharmacological manipulations in animal models and humans. Dopamine, 5-HT (serotonin) and noradrenaline in hypothalamic and striatal regions regulate food intake by affecting hunger and satiety and by affecting rewarding and motivational aspects of feeding. Reduced neurotransmission by dopamine, 5-HT and noradrenaline and compensatory changes, at least in dopamine D2 and 5-HT2C/2A receptors, have been related to the pathophysiology of AN in humans and animal models. Also, in disorders and animal models of BN and BED, monoaminergic neurotransmission is down-regulated but receptor level changes are different from those seen in AN. A hypofunctional dopamine system or overactive α2-adrenoceptors may contribute to an attenuated response to (palatable) food and result in hedonic binge eating. Evidence for the efficacy of monoaminergic treatments for AN is limited, while more support exists for the treatment of BN or BED with monoaminergic drugs. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24866852

Ligand requirements for involvement of PKCε in synergistic analgesic interactions between spinal μ and δ opioid receptors.

PubMed

Schuster, D J; Metcalf, M D; Kitto, K F; Messing, R O; Fairbanks, C A; Wilcox, G L

2015-01-01

We recently found that PKCε was required for spinal analgesic synergy between two GPCRs, δ opioid receptors and α2 A adrenoceptors, co-located in the same cellular subpopulation. We sought to determine if co-delivery of μ and δ opioid receptor agonists would similarly result in synergy requiring PKCε. Combinations of μ and δ opioid receptor agonists were co-administered intrathecally by direct lumbar puncture to PKCε-wild-type (PKCε-WT) and -knockout (PKCε-KO) mice. Antinociception was assessed using the hot-water tail-flick assay. Drug interactions were evaluated by isobolographic analysis. All agonists produced comparable antinociception in both PKCε-WT and PKCε-KO mice. Of 19 agonist combinations that produced analgesic synergy, only 3 required PKCε for a synergistic interaction. In these three combinations, one of the agonists was morphine, although not all combinations involving morphine required PKCε. Morphine + deltorphin II and morphine + deltorphin I required PKCε for synergy, whereas a similar combination, morphine + deltorphin, did not. Additionally, morphine + oxymorphindole required PKCε for synergy, whereas a similar combination, morphine + oxycodindole, did not. We discovered biased agonism for a specific signalling pathway at the level of spinally co-delivered opioid agonists. As the bias is only revealed by an appropriate ligand combination and cannot be accounted for by a single drug, it is likely that the receptors these agonists act on are interacting with each other. Our results support the existence of μ and δ opioid receptor heteromers at the spinal level in vivo. This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2. © 2014 The British Pharmacological Society.

Endothelin-converting enzyme 2 differentially regulates opioid receptor activity

PubMed Central

Gupta, A; Fujita, W; Gomes, I; Bobeck, E; Devi, L A

2015-01-01

BACKGROUND AND PURPOSE Opioid receptor function is modulated by post-activation events such as receptor endocytosis, recycling and/or degradation. While it is generally understood that the peptide ligand gets co-endocytosed with the receptor, relatively few studies have investigated the role of the endocytosed peptide and peptide processing enzymes in regulating receptor function. In this study, we focused on endothelin-converting enzyme 2 (ECE2), a member of the neprilysin family of metallopeptidases that exhibits an acidic pH optimum, localizes to an intracellular compartment and selectively processes neuropeptides including opioid peptides in vitro, and examined its role in modulating μ receptor recycling and resensitization. EXPERIMENTAL APPROACH The effect of ECE2 inhibition on hydrolysis of the endocytosed peptide was examined using thin-layer chromatography and on μ opioid receptor trafficking using either elisa or microscopy. The effect of ECE2 inhibition on receptor signalling was measured using a cAMP assay and, in vivo, on antinociception induced by intrathecally administered opioids by the tail-flick assay. KEY RESULTS The highly selective ECE2 inhibitor, S136492, significantly impaired μ receptor recycling and signalling by only those ligands that are ECE2 substrates and this was seen both in heterologous cells and in cells endogenously co-expressing μ receptors with ECE2. We also found that ECE2 inhibition attenuated antinociception mediated only by opioid peptides that are ECE2 substrates. CONCLUSIONS AND IMPLICATIONS These results suggest that ECE2, by selectively processing endogenous opioid peptides in the endocytic compartment, plays a role in modulating opioid receptor activity. LINKED ARTICLES This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2 PMID:24990314

Endothelin-2, the forgotten isoform: emerging role in the cardiovascular system, ovarian development, immunology and cancer

PubMed Central

Ling, Lowell; Maguire, Janet J; Davenport, Anthony P

2013-01-01

Endothelin-2 [ET-2; also known as vasoactive intestinal contractor (VIC), in rodents] differs from endothelin-1 (ET-1) by only two amino acids, and unlike the third isoform, endothelin-3 (ET-3), it has the same affinity as ET-1 for both ETA and ETB receptors. It is often assumed that ET-2 would mimic the actions of the more abundant ET-1 and current pharmacological interventions used to inhibit the ET system would also block the actions of ET-2. These assumptions have focused research on ET-1 with ET-2 studied in much less detail. Recent research suggests that our understanding of the ET family requires re-evaluation. Although ET-2 is very similar in structure as well as pharmacology to ET-1, and may co-exist in the same tissue compartments, there is converging evidence for an important and distinct ET-2 pathway. Specifically is has been demonstrated that ET-2 has a key role in ovarian physiology, with ET-2-mediated contraction proposed as a final signal facilitating ovulation. Furthermore, ET-2 may also have a pathophysiological role in heart failure, immunology and cancer. Comparison of ET-2 versus ET-1 mRNA expression suggests this may be accomplished at the level of gene expression but differences may also exist in peptide synthesis by enzymes such as endothelin converting enzymes (ECEs) and chymase, which may allow the two pathways to be distinguished pharmacologically and become separate drug targets. LINKED ARTICLES This article is part of a themed section on Endothelin. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.168.issue-1 PMID:22118774

Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases

PubMed Central

Bordoloi, Devivasha; Padmavathi, Ganesan; Monisha, Javadi; Roy, Nand Kishor; Prasad, Sahdeo

2016-01-01

Curcumin, a yellow pigment in the Indian spice Turmeric (Curcuma longa), which is chemically known as diferuloylmethane, was first isolated exactly two centuries ago in 1815 by two German Scientists, Vogel and Pelletier. However, according to the pubmed database, the first study on its biological activity as an antibacterial agent was published in 1949 in Nature and the first clinical trial was reported in The Lancet in 1937. Although the current database indicates almost 9000 publications on curcumin, until 1990 there were less than 100 papers published on this nutraceutical. At the molecular level, this multitargeted agent has been shown to exhibit anti‐inflammatory activity through the suppression of numerous cell signalling pathways including NF‐κB, STAT3, Nrf2, ROS and COX‐2. Numerous studies have indicated that curcumin is a highly potent antimicrobial agent and has been shown to be active against various chronic diseases including various types of cancers, diabetes, obesity, cardiovascular, pulmonary, neurological and autoimmune diseases. Furthermore, this compound has also been shown to be synergistic with other nutraceuticals such as resveratrol, piperine, catechins, quercetin and genistein. To date, over 100 different clinical trials have been completed with curcumin, which clearly show its safety, tolerability and its effectiveness against various chronic diseases in humans. However, more clinical trials in different populations are necessary to prove its potential against different chronic diseases in humans. This review's primary focus is on lessons learnt about curcumin from clinical trials. Linked Articles This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc PMID:27638428

The potential health effects of dietary phytoestrogens.

PubMed

Rietjens, Ivonne M C M; Louisse, Jochem; Beekmann, Karsten

2017-06-01

Phytoestrogens are plant-derived dietary compounds with structural similarity to 17-β-oestradiol (E2), the primary female sex hormone. This structural similarity to E2 enables phytoestrogens to cause (anti)oestrogenic effects by binding to the oestrogen receptors. The aim of the present review is to present a state-of-the-art overview of the potential health effects of dietary phytoestrogens. Various beneficial health effects have been ascribed to phytoestrogens, such as a lowered risk of menopausal symptoms like hot flushes and osteoporosis, lowered risks of cardiovascular disease, obesity, metabolic syndrome and type 2 diabetes, brain function disorders, breast cancer, prostate cancer, bowel cancer and other cancers. In contrast to these beneficial health claims, the (anti)oestrogenic properties of phytoestrogens have also raised concerns since they might act as endocrine disruptors, indicating a potential to cause adverse health effects. The literature overview presented in this paper illustrates that several potential health benefits of phytoestrogens have been reported but that, given the data on potential adverse health effects, the current evidence on these beneficial health effects is not so obvious that they clearly outweigh the possible health risks. Furthermore, the data currently available are not sufficient to support a more refined (semi) quantitative risk-benefit analysis. This implies that a definite conclusion on possible beneficial health effects of phytoestrogens cannot be made. This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc. © 2016 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Using animal models to study post-partum psychiatric disorders

PubMed Central

Perani, C V; Slattery, D A

2014-01-01

The post-partum period represents a time during which all maternal organisms undergo substantial plasticity in a wide variety of systems in order to ensure the well-being of the offspring. Although this time is generally associated with increased calmness and decreased stress responses, for a substantial subset of mothers, this period represents a time of particular risk for the onset of psychiatric disorders. Thus, post-partum anxiety, depression and, to a lesser extent, psychosis may develop, and not only affect the well-being of the mother but also place at risk the long-term health of the infant. Although the risk factors for these disorders, as well as normal peripartum-associated adaptations, are well known, the underlying aetiology of post-partum psychiatric disorders remains poorly understood. However, there have been a number of attempts to model these disorders in basic research, which aim to reveal their underlying mechanisms. In the following review, we first discuss known peripartum adaptations and then describe post-partum mood and anxiety disorders, including their risk factors, prevalence and symptoms. Thereafter, we discuss the animal models that have been designed in order to study them and what they have revealed about their aetiology to date. Overall, these studies show that it is feasible to study such complex disorders in animal models, but that more needs to be done in order to increase our knowledge of these severe and debilitating mood and anxiety disorders. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24527704

Tour of Research Laboratories at the Ford Company

NASA Astrophysics Data System (ADS)

Reitz, J. R.

1981-01-01

A brief description of the physics programs encountered on the tour of the Ford Motor Company Research Laboratories is provided. A visit to the Research Laboratories of the Ford Motor Company is part of the Conference on Physics in the Automotive Industry. The visit will show a cross-section of the programs in Research Staff which are clearly identified as physics research as well as other areas where physicists have established themselves as dominant or team members in what might traditionally be regarded as the province of engineering R&D. After a brief orientation, the Conference visitors will be divided into tour groups and will visit laboratories involved in combustion research, arc-discharge physics, various spectroscopic applications, metal gauging, energy management, optical display systems and solar energy research. Synopses of the specific tour visits follow.

Reading Roundup: Rope a Good Book. Louisiana Summer Reading Program, 1995 Manual.

ERIC Educational Resources Information Center

White, Dorothy, J., Ed.

A manual for the Louisiana Summer Reading Program is presented in 14 sections with a western theme and illustrations. An evaluation form, a 1995 calendar, and a list of audiovisual materials with addresses and prices are also provided. Section 1 discusses promotion, publicity, and programs; and includes sample news releases; program ideas, and…

Go For the Gold...Read! Louisiana Summer Reading Program, 1996.

ERIC Educational Resources Information Center

White, Dorothy J., Ed.

A manual for the 1996 Louisiana Summer Reading Program is presented in five sections with an Olympic and sports-related theme and illustrations. An evaluation form, a 1996 monthly calendar, and clip art images are provided. The first section covers promotion and publicity, and contains facts about the Olympics, promotion ideas, and sample news…

Yearbook 1988. IWGIA: 20 Years.

ERIC Educational Resources Information Center

Gray, Andrew

The theme of this yearbook is the work of the International Work Group for Indigenous Affairs (IWGIA) during the 20 years of its existence and the enormous growth of the indigenous movement in that time. Section 1 traces IWGIA's history and includes the annual report for 1988. Section 2 is a global view of the main events in the indigenous world…

A Retrospective Cross-sectional Analysis of Health Education Disparities in Patients With Diabetes Using Data From the National Ambulatory Medical Care Survey.

PubMed

Branoff, Janelle D; Jiroutek, Michael R; Kelly, Chloe R; Huma, Sadia; Sutton, Beth S

2017-02-01

Purpose The purpose of this study was to determine if there was an association between receipt of diet/nutrition, exercise, and weight loss education in adult patients with a primary diagnosis of diabetes with various demographic and socioeconomic variables using data from the National Ambulatory Medical Care Survey (NAMCS) for the years 2008 to 2011. Methods This retrospective, cross-sectional, observational study design included patients ≥ 18 years of age with diabetes in the NAMCS between 2008 and 2011, inclusive. A series of weighted multivariable logistic regression models was constructed to evaluate predictors of diet/nutrition, exercise, and weight loss education. Odds ratios and 95% confidence intervals were reported. Results Among patients included in this study (n = 3027), 35.6% received diet/nutrition education, 21.8% received exercise education, and 13.6% received weight loss education. From the multivariable analyses, visits using "other" payment type, visits with Medicaid, and visits occurring in non-Metropolitan Statistical Areas were significantly less likely to receive diet/nutrition education; visits using other payment type, visits in non-Metropolitan Statistical Areas, and visits by those ≥ 65 and 45-64 years of age were significantly less likely to receive exercise education. No significant disparities in the receipt of weight loss education were found. Conclusion These findings indicate that although only approximately one third or fewer patients diagnosed with diabetes were receiving diet/nutrition, exercise, or weight loss education, there appeared to be limited disparities among the groups studied. Education rates appear to be trending upward over time, to be slightly improved as compared with previous studies, and to include fewer disparities.

Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study.

PubMed

Dahlkvist, Eva; Hartig, Terry; Nilsson, Annika; Högberg, Hans; Skovdahl, Kirsti; Engström, Maria

2016-09-01

To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. A multi-level, cross-sectional, correlational design. Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health. Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Healthier Children's Meals in Restaurants: An Exploratory Study to Inform Approaches That Are Acceptable Across Stakeholders.

PubMed

Anzman-Frasca, Stephanie; Folta, Sara C; Glenn, Meaghan E; Jones-Mueller, Anita; Lynskey, Vanessa M; Patel, Anjali A; Tse, Lisa L; Lopez, Nanette V

2017-04-01

Assess parents', children's, and restaurant executives' perspectives on children's meals in restaurants. Cross-sectional. Parents and children completed predominantly quantitative surveys at 4 quick- and full-service restaurant locations. Telephone interviews were conducted with executives representing additional restaurants. Parents (n = 59) and their first- through fourth-grade children (n = 58); executives (n = 4). Parent/child perspectives on child meal selection and toy incentives in restaurants; executives' views on kids' meals and barriers to supplying healthier kids' meals. Frequencies, thematic analysis. A total of 63% of children ordered from children's menus, 8% of whom ordered healthier kids' meals. Half of parents reported that children determined their own orders. Taste was the most common reason for children's meal choices. Most (76%) children reported visiting the restaurant previously; 64% of them placed their usual order. Parents' views on toy incentives were mixed. Themes from executive interviews highlighted factors driving children's menu offerings, including children's habits and preferences and the need to use preexisting pantry items. Executives described menu changes as driven by profitability, consumer demand, regulation, and corporate social responsibility. Findings can inform the development of restaurant interventions that are effective in promoting healthier eating and are acceptable to parents, children, and restaurant personnel. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi.

PubMed

Nyondo, Alinane Linda; Muula, Adamson Sinjani; Chimwaza, Angela Faith

2013-12-16

Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs) with healthcare workers and four focus group discussions (FGDs) with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis. Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1) healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2) women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1) word of mouth, (2) card invites, (3) woman's health passport book invites, (4) telephonic invites, (5) use of influential people, and (6) home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants. There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and consultations with men should continue to achieve higher levels of MI.

Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi

PubMed Central

Nyondo, Alinane Linda; Muula, Adamson Sinjani; Chimwaza, Angela Faith

2013-01-01

Background Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. Objective The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. Study design An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs) with healthcare workers and four focus group discussions (FGDs) with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis. Results Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1) healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2) women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1) word of mouth, (2) card invites, (3) woman's health passport book invites, (4) telephonic invites, (5) use of influential people, and (6) home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants. Conclusions There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and consultations with men should continue to achieve higher levels of MI. PMID:24345635

Rural Emergency Nurses' Suggestions for Improving End-of-Life Care.

PubMed

Beckstrand, Renea L; Smith, Kelly E; Luthy, Karlen E Beth; Macintosh, Janelle L B

2017-05-01

Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments. A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify the one aspect of EOL care they would change for dying patients in rural emergency departments. Each qualitative response was individually reviewed by a research team and then coded into a theme. Four major themes and three minor themes were identified. The major themes were providing greater privacy during EOL care for patients and family members, increasing availability of support services, additional staffing, and improved staff and community education. Providing adequate privacy for patients and family members was a major obstacle to providing EOL care in the emergency department, largely because of poor department design, especially in rural emergency departments where space is limited. Lack of support services and adequate staffing were also obstacles to providing quality EOL care in rural emergency departments. Consequently, rural nurses are commonly pulled away from EOL care to perform ancillary duties because additional support personnel are lacking. Providing EOL care in rural emergency departments is a challenging task given the limited staffing and resources, and thus it is imperative that nurses' suggestions for improvement of EOL care be acknowledged. Because of the current lack of research in rural EOL care, additional research is needed. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

How Can eHealth Technology Address Challenges Related to Multimorbidity? Perspectives from Patients with Multiple Chronic Conditions.

PubMed

Zulman, Donna M; Jenchura, Emily C; Cohen, Danielle M; Lewis, Eleanor T; Houston, Thomas K; Asch, Steven M

2015-08-01

Patient eHealth technology offers potential support for disease self-management, but the value of existing applications for patients with multiple chronic conditions (MCCs) is unclear. To understand self-management and health care navigation challenges that patients face due to MCCs and to identify opportunities to support these patients through new and enhanced eHealth technology. After administering a screening survey, we conducted 10 focus groups of 3-8 patients grouped by age, sex, and common chronic conditions. Patients discussed challenges associated with having MCCs and their use of (and desires from) technology to support self-management. Three investigators used standard content analysis methods to code the focus group transcripts. Emergent themes were reviewed with all collaborators, and final themes and representative quotes were validated with a sample of participants. Fifty-three individuals with ≥3 chronic conditions and experience using technology for health-related purposes. Focus group participants had an average of five chronic conditions. Participants reported using technology most frequently to search for health information (96%), communicate with health care providers (92%), track medical information (83%), track medications (77%), and support decision-making about treatment (55%). Three themes emerged to guide eHealth technology development: (1) Patients with MCCs manage a high volume of information, visits, and self-care tasks; (2) they need to coordinate, synthesize, and reconcile health information from multiple providers and about different conditions; (3) their unique position at the hub of multiple health issues requires self-advocacy and expertise. Focus groups identified desirable eHealth resources and tools that reflect these themes. Although patients with multiple health issues use eHealth technology to support self-care for specific conditions, they also desire tools that transcend disease boundaries. By addressing the holistic needs of patients with MCCs, eHealth technology can advance health care from a disease-centered to a patient-centered model.

Electronic medical records and efficiency and productivity during office visits.

PubMed

Furukawa, Michael F

2011-04-01

To estimate the relationship between electronic medical record (EMR) use and efficiency of utilization and provider productivity during visits to US office-based physicians. Cross-sectional analysis of the 2006-2007 National Ambulatory Medical Care Survey. The sample included 62,710 patient visits to 2625 physicians. EMR systems included demographics, clinical notes, prescription orders, and laboratory and imaging results. Efficiency was measured as utilization of examinations, laboratory tests, radiology procedures, health education, nonmedication treatments, and medications. Productivity was measured as total services provided per 20-minute period. Survey-weighted regressions estimated association of EMR use with services provided, visit intensity/duration, and productivity. Marginal effects were estimated by averaging across all visits and by major reason for visit. EMR use was associated with higher probability of any examination (7.7%, 95% confidence interval [CI] = 2.4%, 13.1%); any laboratory test (5.7%, 95% CI = 2.6%, 8.8%); any health education (4.9%, 95% CI = 0.2%, 9.6%); and fewer laboratory tests (-7.1%, 95% CI = -14.2%, -0.1%). During pre/post surgery visits, EMR use was associated with 7.3% (95% CI= -12.9%, -1.8%) fewer radiology procedures. EMR use was not associated with utilization of nonmedication treatments and medications, or visit duration. During routine visits for a chronic problem, EMR use was associated with 11.2% (95% CI = 5.7%, 16.8%) more diagnostic/screening services provided per 20-minute period. EMR use had a mixed association with efficiency and productivity during office visits. EMRs may improve provider productivity, especially during visits for a new problem and routine chronic care.

Effect of UV radiation on habitat selection by Girella laevifrons and Graus nigra (Kyphosidae).

PubMed

Pulgar, J; Lagos, P; Maturana, D; Valdés, M; Aldana, M; Pulgar, V M

2015-02-01

The effect of UV radiation on habitat use of two species of intertidal fishes that inhabit the same pools but exhibit different activity levels and diets was measured: the highly active omnivorous Girella laevifrons and the cryptic carnivorous Graus nigra. Individuals of each species were acclimated to a tank divided in three sections with different illumination; no light (NL), ultraviolet light (UV) and white light (WL), and the time spent and number of visits to each section were recorded. Although both species preferred the NL section, G. laevifrons spent more time in UV and less time in WL compared with G. nigra; G. laevifrons also displayed higher number of visits to UV, suggesting a different tendency in space use in response to UV exposure in intertidal fishes. © 2015 The Fisheries Society of the British Isles.

Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

PubMed

Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

2017-10-01

Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

Theme Section: How Healthy Are America's Children?

ERIC Educational Resources Information Center

Ungar, Manya; And Others

1989-01-01

Fourteen brief articles provide information about health threats to children, covering alcohol and drug abuse, nutrition, arthritis, Lyme Disease, Reye's Syndrome, school bus safety, inner ear disorders, dental health, and toy safety. (CB)

Accessible Astronomy.

ERIC Educational Resources Information Center

Glickstein, Neil

1994-01-01

Describes the development of a theme-based, multidisciplinary course. The article partitions into the following sections: (1) Constructing the Course; (2) Putting the Ideas to Work; (3) Connecting Science and Society; and (4) The Arts and Astronomy. (ZWH)

[An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group].

PubMed

Kim, Dasom; Lee, Insook

2017-10-01

This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements. © 2017 Korean Society of Nursing Science

What keeps health professionals working in rural district hospitals in South Africa?

PubMed Central

Gunst, Colette; Blitz, Julia; Coetzee, Johan F.

2015-01-01

Background The theme of the 2014 Southern African Rural Health Conference was ‘Building resilience in facing rural realities’. Retaining health professionals in South Africa is critical for sustainable health services. Only 12% of doctors and 19% of nurses have been retained in the rural areas. The aim of the workshop was to understand from health practitioners why they continued working in their rural settings. Conference workshop The workshop consisted of 29 doctors, managers, academic family physicians, nurses and clinical associates from Southern Africa, with work experience from three weeks to 13 years, often in deep rural districts. Using the nominal group technique, the following question was explored, ‘What is it that keeps you going to work every day?’ Participants reflected on their work situation and listed and rated the important reasons for continuing to work. Results Five main themes emerged. A shared purpose, emanating from a deep sense of meaning, was the strongest reason for staying and working in a rural setting. Working in a team was second most important, with teamwork being related to attitudes and relationships, support from visiting specialists and opportunities to implement individual clinical skills. A culture of support was third, followed by opportunities for growth and continuing professional development, including teaching by outreaching specialists. The fifth theme was a healthy work-life balance. Conclusion Health practitioners continue to work in rural settings for often deeper reasons relating to a sense of meaning, being part of a team that closely relate to each other and feeling supported. PMID:26245623

District nurses' perceptions of osteoporosis management: a qualitative study.

PubMed

Claesson, A; Toth-Pal, E; Piispanen, P; Salminen, H

2015-07-01

Underdiagnosis of osteoporosis is common. This study investigated Swedish district nurses' perceptions of osteoporosis management. They perceived the condition as having low priority, and the consequences of this perception were insufficient awareness of the condition and perceptions of bone-specific medication as unsafe. They perceived, though, competency when working with fall prevention. Undertreatment of patients with osteoporosis is common. Sweden's medical care strategy dictates prioritisation of various conditions; while guidelines exist, osteoporosis is not prioritised. The aim of this study was to investigate district nurses' perceptions of osteoporosis management within Sweden's primary health care system. Four semi-structured focus group interviews were conducted with 13 female district nurses. The interviews were analysed using thematic analysis. The overall theme was perceiving osteoporosis management as ambiguous. The themes were perceiving barriers and perceiving opportunities. These subthemes were linked to perceiving barriers: (i) insufficient procedures, lack of time and not aware of the condition; (ii) insufficient knowledge about diagnosis and about fracture risk assessment tools; (iii) low priority condition and unclear responsibility for osteoporosis management; and (iv) bone-specific medication was sometimes perceived to be unsafe. These subthemes were linked to perceiving opportunities: (i) professional competency when discussing fall prevention in home visit programs, (ii) willingness to learn more about osteoporosis management, (iii) collaboration with other professionals and (iv) willingness to identify individuals at high risk of fracture. Osteoporosis was reported, by the district nurses, to be a low-priority condition with consequences being unawareness of the condition, insufficient knowledge about bone-specific medications, fracture risk assessment tools and procedures. These may be some of the explanations for the undertreatment of osteoporosis. At the same time, the district nurses described competency performing the home visits, which emerged as an optimal opportunity to discuss fall prevention and to introduce FRAX with the aim to identify individuals at high risk of fracture.

Experiences of security and continuity of care: Patients' and families' narratives about the work of specialized palliative home care teams.

PubMed

Klarare, Anna; Rasmussen, Birgit H; Fossum, Bjöörn; Fürst, Carl Johan; Hansson, Johan; Hagelin, Carina Lundh

2017-04-01

Those who are seriously ill and facing death are often living with physical, emotional, social, and spiritual suffering. Teamwork is considered to be necessary to holistically meet the diverse needs of patients in palliative care. Reviews of studies regarding palliative care team outcomes have concluded that teams provide benefits, especially regarding pain and symptom management. Much of the research concerning palliative care teams has been performed from the perspective of the service providers and has less often focused on patients' and families' experiences of care. Our aim was to investigate how the team's work is manifested in care episodes narrated by patients and families in specialized palliative home care (SPHC). A total of 13 interviews were conducted with patients and families receiving specialized home care. Six patients and seven family members were recruited through SPHC team leaders. Interviews were transcribed verbatim and the transcripts qualitatively analyzed into themes. Two themes were constructed through thematic analysis: (1) security ("They are always available," "I get the help I need quickly"); and (2) continuity of care ("They know me/us, our whole situation and they really care"). Of the 74 care episodes, 50 were descriptions of regularly scheduled visits, while 24 related to acute care visits and/or interventions. Patients' and family members' descriptions of the work of SPHC teams are conceptualized through experiences of security and continuity of care. Experiences of security are fostered through the 24/7 availability of the team, sensitivity and flexibility in meeting patients' and families' needs, and practical adjustments to enable care at home. Experiences of continuity of care are fostered through the team's collective approach, where the individual team member knows the patients and family members, including their whole situation, and cares about the little things in life as well as caring for the family unit.

What Patients Value About Reading Visit Notes: A Qualitative Inquiry of Patient Experiences With Their Health Information

PubMed Central

Fossa, Alan; Folcarelli, Patricia H; Walker, Jan; Bell, Sigall K

2017-01-01

Background Patients are increasingly asking for their health data. Yet, little is known about what motivates patients to engage with the electronic health record (EHR). Furthermore, quality-focused mechanisms for patients to comment about their records are lacking. Objective We aimed to learn more about patient experiences with reading and providing feedback on their visit notes. Methods We developed a patient feedback tool linked to OpenNotes as part of a pilot quality improvement initiative focused on patient engagement. Patients who had appointments with members of 2 primary care teams piloting the program between August 2014-2015 were eligible to participate. We asked patients what they liked about reading notes and about using a feedback tool and analyzed all patient reports submitted during the pilot period. Two researchers coded the qualitative responses (κ=.74). Results Patients and care partners submitted 260 reports. Among these, 98.5% (256/260) of reports indicated that the reporting tool was valuable, and 68.8% (179/260) highlighted what patients liked about reading notes and the OpenNotes patient reporting tool process. We identified 4 themes describing what patients value about note content: confirm and remember next steps, quicker access and results, positive emotions, and sharing information with care partners; and 4 themes about both patients’ use of notes and the feedback tool: accuracy and correcting mistakes, partnership and engagement, bidirectional communication and enhanced education, and importance of feedback. Conclusions Patients and care partners who read notes and submitted feedback reported greater engagement and the desire to help clinicians improve note accuracy. Aspects of what patients like about using both notes as well as a feedback tool highlight personal, relational, and safety benefits. Future efforts to engage patients through the EHR may be guided by what patients value, offering opportunities to strengthen care partnerships between patients and clinicians. PMID:28710055

District nurses' experiences of preventive home visits to 75-year-olds in Stockholm: a qualitative study.

PubMed

Lagerin, Annica; Törnkvist, Lena; Hylander, Ingrid

2016-09-01

Aims This study had two aims: to describe the dialogue between district nurses (DNs) and older people in preventive home visits (PHVs) from the perspective of the DNs, and to identify barriers to and facilitators of this dialogue as perceived by the DNs. The number of older people is rapidly increasing in all western countries, and as people's age increases, the probability that they will have multiple diseases also increases. Planned actions are therefore needed to promote health and prevent diseases among older people so they can remain in good health and live in their homes for as long as possible. In Sweden, PHVs to 75-year-olds by DNs are one such action. This qualitative study included five group interviews with 20 DNs. Data were analysed with qualitative content analysis. Findings DNs' experiences of barriers to and facilitators of a successful health dialogue were sorted into five domains. Together, these domains provided a systematic description of the interaction between the DN and the older person in the PHV. The domains included: establishing trustful contact, conducting a structured interview, making an overall assessment, proposing health-promoting activities and offering follow-up. The barriers and facilitators could be related to the older person, the DN or the home environment. The latent content of the interviews was evident in three themes that were related to the DNs' experiences of barriers and facilitators. These themes illustrated professional dilemmas that the DNs had to resolve to achieve the purpose of the PHV. The study demonstrates that the interaction between a DN and an older person in a PHV can be described as a complex social process in which the DN balances a personal and professional approach, combines a person-oriented and a task-oriented approach and employs both a salutogenic and pathogenic perspective.

Taking the edge off: why patients choose St. John's Wort.

PubMed

Wagner, P J; Jester, D; LeClair, B; Taylor, A T; Woodward, L; Lambert, J

1999-08-01

The number of visits to alternative medicine practitioners in this country is estimated at 425 million, which is more than the number of visits to allopathic primary care physicians in 1990. Patients' use of St. John's Wort (SJW) has followed this sweeping trend. The purpose of our study was to examine the reasons people choose to self-medicate with SJW instead of seeking care from a conventional health care provider. We used open-ended interviews with key questions to elicit information. Twenty-two current users of SJW (21 women; 20 white; mean age = 45 years) in a Southern city participated. All interviews were transcribed, and descriptive participant quotes were extracted by a research assistant. Quotes were reviewed for each key question for similarities and contextual themes. Four dominant decision-making themes were consistently noted. These were: (1) Personal Health Care Values: subjects had a history of alternative medicine use and a belief in the need for personal control of health; (2) Mood: all SJW users reported a depressed mood and occasionally irritability, cognitive difficulties, social isolation, and hormonal mood changes; (3) Perceptions of Seriousness of Disease and Risks of Treatment: SJW users reported the self-diagnosis of "minor" depression, high risks of prescription drugs, and a perception of safety with herbal remedies; and (4) Accessibility Issues: subjects had barriers to and lack of knowledge of traditional health care providers and awareness of the ease of use and popularity of SJW. Also of note was the fact that some SJW users did not inform their primary care providers that they were taking the herb (6 of 22). Users reported moderate effectiveness and few side effects of SJW. SJW users report depression, ease of access to alternative medicines, and a history of exposure to and belief in the safety of herbal remedies. Users saw little benefit to providing information about SJW to primary care physicians.

Community health workers' experiences of using video teaching tools during home visits-A pilot study.

PubMed

Coetzee, Bronwyné; Kohrman, Hannah; Tomlinson, Mark; Mbewu, Nokwanele; Le Roux, Ingrid; Adam, Maya

2018-03-01

Innovations in health, such as the use of tablet computers, show promise in broadening the scope of work of community health workers (CHWs), and play an important role in keeping CHWs and their clients up to date with advancements in health. While the use of mobile phones and tablets is innovative, the applicability of these technologies in different contexts remains poorly understood. Furthermore, little is known about the acceptability and feasibility of the use of video teaching tools on such devices across diverse contexts. In this study, we aimed to explore the acceptability and feasibility of using tablets with teaching videos (about HIV, alcohol, nutrition and breastfeeding) to support the health promotion efforts of 24 CHWs who work with pregnant mothers and mothers of young children in an urban township in South Africa. Between November 2015 and May 2016, we conducted focus groups and identified four key themes (with several sub-themes) that demonstrated factors related to the acceptability and feasibility of these devices and their content. Focus group transcripts were analysed thematically using qualitative data analysis software. The findings indicated that while the devices contained several supportive features (such as lightening the workload, and stimulating interest in their work), they also contained several restrictive features (safety and confidentiality). CHWs considered the video content an important tool to engage not only their clients but also family members and the community at large. Issues surrounding safety, privacy and confidentiality of using these devices require careful consideration prior to implementation in large-scale studies. Furthermore, stigma associated with household visits by CHWs and the nature of their work also need to be addressed by researchers and programme implementers. Overall, CHWs deemed the devices and the video content an acceptable and feasible means with which to provide health promotion and education among their clients. © 2017 John Wiley & Sons Ltd.

Computational physics and applied mathematics capability review June 8-10, 2010

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Stephen R

2010-01-01

Los Alamos National Laboratory will review its Computational Physics and Applied Mathematics (CPAM) capabilities in 2010. The goals of capability reviews are to assess the quality of science, technology, and engineering (STE) performed by the capability, evaluate the integration of this capability across the Laboratory and within the scientific community, examine the relevance of this capability to the Laboratory's programs, and provide advice on the current and future directions of this capability. This is the first such review for CPAM, which has a long and unique history at the Laboratory, starting from the inception of the Laboratory in 1943. Themore » CPAM capability covers an extremely broad technical area at Los Alamos, encompassing a wide array of disciplines, research topics, and organizations. A vast array of technical disciplines and activities are included in this capability, from general numerical modeling, to coupled multi-physics simulations, to detailed domain science activities in mathematics, methods, and algorithms. The CPAM capability involves over 12 different technical divisions and a majority of our programmatic and scientific activities. To make this large scope tractable, the CPAM capability is broken into the following six technical 'themes.' These themes represent technical slices through the CPAM capability and collect critical core competencies of the Laboratory, each of which contributes to the capability (and each of which is divided into multiple additional elements in the detailed descriptions of the themes in subsequent sections), as follows. Theme 1: Computational Fluid Dynamics - This theme speaks to the vast array of scientific capabilities for the simulation of fluids under shocks, low-speed flow, and turbulent conditions - which are key, historical, and fundamental strengths of the Laboratory. Theme 2: Partial Differential Equations - The technical scope of this theme is the applied mathematics and numerical solution of partial differential equations (broadly defined) in a variety of settings, including particle transport, solvers, and plasma physics. Theme 3: Monte Carlo - Monte Carlo was invented at Los Alamos. This theme discusses these vitally important methods and their application in everything from particle transport, to condensed matter theory, to biology. Theme 4: Molecular Dynamics - This theme describes the widespread use of molecular dynamics for a variety of important applications, including nuclear energy, materials science, and biological modeling. Theme 5: Discrete Event Simulation - The technical scope of this theme represents a class of complex system evolutions governed by the action of discrete events. Examples include network, communication, vehicle traffic, and epidemiology modeling. Theme 6: Integrated Codes - This theme discusses integrated applications (comprised of all of the supporting science represented in Themes 1-5) that are of strategic importance to the Laboratory and the nation. The Laboratory has in approximately 10 million source lines of code in over 100 different such strategically important applications. Of these themes, four of them will be reviewed during the 2010 review cycle: Themes 1,2, 3, and 6. Because these reviews occur every three years, Themes 4 and 5 will be reviewed in 2013, along with Theme 6 (which will be reviewed during each review, owing to this theme's role as an integrator of the supporting science represented by the other five themes). Yearly written status reports will be provided to the CPAM Committee Chair during off-cycle years.« less

'Festival in a Box': Development and qualitative evaluation of an outreach programme to engage socially isolated people with dementia.

PubMed

Eades, Michael; Lord, Kathryn; Cooper, Claudia

2016-07-27

We co-designed and piloted 'Festival in a Box', an outreach programme to enable socially isolated people with dementia to engage with and enjoy cultural activities in their homes. It comprised 3-4 weekly home visits, each led by a professional artist to create art works using materials brought in 'the box'. Activities included music, poetry, pottery, crafts and photography. We qualitatively interviewed 13 participants (6 people with dementia, 4 artists, 3 befrienders). Six participants with dementia completed, enjoyed and engaged with the planned visits. Main themes were: engagement, reflection on value of previous cultural activities, precariousness and isolation in current neighbourhood and the importance of a voice and being heard. Befrienders reported their preconceptions of what participants could do were challenged. Artists reported shifts in their preconceptions about dementia and the influence of the project on their professional practice. We propose that the 'Festival in a Box' pilot study suggests a means through which community arts festivals could work with socially isolated people with dementia to contribute to the creation of 'Dementia Friendly Communities'. A larger-scale pilot study is now needed to develop this hypothesis. © The Author(s) 2016.

Clinician style and examination room computers: a video ethnography.

PubMed

Ventres, William; Kooienga, Sarah; Marlin, Ryan; Vuckovic, Nancy; Stewart, Valerie

2005-04-01

The use of computers in medical examination rooms is growing. Advocates of this technology suggest that all family physicians should have and use examination room computers (ERCs) within the near future. This study explored how family physicians incorporate the use of ERCs in their interactions with patients. This qualitative study involved five family physicians, one family nurse practitioner, and a convenience sample of 29 patients. Data included videotaped visits, clinician interviews, and videotape reviews. The setting was an urban family practice with a 7-year history of viewing electronic medical records. The main outcome measures were themes emergent from videotaped data. We identified three distinct practice styles that shaped the use of the ERC: informational, interpersonal, and managerial styles. Clinicians with an informational style are guided by their attention to gathering data as prompted by the computer screen. Clinicians with an interpersonal style focus their attention and body language on patients. Clinicians with a managerial style bridge informational and interpersonal styles by alternating their attention in defined intervals between patients and the computer. Family physicians have varying practice styles that affect the way they use examination room computers during visits with patients.

Care control and collaborative working in a prison hospital.

PubMed

Foster, John; Bell, Linda; Jayasinghe, Neil

2013-03-01

This paper reports findings from a qualitative research project, using interviews, focus groups and participant observations, which sought to investigate "good practice" in a nurse-led prison hospital wing for male prisoners. The study raised issues about tensions between "caring" and "control" of prisoners from the perspectives of professionals working or visiting the wing. This paper discusses collaborative working between professionals from different backgrounds, including nurses and healthcare (prison) officers who were based on the wing and others who visited such as probation, medical, Inreach team or Counselling Advice, Referral, Assessment and Through Care team staff (CARAT). The key finding was that there is a balance between therapy and security/risk. In order to maintain this, the two main groups based on the hospital wing--nurses and prison officers--moved between at times cooperating, coordinating and collaborating with each other to maintain this balance. Other themes were care and control, team working, individual and professional responsibilities and communication issues. Enhancing the role of nurses should be encouraged so that therapy remains paramount, and we conclude with some recommendations to encourage collaborative working in prison healthcare settings to ensure that therapy continues to be paramount while security and safety are maintained.

Long-term Dental Visiting Patterns and Adult Oral Health

PubMed Central

Thomson, W.M.; Williams, S.M.; Broadbent, J.M.; Poulton, R.; Locker, D.

2010-01-01

To date, the evidence supporting the benefits of dental visiting comes from cross-sectional studies. We investigated whether long-term routine dental visiting was associated with lower experience of dental caries and missing teeth, and better self-rated oral health, by age 32. A prospective cohort study in New Zealand examined 932 participants’ use of dentistry at ages 15, 18, 26, and 32. At each age, routine attenders (RAs) were identified as those who (a) usually visited for a check-up, and (b) had made a dental visit during the previous 12 months. Routine attending prevalence fell from 82% at age 15 to 28% by 32. At any given age, routine attenders had better-than-average oral health, fewer had teeth missing due to caries, and they had lower mean DS and DMFS scores. By age 32, routine attenders had better self-reported oral health and less tooth loss and caries. The longer routine attendance was maintained, the stronger the effect. Routine dental attendance is associated with better oral health. PMID:20093674

Anaemia in pregnancy and associated factors: a cross sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana.

PubMed

Anlaakuu, Peter; Anto, Francis

2017-08-11

Anaemia in pregnancy is an important health issue resulting in high maternal morbidity and mortality. The purpose of the current study was to identify factors associated with anaemia among pregnant women receiving antenatal care at the Sunyani Municipal Hospital in Ghana. A cross-sectional study involving pregnant women seeking antenatal care at the Sunyani Municipal Hospital was conducted between May and June, 2015. It involved the collection of data on socio demographic and obstetric variables, medical interventions and malaria infection, consumption of iron containing foods and supplements using a case record form and a structured questionnaire. Also, data on haemoglobin concentrations at first and current antenatal visit were collected. Bivariate and multivariate statistical analysis were done to determine factors associated with anaemia. Out of the 316 participants, 129 (40.8%) were found to be anaemic (Hb <11.0 g/dl) at the time of their first ANC visit (mean Hb: 11.21 g/dl, range 6.8-15.1 g/dl). Seventy-nine (61.2%) of them had mild anemia (Hb 9.0-10.9 g/dl), 48 (37.2%) had moderate anemia (Hb 7.0-8.9 g/dl) whilst 2 (1.6%) had severe anemia (Hb <7.0 g/dl). During their most recent ANC visit, the prevalence of anaemia was found to be similar to that of the first visit with 131 (41.5%) of them being anaemic [mean Hb: 11.24 g/dl, range 8.10-14.5 g/dl]. The haemoglobin levels however improved significantly during the most recent visit compared to the first with none of the women being severely anaemic (Hb <7.0 g/dl). The prevalence of moderate anaemia reduced from 37.2% (CI 28.9-46.2) during the first visit to 19.1% (12.7-26.9) during the most recent visit, a reduction of 48.7%. Malaria infection, frequency at which one consumed fish/snails and gestational age at first ANC visit were the main factors found to be associated with anaemia among the pregnant women. Malaria infection, fish/snails intake and gestational age at first ANC visit were significantly associated with anaemia. Addressing these factors can reduce the incidence of anaemia in pregnancy.

Researching the Practice, Practicing the Research, and Promoting Responsible Policy: Usable Knowledge in Mind, Brain, and Education

ERIC Educational Resources Information Center

Christodoulou, Joanna A.; Daley, Samantha G.; Katzir, Tami

2009-01-01

The theme of Usable Knowledge in Mind, Brain, and Education will be a special section that will appear regularly in the journal. The section will focus on the synergistic connections between biology, cognitive science, and human development on the one hand and educational thought, policy, and practice on the other. Efforts to create usable…

New Directions in Developmental Emotion Regulation Research across the Life Span: Introduction to the Special Section

ERIC Educational Resources Information Center

Zimmermann, Peter; Thompson, Ross A.

2014-01-01

Research on the development of emotion regulation has become a prominent topic in developmental science covering a broad age range from infancy to old age because of its theoretical importance and practical implications. This introductory essay of this special section includes reflections on some of the conceptual themes of this research field and…

Intermediate SCDC Spanish Curricula Units. Language Arts, Unit 1, Kits 1-4, Teacher's Guide.

ERIC Educational Resources Information Center

Spanish Curricula Development Center, Miami Beach, FL.

Reflecting the theme "our community", this unit consists of Kits 1-4 which are organized in three sections: reading, language analysis, and creative expression. The reading section includes two readers which contain three poems and five stories dealing with a grandmother's efforts to help support the family, a female pilot who successfully lands a…

Amoebiasis among patrons visiting gay saunas in Taiwan.

PubMed

Hung, C-C; Ko, N-Y; Ko, W-C; Lee, H-C; Ji, D-D; Liu, W-C; Chang, S-C

2008-10-01

This study aimed to assess the prevalence of amoebiasis among patrons visiting gay saunas in Taiwan. A cross-sectional survey was conducted using questionnaire interview and indirect hemagglutination assays and specific Entamoeba histolytica antigen assays of blood and rectal swab specimens, respectively, among patrons visiting 10 gay saunas between September 2006 and December 2006. During the three-month study period, 208 blood and 120 rectal swab specimens were tested for E. histolytica infection. Amoebiasis was detected among 3.8% and 3.3% of the patrons by serologies and antigen assays, respectively. During the latest sexual encounter, more than 70% of the patrons had oral-anogenital sex, and only 20% used condoms during oral-anogenital contact. Our findings suggest that there is a potential risk of E. histolytica transmission among the patrons visiting gay saunas who do not practise safe sex consistently in Taiwan.

CERT TST December 2015 Visit Summary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Little, Robert Currier; Bailey, Teresa S.; Gamblin, G. Todd

2016-01-25

The annual PSAAP II TST visit to Texas A&M’s CERT Center was held on December 1-3, 2015. The agenda for the visit is attached. Non-TAMU attendees were: TST Members – Teresa Bailey (LLNL), Todd Gamblin (LLNL), Bob Little (LANL) – Chair, Chad Olinger (LANL), Shawn Pautz (SNL), Alan Williams (SNL);Other Lab staff – Skip Kahler (LANL), Ana Kupresanin (LLNL), and Rob Lowrie (LANL); AST Members – Nelson Hoffman (LANL) and Bob Voigt (Leidos) The TST wishes to express our appreciation to all involved with CERT for the high-quality posters and presentations and for the attention to logistics that enabled amore » successful visit. We have broken our comments into four sections: (1) Kudos, (2) Recommendations, (3) Feedback on Priorities for April Review, and (4) Follow-Up Activities with Labs.« less

Nonmelanoma skin cancer visits and procedure patterns in a nationally representative sample: national ambulatory medical care survey 1995-2007.

PubMed

Wysong, Ashley; Linos, Eleni; Hernandez-Boussard, Tina; Arron, Sarah T; Gladstone, Hayes; Tang, Jean Y

2013-04-01

The rising incidence of nonmelanoma skin cancer (NMSC) is well documented, but data are limited on the number of visits and treatment patterns of NMSC in the outpatient setting. To evaluate practice and treatment patterns of NMSC in the United States over the last decade and to characterize differences according to sex, age, race, insurance type, and physician specialty. Adults with an International Classification of Diseases, Ninth Revision, diagnosis of NMSC were included in this cross-sectional survey study of the National Ambulatory Medical Care Survey between 1995 and 2007. Primary outcomes included population-adjusted NMSC visit rates and odds ratios of receiving a procedure for NMSC using logistic regression. Rates of NMSC visits increased between 1995 and 2007. The number of visits was significantly higher in men, particularly those aged 65 and older. Fifty-nine percent of NMSC visits were associated with a procedure, and the individuals associated with that visit were more likely to be male, to be seen by a dermatologist, and to have private-pay insurance. Nonmelanoma skin cancer visit rates increased from 1995 to 2007 and were higher in men than women. Visits to a dermatologist are more likely to be associated with a procedure for NMSC, and there may be discrepancies in treatment patterns based on insurance type and sex. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Low caregiver health literacy is associated with higher pediatric emergency department use and nonurgent visits.

PubMed

Morrison, Andrea K; Schapira, Marilyn M; Gorelick, Marc H; Hoffmann, Raymond G; Brousseau, David C

2014-01-01

We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. This year long cross-sectional study utilized the Newest Vital Sign questionnaire to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model 2 outcomes-prior ED visits and ED visit urgency-stratified by chronic illness. Analyses were weighted by triage level. Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (adjusted incidence rate ratio 1.5; 95% confidence interval 1.2, 1.8) and increased odds of a nonurgent index ED visit (adjusted odds ratio 2.4; 95% confidence interval 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of nonurgent index ED visits (48% vs. 22%; adjusted odds ratio 3.2; 1.8, 5.7). Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for nonurgent conditions. In children without a chronic illness, low health literate caregivers had more than 3 times greater odds of presenting for a nonurgent condition than those with adequate health literacy. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Low Caregiver Health Literacy is Associated with Higher Pediatric Emergency Department Use and Non-urgent Visits

PubMed Central

Morrison, Andrea K.; Schapira, Marilyn M.; Gorelick, Marc H.; Hoffmann, Raymond G.; Brousseau, David C.

2014-01-01

Objective We sought to determine the association between low caregiver health literacy and child emergency department (ED) use, both the number and urgency of ED visits. Methods This year long cross-sectional study utilized the Newest Vital Sign to measure the health literacy of caregivers accompanying children to a pediatric ED. Prior ED visits were extracted from a regional database. ED visit urgency was classified by resources utilized during the index ED visit. Regression analyses were used to model the outcomes: 1) prior ED visits and 2) ED visit urgency, stratified by chronic illness. Analyses were weighted by triage level. Results Overall, 503 caregivers completed the study; 55% demonstrated low health literacy. Children of caregivers with low health literacy had more prior ED visits (aIRR 1.5; 95% C.I.1.2, 1.8) and increased odds of a non-urgent index ED visit (AOR 2.4; 1.3, 4.4). Among children without chronic illness, low caregiver health literacy was associated with an increased proportion of non-urgent index ED visits (48% vs 22%; AOR 3.2; 1.8, 5.7). Conclusions Over half of caregivers presenting with their children to the ED have low health literacy. Low caregiver health literacy is an independent predictor of higher ED use and use of the ED for non-urgent conditions. In children without a chronic illness, low health literate caregivers had more than three times great odds of presenting for a non-urgent condition than those with adequate health literacy. PMID:24767784

Informed and patient-centered decision-making in the primary care visits of African Americans with depression.

PubMed

Hines, Anika L; Roter, Debra; Ghods Dinoso, Bri K; Carson, Kathryn A; Daumit, Gail L; Cooper, Lisa A

2018-02-01

We examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. We performed a cross-sectional analysis of audiotaped clinical encounters and post-visit surveys of 76 patients and their clinicians. We used RIAS to characterize patient-centeredness of visit dialogue. IDM entailed discussion of 3 components: the nature of the decision, alternatives, and pros/cons. PCDM entailed discussion of: lifestyle/coping strategies, knowledge/beliefs, or treatment concerns. We examined the association of IDM and PCDM with visit duration, overall patient-centeredness, and patient/clinician interpersonal ratings. Approximately one-quarter of medication and counseling decisions included essential IDM elements and 40% included at least one PCDM element. In high patient-centered visits, IDM was associated with patients feeling respected in counseling and liking clinicians in medication decisions. IDM was not related to clinician ratings. In low patient-centered visits, PCDM in counseling decisions was positively associated with patients feeling respected and clinicians respecting patients. The associations between IDM and PCDM with interpersonal ratings was moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors of dental visits for routine check-ups and for the resolution of problems among preschool children.

PubMed

Camargo, Maria Beatriz Junqueira; Barros, Aluísio J D; Frazão, Paulo; Matijasevich, Alicia; Santos, Iná S; Peres, Marco Aurélio; Peres, Karen Glazer

2012-02-01

To estimate the prevalence of dental visits among preschool children and determine the factors associated with using dental services. A cross-sectional study was conducted with 1,129 five-year-old children from the Pelotas Birth Cohort Study in Pelotas (Southern Brazil) 2004, from September 2009 to January 2010. Use of dental services at least once in the child's life and the reason for the child's first dental visit were recorded. The categories assigned for the first dental visit were: routine check-up, resolution of a problem, or never saw a dentist. The oral examinations and interviews were performed in the children's homes. Socioeconomic aspects and independent variables related to the mother and child were analyzed using multivariable logistic regression. The prevalence of dental visits (both categories combined) was 37.0%. The main predictors for a routine visit were higher economic status, mothers with more schooling, and mothers who had received guidance about prevention. Major predictors for a visit because of a problem were having felt pain in the previous six months, mothers with higher education level, and mothers who had received guidance about prevention. Approximately 45.0% of mothers received information about how to prevent cavities, usually from the dentist. Children of mothers who adhered to health programs were more likely to have had a routine dental visit. The rate of preschool visits to dental services was lower than the rate for medical appointments (childcare). In addition to income and education, maternal behavior plays an important role in routine visits. Pain reported in the last six months and a high number of teeth affected by tooth decay, independent of other factors, were associated with visits for a specific problem. It is important to integrate oral health instruction into maternal and child health programs.

Green Space Visits among Adolescents: Frequency and Predictors in the PIAMA Birth Cohort Study.

PubMed

Bloemsma, Lizan D; Gehring, Ulrike; Klompmaker, Jochem O; Hoek, Gerard; Janssen, Nicole A H; Smit, Henriëtte A; Vonk, Judith M; Brunekreef, Bert; Lebret, Erik; Wijga, Alet H

2018-04-30

Green space may influence health through several pathways, for example, increased physical activity, enhanced social cohesion, reduced stress, and improved air quality. For green space to increase physical activity and social cohesion, spending time in green spaces is likely to be important. We examined whether adolescents visit green spaces and for what purposes. Furthermore, we assessed the predictors of green space visits. In this cross-sectional study, data for 1911 participants of the Dutch PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort were analyzed. At age 17, adolescents reported how often they visited green spaces for physical activities, social activities, relaxation, and to experience nature and quietness. We assessed the predictors of green space visits altogether and for different purposes by log-binomial regression. Fifty-three percent of the adolescents visited green spaces at least once a week in summer, mostly for physical and social activities. Adolescents reporting that a green environment was (very) important to them visited green spaces most frequently {adjusted prevalence ratio (PR) [95% confidence interval (CI)] very vs. not important: 6.84 (5.10, 9.17) for physical activities and 4.76 (3.72, 6.09) for social activities}. Boys and adolescents with highly educated fathers visited green spaces more often for physical and social activities. Adolescents who own a dog visited green spaces more often to experience nature and quietness. Green space visits were not associated with the objectively measured quantity of residential green space, i.e., the average normalized difference vegetation index (NDVI) and percentages of urban, agricultural, and natural green space in circular buffers around the adolescents' homes. Subjective variables are stronger predictors of green space visits in adolescents than the objectively measured quantity of residential green space. https://doi.org/10.1289/EHP2429.

Meaning-making appraisals relevant to adjustment for veterans with spinal cord injury.

PubMed

DeRoon-Cassini, Terri A; de St Aubin, Ed; Valvano, Abbey K; Hastings, James; Brasel, Karen J

2013-05-01

The purpose of the present study was to conduct a mixed-methods investigation of meaning-making appraisals generated from spinal cord injury survivors' narratives of their injury experience. The sample consisted of 79 participants from an urban midwestern Veterans Affairs facility. The study design was cross-sectional and incorporated semistructured, face-to-face interviews, taking approximately 1 hr to complete. Measures of posttraumatic stress disorder, depression, psychological well-being, and purpose in life were completed as part of the interview. A data analytic approach based on grounded theory that allowed qualitative themes to be transformed to quantitative data was employed. Seven salient meaning-making themes were identified. Significant relationships were identified between certain meaning-making themes (e.g., identity integration positively related to positive growth), and certain themes were also significantly related to postinjury psychological health and distress separately (e.g., perceived burden on others was significantly related to greater depression scores). Findings are discussed within the context of clinical interventions that foster positive posttrauma outcomes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Is park visitation associated with leisure-time and transportation physical activity?

PubMed

Veitch, Jenny; Ball, Kylie; Crawford, David; Abbott, Gavin; Salmon, Jo

2013-11-01

The aim of this study was to examine whether frequency of park visitation was associated with time spent in various domains of physical activity among adults living in a disadvantaged neighbourhood of Victoria, Australia. In 2009, participants (n=319) self-reported park visitation and physical activity including: walking and cycling for transport, leisure-time walking, leisure-time moderate- to vigorous-intensity physical activity, and total physical activity. The mean number of park visits per week was 3.3 (SD=3.8). Park visitation was associated with greater odds of engaging in high (as compared to low) amounts of transportation physical activity, leisure-time walking, leisure-time moderate- to vigorous-intensity physical activity (MVPA) and total physical activity. Each additional park visit per week was associated with 23% greater odds of being in the high category for transportation physical activity, 26% greater odds of engaging in high amounts of leisure-time walking, 11% greater odds of engaging in MVPA, and 40% greater odds of high total physical activity. Acknowledging the cross-sectional study design, the findings suggest that park visitation may be an important predictor and/or destination for transportation and leisure-time walking and physical activity. Findings highlight the potentially important role of parks for physical activity. © 2013.

The delivery of clinical preventive services: acute care intervention.

PubMed

Hahn, D L

1999-10-01

. Evidence-based clinical preventive services are underutilized. We explored the major factors associated with delivery of these services in a large physician-owned community-based group practice that provided care for both fee-for-service (FFS) and health maintenance organization (HMO) patient populations. We performed a cross-sectional audit of the computerized billing data of all adult outpatients seen at least once by any primary care provider in 1995 (N = 75,621). Delivery of preventive services was stratified by age, sex, visit frequency, insurance status (FFS or HMO), and visit type (acute care only or scheduled preventive visit). Insurance status and visit type were the strongest predictors of clinical preventive service delivery. Patients with FFS coverage received 6% to 13% (absolute difference) fewer of these services than HMO patients. Acute-care-only patients received 9% to 45% fewer services than patients who scheduled preventive visits. The combination of these factors was associated with profound differences. Having insurance to pay for preventive services is an important factor in the delivery of such care. Encouraging all patients to schedule preventive visits has been suggested as a strategy for increasing delivery, but that is not practical in this setting. Assessing the need for preventive services and offering them during acute care visits has equal potential for increasing delivery.

Oppression and resiliency in a post-apartheid South Africa: unheard voices of Black gay men and lesbians.

PubMed

Graziano, Kevin J

2004-08-01

Guided by photovoice, a form of participatory action research that uses documentary photography and storytelling, this study examines how Black gay men and lesbians view themselves in relation to White gay men and lesbians in South Africa. Participants were from 4 South African townships and included 4 women, and 3 men. Participants discussed interracial dating, a lack of education, and information regarding differing sexualities and health care. They reported being sexually and physically assaulted for challenging the heterosexual status quo. Other themes that emerged from this study were classism, cultural traditions of visiting African healers, and segregated social spaces. Amidst oppression and despair, participants showed signs of strength, hope, and optimism.

Center Director Bridges visits Disability Awareness and Action working Group Technology Fair

NASA Technical Reports Server (NTRS)

1999-01-01

Center Director Roy Bridges (standing, center) poses with members of the Disability Awareness and Action Working Group (DAAWG), which is holding the 1999 Technology Fair Oct. 20-21 at Kennedy Space Center. The Fair is highlighting vendors demonstrating mobility, hearing, vision and silent disability assistive technology. The purpose is to create an awareness of the types of technology currently available to assist people with various disabilities in the workplace. The theme is that of this year's National Disability Employment Awareness Month, 'Opening Doors to Ability.' Some of the vendors participating are Canine Companions for Independence, Goodwill Industries, Accessible Structures, Division of Blind Services, Space Coast Center for Independent Living, KSC Fitness Center and Delaware North Parks Services.

Technology-dependent children and the demand for pharmaceutical care.

PubMed

Okido, Aline Cristiane Cavicchioli; Cunha, Suelen Teles da; Neves, Eliane Tatsch; Dupas, Giselle; Lima, Regina Aparecida Garcia de

2016-01-01

to understand the experience of mothers of technology-dependent children as regards pharmaceutical care. this was a qualitative, descriptive-exploratory study developed based on open interviews using a structured characterization tool, and applied during home visits to 12 mothers caring for technology-dependent children. The data was submitted to inductive content analysis. this study is split into two themes: (i) maternal overload during pharmaceutical care, demonstrating the need to administer drugs continuously and the repercussions of this exhaustive care on the caregivers; (ii) the ease or difficulty of access to the medicines required, showing informal strategies and support networks. pharmaceutical care is a daily challenge expressed in maternal overload and difficulty accessing the drugs, made worse by failures in the care network and coordinated care.

KSC-2014-4265

NASA Image and Video Library

2014-10-15

CAPE CANAVERAL, Fla. – NASA Kennedy Space Center Director Bob Cabana, left, presents a special plaque to Michael Kersjes, author and former special education teacher and football coach from Michigan, after his presentation to workers during the Disability Awareness and Action Working Group, or DAAWG, event. The theme of Kersjes' presentation was "Power of the Human Spirit." Kersjes is the author of the book, "A Smile as Big as the Moon," which told the true story of how he worked to get special education students into Space Camp, a competitive education program at the U.S. Space and Rocket Center in Huntsville, Alabama. His book was made into a movie in 2012. For information on Kennedy's diversity programs, visit http://odeo.ksc.nasa.gov. Photo credit: NASA/Kim Shiflett

Inevitability of Interdisciplinary Approaches

NASA Astrophysics Data System (ADS)

Andersson, Bertil

On a summer day in 2005 Jan Vasbinder visited me at the European Science Foundation. Jan had a dream: to set up a European institute dedicated to sciences for our future and based on the principles of the Santa Fe Institute. It was to be an independent institute that would grow a new kind of scientific research community, one emphasizing multi-disciplinary collaboration in pursuit of understanding the common themes that arise in natural, artificial, and social systems. It was a wonderful dream, and I bought into it right away. So I became founding father and initial funder of Institute Para Limes IPL. In March 2006 ESF hosted the first meeting of the founding fathers, in which the structure, governance and the first research agenda were decided upon...

Analysis of the variation in OCT measurements of a structural bottle neck for eye-brain transfer of visual information from 3D-volumes of the optic nerve head, PIMD-Average [02π

NASA Astrophysics Data System (ADS)

Söderberg, Per G.; Malmberg, Filip; Sandberg-Melin, Camilla

2016-03-01

The present study aimed to analyze the clinical usefulness of the thinnest cross section of the nerve fibers in the optic nerve head averaged over the circumference of the optic nerve head. 3D volumes of the optic nerve head of the same eye was captured at two different visits spaced in time by 1-4 weeks, in 13 subjects diagnosed with early to moderate glaucoma. At each visit 3 volumes containing the optic nerve head were captured independently with a Topcon OCT- 2000 system. In each volume, the average shortest distance between the inner surface of the retina and the central limit of the pigment epithelium around the optic nerve head circumference, PIMD-Average [02π], was determined semiautomatically. The measurements were analyzed with an analysis of variance for estimation of the variance components for subjects, visits, volumes and semi-automatic measurements of PIMD-Average [0;2π]. It was found that the variance for subjects was on the order of five times the variance for visits, and the variance for visits was on the order of 5 times higher than the variance for volumes. The variance for semi-automatic measurements of PIMD-Average [02π] was 3 orders of magnitude lower than the variance for volumes. A 95 % confidence interval for mean PIMD-Average [02π] was estimated to 1.00 +/-0.13 mm (D.f. = 12). The variance estimates indicate that PIMD-Average [02π] is not suitable for comparison between a onetime estimate in a subject and a population reference interval. Cross-sectional independent group comparisons of PIMD-Average [02π] averaged over subjects will require inconveniently large sample sizes. However, cross-sectional independent group comparison of averages of within subject difference between baseline and follow-up can be made with reasonable sample sizes. Assuming a loss rate of 0.1 PIMD-Average [02π] per year and 4 visits per year it was found that approximately 18 months follow up is required before a significant change of PIMDAverage [02π] can be observed with a power of 0.8. This is shorter than what has been observed both for HRT measurements and automated perimetry measurements with a similar observation rate. It is concluded that PIMDAverage [02π] has the potential to detect deterioration of glaucoma quicker than currently available primary diagnostic instruments. To increase the efficiency of PIMD-Average [02π] further, the variation among visits within subject has to be reduced.

Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea.

PubMed

Suk, Min Hyun; Oh, Won-Oak; Im, YeoJin

2018-01-01

With the recent growth of multicultural families in the Korean society, the importance of the role of qualified visiting nurses in the delivery of culturally sensitive health care has grown dramatically. As the primary health care provider for multicultural families enrolled in public community-based health care centers, the cultural competence of visiting nurses is an essential qualification for the provision of quality health care for multicultural families, especially in rural areas. Cultural competence of visiting nurses is based on their cultural awareness and empathetic attitude toward multicultural families. This study aimed to examine the levels of cultural competence, empowerment, and empathy in visiting nurses, and to verify the factors that affect the cultural competence of visiting nurses working with rural multicultural families in South Korea. Employing a cross-sectional descriptive study design, data from 143 visiting nurses working in rural areas were obtained. Data collection took place between November 2011 and August 2012. The measurement tools included the modified Korean version of the Cultural Awareness Scale, the Text of Items Measuring Empowerment, and the Interpersonal Reactivity Index to measure the level of empathy of visiting nurses. Analyses included descriptive statistics, a t-test, an ANOVA, a Pearson correlation coefficient analysis, and a multiple linear regression analysis. The cultural competence score of the visiting nurses was 3.07 on a 5-point Likert scale (SD = 0.30). The multiple regression analysis revealed that the cultural competence of visiting nurses was significantly influenced by experience of cultural education, empathy, and scores on the meaning subscale of the empowerment tool (R 2  = 10.2%). Institutional support to enhance visiting nurses' empowerment by assuring the significance of their job and specific strategies to enhance their empathy would be helpful to improve the cultural competence of visiting nurses. Additionally, regular systematic education on culturally sensitive care would be helpful to enable visiting nurses to provide culturally sensitive care for multicultural families.

75 FR 68395 - Agency Self-Evaluation Under Section 504 of the Rehabilitation Act of 1973

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

...-800-325- 0778, or visit our Internet site, Social Security Online, at http://www.socialsecurity.gov... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2010-0069] Agency Self-Evaluation Under Section 504 of the Rehabilitation Act of 1973 AGENCY: Social Security Administration. ACTION: Notice and request...

Psychology and Counseling Library Research Guide.

ERIC Educational Resources Information Center

Sylvia, Margaret

This document is a guide for library research in psychology or counseling. The first section discusses how to do research in the library, including choosing a topic, beginning with books, updating the information with journals, checking out books, interlibrary loan, visiting other libraries, and writing the paper. The second section provides…

Quality of Acute Care for Patients With Urinary Stones in the United States.

PubMed

Scales, Charles D; Bergman, Jonathan; Carter, Stacey; Jack, Gregory; Saigal, Christopher S; Litwin, Mark S

2015-11-01

To describe guideline adherence for patients with suspected upper tract stones. We performed a cross-sectional analysis of visits recorded by the National Hospital Ambulatory Medical Care Survey (emergency department [ED] component) in 2007-2010 (most recent data). We assessed adherence to clinical guidelines for diagnostic laboratory testing, imaging, and pharmacologic therapy. Multivariable regression models controlled for important covariates. An estimated 4,956,444 ED visits for patients with suspected kidney stones occurred during the study period. Guideline adherence was highest for diagnostic imaging, with 3,122,229 (63%) visits providing optimal imaging. Complete guideline-based laboratory testing occurred in only 2 of every 5 visits. Pharmacologic therapy to facilitate stone passage was prescribed during only 17% of eligible visits. In multivariable analysis of guideline adherence, we found little variation by patient, provider, or facility characteristics. Guideline-recommended care was absent from a substantial proportion of acute care visits for patients with suspected kidney stones. These failures of care delivery likely increase costs and temporary disability. Targeted interventions to improve guideline adherence should be designed and evaluated to improve care for patients with symptomatic kidney stones. Published by Elsevier Inc.

Quality of Acute Care for Patients with Urinary Stones in the United States

PubMed Central

Scales, Charles D.; Bergman, Jonathan; Carter, Stacey; Jack, Gregory; Saigal, Christopher S.; Litwin, Mark S.

2015-01-01

Objective To describe guideline adherence for patients with suspected upper tract stones. Methods We performed a cross-sectional analysis of visits recorded by the National Hospital Ambulatory Medical Care Survey (ED component) in 2007–2010 (most recent data). We assessed adherence to clinical guidelines for diagnostic laboratory testing, imaging, and pharmacologic therapy. Multivariable regression models controlled for important covariates. Results An estimated 4,956,444 ED visits for patients with suspected kidney stones occurred during the study period. Guideline adherence was highest for diagnostic imaging, with 3,122,229 (63%) visits providing optimal imaging. Complete guideline-based laboratory testing occurred in only 2 of every 5 visits. Pharmacologic therapy to facilitate stone passage was prescribed during only 17% of eligible visits. In multivariable analysis of guideline adherence, we found little variation by patient, provider or facility characteristics. Conclusions Guideline-recommended care was absent from a substantial proportion of acute care visits for patients with suspected kidney stones. These failures of care delivery likely increase costs and temporary disability. Targeted interventions to improve guideline adherence should be designed and evaluated to improve care for patients with symptomatic kidney stones. PMID:26335495

The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care

PubMed Central

Roter, Debra L.; Carson, Kathryn A.; Beach, Mary Catherine; Sabin, Janice A.; Greenwald, Anthony G.; Inui, Thomas S.

2012-01-01

Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and patient ratings. Results. Among Black patients, general race bias was associated with more clinician verbal dominance, lower patient positive affect, and poorer ratings of interpersonal care; race and compliance stereotyping was associated with longer visits, slower speech, less patient centeredness, and poorer ratings of interpersonal care. Among White patients, bias was associated with more verbal dominance and better ratings of interpersonal care; race and compliance stereotyping was associated with less verbal dominance, shorter visits, faster speech, more patient centeredness, higher clinician positive affect, and lower ratings of some aspects of interpersonal care. Conclusions. Clinician implicit race bias and race and compliance stereotyping are associated with markers of poor visit communication and poor ratings of care, particularly among Black patients. PMID:22420787

Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries.

PubMed

Agarwal, Parul; Bias, Thomas K; Madhavan, Suresh; Sambamoorthi, Nethra; Frisbee, Stephanie; Sambamoorthi, Usha

2016-04-27

The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47), Hispanics (IRR = 1.63), polypharmacy (IRR = 1.89), and tobacco use (IRR = 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33). The county-level factors associated with ED visits were unemployment rate (IRR = 0.94) and number of urgent care clinics (IRR = 0.96). Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.

Trends and quality of care in outpatient visits to generalist and specialist physicians delivering primary care in the United States, 1997-2010.

PubMed

Edwards, Samuel T; Mafi, John N; Landon, Bruce E

2014-06-01

Although many specialists serve as primary care physicians (PCPs), the type of patients they serve, the range of services they provide, and the quality of care they deliver is uncertain. To describe trends in patient, physician, and visit characteristics, and compare visit-based quality for visits to generalists and specialists self-identified as PCPs. Cross-sectional study and time trend analysis. Nationally representative sample of visits to office-based physicians from the National Ambulatory Medical Care Survey, 1997-2010. Proportions of primary care visits to generalist and specialists, patient characteristics, principal diagnoses, and quality. Among 84,041 visits to self-identified PCPs representing an estimated 4.0 billion visits, 91.5 % were to generalists, 5.9 % were to medical specialists and 2.6 % were to obstetrician/gynecologists. The proportion of PCP visits to generalists increased from 88.4 % in 1997 to 92.4 % in 2010, but decreased for medical specialists from 8.0 % to 4.8 %, p = 0.04). The proportion of medical specialist visits in which the physician self-identified as the patient's PCP decreased from 30.6 % in 1997 to 9.8 % in 2010 (p < 0.01). Medical specialist PCPs take care of older patients (mean age 61 years), and dedicate most of their visits to chronic disease management (51.0 %), while generalist PCPs see younger patients (mean age 55.4 years) most commonly for new problems (40.5 %). Obstetrician/gynecologists self-identified as PCPs see younger patients (mean age 38.3 p < 0.01), primarily for preventive care (54.0 %, p < 0.01). Quality of care for cardiovascular disease was better in visits to cardiologists than in visits to generalists, but was similar or better in visits to generalists compared to visits to other medical specialists. Medical specialists are less frequently serving as PCPs for their patients over time. Generalist, medical specialist, and obstetrician/gynecologist PCPs serve different primary care roles for different populations. Delivery redesign efforts must account for the evolving role of generalist and specialist PCPs in the delivery of primary care.

Proceedings-Shrublands under fire: disturbance and recovery in a changing world; 2006 June 6-8; Cedar City, UT

Treesearch

Stanley G. Kitchen; Rosemary L. Pendleton; Thomas A. Monaco; Jason Vernon

2008-01-01

The 27 papers in these proceedings are divided into five sections. The first includes an introduction to the symposium theme of Shrublands under Fire, along with a keynote address comparing ecosystem degradation in Iran with current problems in the semi-arid to arid Western United States. The next three sections cluster papers on invasive species, community dynamics...

Interactional Resources for Quality Improvement: Learning From Participants Through a Qualitative Study.

PubMed

Brooks, Joanna Veazey; Gorbenko, Ksenia; Bosk, Charles

Implementing quality improvement in hospitals requires a multifaceted commitment from leaders, including financial, material, and personnel resources. However, little is known about the interactional resources needed for project implementation. The aim of this analysis was to identify the types of interactional support hospital teams sought in a surgical quality improvement project. Hospital site visits were conducted using a combination of observations, interviews, and focus groups to explore the implementation of a surgical quality improvement project. Twenty-six site visits were conducted between October 2012 and August 2014 at a total of 16 hospitals that agreed to participate. All interviews were recorded, transcribed, and coded for themes using inductive analysis. We interviewed 321 respondents and conducted an additional 28 focus groups. Respondents reported needing the following types of interactional support during implementation of quality improvement interventions: (1) a critical outside perspective on their implementation progress; (2) opportunities to learn from peers, especially around clinical innovations; and (3) external validation to help establish visibility for and commitment to the project. Quality improvement in hospitals is both a clinical endeavor and a social endeavor. Our findings show that teams often desire interactional resources as they implement quality improvement initiatives. In-person site visits can provide these resources while also activating emotional energy for teams, which builds momentum and sustainability for quality improvement work. Policymakers and quality improvement leaders will benefit from developing strategies to maximize interactional learning and feedback for quality improvement teams. Further research should investigate the most effective methods for meeting these needs.

Opportunities for improved diabetes care among patients of safety net practices: a safety net providers' strategic alliance study.

PubMed

Reichsman, Ann; Werner, James; Cella, Peggi; Bobiak, Sarah; Stange, Kurt C

2009-01-01

To identify barriers and opportunities for quality diabetes care in safety net practices. In 3 federally qualified health centers and 1 free clinic, 19 primary care clinicians profiled patient and visit characteristics and quality of care measures for 181 consecutive visits by adult type 2 diabetic patients. Open-ended questions assessed patient and clinician perception of barriers to diabetes care and patient report of enabling factors. A multidisciplinary team identified themes from open-ended responses. Logistic regression analyses assessed the association of the identified barriers/enablers with 2 measures of quality care: glycosylated hemoglobin and prophylactic aspirin use. Ranked barriers noted by patients included adherence (40%), financial/insurance (23%), and psychosocial (13%) factors. Clinicians ranked systemic factors, including financial/ insurance (32%) and cultural/psychosocial (29%) factors, as important to adherence (29%) in determining quality diabetes care. Patients reported dietary and medical adherence (37%) and family/health care worker support (17%) as helpful factors. Among 175 patients with available data, glycosylated hemoglobin levels were associated with patient report of financial/insurance factors both as a barrier when visits and medications were unaffordable and as an opportunity when free or low-cost medications and services were provided. Patients' adherence with aspirin prophylaxis was strongly associated with African American race, prior prescription of aspirin and distribution of aspirin at the practice site (p<.001). Patients were less likely than clinicians to identify systemic and contextual factors contributing to poor diabetes care. From the front line's perspective, enabling patient self-management and systemic support is a target for improving diabetes care in safety net practices.

What will it take for disease management to demonstrate a return on investment? New perspectives on an old theme.

PubMed

Linden, Ariel Linden

2006-04-01

Disease management programs are expected (and usually contractually required) to reduce total costs in the diseases they manage. To discuss the appropriateness of using utilization indexes in lieu of cost and the importance of reviewing utilization trends to determine whether sufficient opportunity exists for a program to be financially effective; and to conduct an analysis to determine the number of admissions that must be reduced for a program to achieve various levels of return on investment. Descriptive. Historical inpatient cost trends, discharges per 10,000 population, the mean length of stay, and emergency department visits per 10,000 population for acute myocardial infarction, congestive heart failure, asthma, and diabetes mellitus are presented. A "number-needed-to-decrease" analysis is performed to determine the number of admissions or emergency department visits that must be reduced to meet varying levels of return on investment. (1) Hospital days per 10,000 population for these conditions trended downward, while costs during the same period escalated. (2) Discharge and emergency department visit rates per 10,000 population were flat and low during the observation period, while the mean length of stay declined. Results of the number-needed-to-decrease analysis suggest that disease management programs will have to decrease admissions 10% to 30% to cover program fees alone. A review of historical utilization trends and a number-needed-to-decrease analysis should be conducted before disease management program implementation to determine whether sufficient opportunity exists to reduce utilization to levels that will ensure a positive return on investment.

Interactional Resources for Quality Improvement: Learning from Participants through a Qualitative Study

PubMed Central

Brooks, Joanna Veazey; Gorbenko, Ksenia; Bosk, Charles

2017-01-01

BACKGROUND Implementing quality improvement in hospitals requires a multi-faceted commitment from leaders, including financial, material, and personnel resources. However, little is known about the interactional resources needed for project implementation. The aim of this analysis was to identify the types of interactional support hospital teams sought in a surgical quality improvement project. METHODS Hospital site visits were conducted using a combination of observations, interviews, and focus groups to explore the implementation of a surgical quality improvement project. Twenty-six site visits were conducted between October 2012 and August 2014 at a total of 16 hospitals that agreed to participate. All interviews were recorded, transcribed, and coded for themes using inductive analysis. RESULTS We interviewed 321 respondents and conducted an additional 28 focus groups. Respondents reported needing the following types of interactional support during implementation of quality improvement interventions: 1) a critical outside perspective on their implementation progress; 2) opportunities to learn from peers, especially around clinical innovations; and 3) external validation to help establish visibility for and commitment to the project. CONCLUSIONS Quality improvement in hospitals is both a clinical and a social endeavor. Our findings show that teams often desire interactional resources as they implement quality improvement initiatives. In-person site visits can provide these resources while also activating emotional energy for teams, which builds momentum and sustainability for quality improvement work. IMPLICATIONS Policymakers and quality improvement leaders will benefit from developing strategies to maximize interactional learning and feedback for quality improvement teams. Further research should investigate the most effective methods for meeting these needs. PMID:28375951

Monitoring tobacco brand websites to understand marketing strategies aimed at tobacco product users and potential users.

PubMed

Escobedo, Patricia; Cruz, Tess Boley; Tsai, Kai-Ya; Allem, Jon-Patrick; Soto, Daniel W; Kirkpatrick, Matthew G; Pattarroyo, Monica; Unger, Jennifer B

2017-09-11

Limited information exists about strategies and methods used on brand marketing websites to transmit pro-tobacco messages to tobacco users and potential users. This study compared age verification methods, themes, interactive activities and links to social media across tobacco brand websites. This study examined 12 tobacco brand websites representing four tobacco product categories: cigarettes, cigar/cigarillos, smokeless tobacco, and e-cigarettes. Website content was analyzed by tobacco product category and data from all website visits (n = 699) were analyzed. Adult smokers (n=32) coded websites during a one-year period, indicating whether or not they observed any of 53 marketing themes, seven interactive activities, or five external links to social media sites. Most (58%) websites required online registration before entering, however e-cigarette websites used click-through age verification. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature themes related to "party" lifestyle, and e-cigarette websites were much more likely to feature themes related to harm reduction. Cigarette sites featured greater levels of interactive content compared to other tobacco products. Compared to cigarette sites, cigar/cigarillo sites were more likely to feature activities related to events and music. Compared to cigarette sites, both cigar and e-cigarette sites were more likely to direct visitors to external social media sites. Marketing methods and strategies normalize tobacco use by providing website visitors with positive themes combined with interactive content, and is an area of future research. Moreover, all tobacco products under federal regulatory authority should be required to use more stringent age verification gates. Findings indicate the Food and Drug Administration (FDA) should require brand websites of all tobacco products under its regulatory authority use more stringent age verification gates by requiring all visitors be at least 18 years of age and register online prior to entry. This is important given that marketing strategies may encourage experimentation with tobacco or deter quit attempts among website visitors. Future research should examine the use of interactive activities and social media on a wide variety of tobacco brand websites as interactive content is associated with more active information processing. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Emergency Department Use among Adults with Autism Spectrum Disorders (ASD)

PubMed Central

Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha

2016-01-01

A cross-sectional analyses using Nationwide Emergency Department Sample (2006-2011) was conducted to examine the trends, type of ED visits, and mean total ED charges for adults aged 22-64 years with and without ASD (matched 1:3). Around 0.4% ED visits (n = 25,527) were associated with any ASD and rates of such visits more than doubled from 2006 to 2011 (2,549 to 6,087 per 100,000 admissions). Adults with ASD visited ED for: primary psychiatric disorder (15%ASD vs. 4.2%noASD), primary non-psychiatric disorder (16%ASD vs. 14%noASD), and any injury (24%ASD vs. 28%noASD). Mean total ED charges for adults with ASD were 2.3 times higher than adults without ASD. Findings emphasize the need to examine the extent of frequent ED use in this population. PMID:26762115

Effects of relational coordination among colleagues and span of control on work engagement among home-visiting nurses.

PubMed

Naruse, Takashi; Sakai, Mahiro; Nagata, Satoko

2016-04-01

Home-visiting nursing agencies are required to foster staff nurse's work engagement; thus, the factors related to work engagement require identification. This study examined relational coordination among colleagues and agency span of control on the work engagement of home-visiting nurses. Cross-sectional data from 93 staff nurses in 31 home-visiting nursing agencies were collected via a survey and analyzed using mixed linear regression. There was no significant main effect of relational coordination among nurse colleagues on work engagement. In large agencies with a large span of control, relational coordination among nursing colleagues predicted work engagement. Nursing managers' relational coordination was found to be positively associated with staff nurse work engagement. Agency span of control is a moderating factor on the positive effect of relational coordination with nursing colleagues on staff nurse work engagement. © 2016 Japan Academy of Nursing Science.

Interactive Exhibits Foster Partnership and Engage Diverse Learners at Their Local Libraries

NASA Astrophysics Data System (ADS)

LaConte, K.; Dusenbery, P.; Fitzhugh, G.; Harold, J. B.; Holland, A.

2016-12-01

Learners frequently need to access increasingly complex information to help them understand our changing world. More and more libraries are transforming themselves into places where learners not only access STEM information, but interact with professionals and undertake hands-on learning. Libraries are beginning to position themselves as part of learning ecosystems that contribute to a collective impact on the community. Traveling STEM exhibits are catalyzing these partnerships and engaging students, families, and adults in repeat visits through an accessible venue: their public library. The impact of the STAR Library Education Network's (STAR_Net) Discover Earth: A Century of Change exhibit on partnerships, the circulation of STEM resources, and the engagement of learners was studied by an external evaluation team. The STAR_Net project's summative evaluation utilized mixed methods to investigate project implementation and its outcomes. Methods included pre- and post-exhibit surveys administered to staff from each library that hosted the exhibits; interviews with staff from host libraries; patron surveys; exhibit-related circulation records; web metrics regarding the online STAR_Net community of practice; and site visits. A subset of host libraries recruited professionals, who delivered programming that connected Earth systems science, weather, climate, and conservation themes from the exhibit to local issues. Library patrons improved their knowledge about STEM topics presented in the exhibits and associated programming, and patrons viewing the exhibit reflected the demographics of their communities. In a follow-up survey, patrons reported spending an average of 60 minutes looking at the exhibit over their cumulative visits to the library. In contrast, visitors might visit a museum only once to look at a comparably-sized traveling exhibit due to barriers such as cost and distance. Exhibit host libraries reported an increase in the circulation of Earth science materials of 27% while the exhibit was at their library. The summative evaluation results, as well as tips for working with your local library, will be shared.

Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.

PubMed

Ness, Genevieve Lynn; Sheehan, Amy Heck; Snyder, Margie E

2014-01-01

OBJECTIVE To characterize students' views and opinions of professionalism on popular social media sites and compare responses about social media behavior among students in different groups. DESIGN Cross-sectional survey. SETTING Four colleges of pharmacy in midwestern United States. PARTICIPANTS 516 graduating student pharmacists. INTERVENTIONS Online survey with open-ended questions. MAIN OUTCOME MEASURES Qualitative analysis of responses and themes. RESULTS A total of 212 student pharmacists completed surveys (41% response rate). Mean (± SD) age was 25.2 ± 4.6 years, and 72% of respondents were women. Major overarching themes identified in the qualitative analysis were separation of personal and professional lives, how accountability for actions should vary by severity, and the extent of representation of the students' character on social media. CONCLUSION Identified themes provided important insights into the ways in which student pharmacists view social media and use this widely accessible means of personal communication.

Pediatric Emergency Department Resource Utilization among Children with Primary Care Clinic Contact in the Preceding 2 Days: A Cross-Sectional Study.

PubMed

Grech, Christina K; Laux, Molly A; Burrows, Heather L; Macy, Michelle L; Pomeranz, Elaine S

2017-09-01

To characterize pediatric patient contacts with their primary care clinic in the 2 days preceding a visit to the emergency department (ED) and explore how the type of clinic contact relates to ED resource use. We conducted a retrospective chart review of 368 pediatric ED visits in the first 7 days of each month, from September 2012 to August 2013. Visits were included if the family contacted their child's general pediatric clinic in the study health system in the 2 days preceding the ED visit. Descriptive statistics were calculated. Primary outcomes were ED resource use (tests, treatments) and disposition (admission or discharge). Outcomes by type of clinic contact were compared with χ 2 statistics. Of 1116 records with ED visits in the 12 study weeks extracted from the electronic medical record, 368 ED visits met inclusion criteria. Most ED visits followed a single clinic contact (78.8%). Of the 474 clinic contacts, 149 were in-person visits, 216 phone calls when clinic was open, and 109 phone calls when clinic was closed. ED visits that followed an in-person clinic contact with advice to go to the ED had significantly greater rates of testing and admission than those advised to go to the ED after phone contact and those never advised to go to the ED. In-person clinic visits with advice to go to the ED were associated with the greatest ED resource use. Limitations include a study of a single health system without a uniform process for triaging patients to the ED across clinics. Copyright © 2017 Elsevier Inc. All rights reserved.

Primary care physician assistant and advance practice nurses roles: Patient healthcare utilization, unmet need, and satisfaction.

PubMed

Everett, Christine M; Morgan, Perri; Jackson, George L

2016-12-01

Team-based care involving physician assistants (PAs) and advance practice nurses (APNs) is one strategy for improving access and quality of care. PA/APNs perform a variety of roles on primary care teams. However, limited research describes the relationship between PA/APN role and patient outcomes. We examined multiple outcomes associated with primary care PA/APN roles. In this cross-sectional survey analysis, we studied adult respondents to the 2010 Health Tracking Household Survey. Outcomes included primary care and emergency department visits, hospitalizations, unmet need, and satisfaction. PA/APN role was categorized as physician only (no PA/APN visits; reference), usual provider (PA/APN provide majority of primary care visits) or supplemental provider (physician as usual provider, PA/APN provide a subset of visits). Multivariable logistic and multinomial logistic regressions were performed. Compared to people with physician only care, patients with PA/APNs as usual providers [5-9 visits RRR=2.4 (CI 1.8-3.4), 10+ visits RRR=3.0 (CI 2.0-4.5): reference 2-4 visits] and supplemental providers had increased risk of having 5 or more primary care visits [5-9 visits RRR=1.3 (CI 1.0-1.6)]. Patients reporting PA/APN as supplemental providers had increased risk of emergency department utilization [2+ visits: RRR 1.8 (CI 1.3, 2.5)], and lower satisfaction [very dissatisfied: RRR 1.8 (CI 1.03-3.0)]. No differences were seen for hospitalizations or unmet need. Healthcare utilization patterns and satisfaction varied between adults with PA/APN in different roles, but reported unmet need did not. These findings suggest a wide range of outcomes should be considered when identifying the best PA/APN role on primary care teams. Copyright © 2016 Elsevier Inc. All rights reserved.

AGE AND REASONS OF THE FIRST DENTAL VISIT OF CHILDREN IN LEBANON.

PubMed

Daou, Maha H; Eden, Ece; El Osta, Nada

2016-01-01

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommended that the child's first dental visit should be during the child's first year of life for dental disease prevention and to decrease the invasive restorative interventions. In Lebanon, no study has been conducted to determine the age and the reasons of the first dental visit of children and who requested the first dental screening. To assess at what age occurred the first dental visit in a group of Lebanese children visiting a private pediatric dental clinic and to explore the reasons for their first dental consultation. An observational cross-sectional study was conducted. During a five-year period, all children visiting the pediatric clinic were invited to participate in the study. Parents were asked about the general health status of their child, the use of antibiotics before the age of 2 years. Parents were also requested to give the dental reasons for their initial visit to a pedodontist. Two hundred and twenty children (mean age 4.24 ± 1.35 years) visited the pedodontic care office for the first time and were included in the study. All participants had visited a pediatrician before the age of 1 year. Fifty-seven (25.9%) children were referred by a dentist and 163 (74.1%) came with their parents without referral. All participants had at least one reason for the first consultation; the most common were the presence of decayed teeth (50.9%) and a dental pain perception (29.5%). All participants had visited a pediatrician at an earlier age but none was referred to a pedodontist by a pediatrician for check-up or prevention. Children came upon the decision of their parents. A dental problem was the major reason which triggered the first visit. Therefore, pediatricians in Lebanon need to keep themselves updated on recommendations regarding children oral health and be encouraged to play an important role in prompting oral health and first dental visits.

Use of Opioids and Other Analgesics by Older Adults in the United States, 1999–2010

PubMed Central

Steinman, Michael A.; Komaiko, Kiya D.R.; Fung, Kathy Z.; Ritchie, Christine S.

2016-01-01

Background & Objective There has been concern over rising use of prescription opioids in young and middle-aged adults. Much less is known about opioid prescribing in older adults, for whom clinical recommendations and the balance of risks and benefits differ from younger adults. We evaluated changes in use of opioids and other analgesics in a national sample of clinic visits made by older adults between 1999 to 2010. Design, Setting, Subjects Observational study of adults age 65 and older from the 1999–2010 National Ambulatory and National Hospital Ambulatory Medical Care Surveys, serial cross-sectional surveys of outpatient visits in the United States. Methods Medication use was assessed at each study visit and included medications in use prior to the visit and medications newly prescribed at the visit. Results were adjusted for survey weights and design factors to provide nationally representative estimates. Results Mean age was 75 +/−7 years, and 45% of visits occurred in primary care settings. Between 1999–2000 and 2009–10, the percent of clinic visits at which an opioid was used rose from 4.1% to 9.0% (P<.001). Although use of all major opioid classes increased, the largest contributor to increased use was hydrocodone-containing combination opioids, which rose from 1.1% to 3.5% of visits over the study period (P<.001). Growth in opioid use was observed across a wide range of patient and clinic characteristics, including in visits for musculoskeletal problems (10.7% of visits in 1999–00 to 17.0% in 2009–10, P<.001) and in visits for other reasons (2.8% to 7.3%, P<.001). Conclusions Opioid use by older adults visiting clinics more than doubled between 1999–2010, and occurred across a wide range of patient characteristics and clinic settings. PMID:25352175

Associations between sugar-sweetened beverage consumption and fast-food restaurant frequency among adolescents and their friends.

PubMed

Bruening, Meg; MacLehose, Richard; Eisenberg, Marla E; Nanney, Marilyn S; Story, Mary; Neumark-Sztainer, Dianne

2014-01-01

To assess associations between adolescents and their friends with regard to sugar-sweetened beverage (SSB)/diet soda intake and fast-food (FF) restaurant visits. Population-based, cross-sectional survey study with direct measures from friends. Twenty Minneapolis/St Paul schools during 2009-2010. Adolescents (n = 2,043; mean age, 14.2 ± 1.9 years; 46.2% female; 80% non-white). Adolescent SSB/diet soda intake and FF visits. Generalized estimating equation logistic models were used to examine associations between adolescents' SSB/diet soda intake and FF visits and similar behaviors in nominated friends (friend groups and best friends). School-level (middle vs high school) interactions were assessed. Significant associations were found between adolescents and friends behaviors for each of the beverages assessed (P < .05), but they varied by friendship type and school level. Five of 6 models of FF visits (including all FF visits) were significantly associated (P < .05) among adolescents and their friends. Significant interactions by school level were present among adolescents' and friends' FF visits, with associations generally for high school participants compared with middle school participants (P < .05). Findings suggest that for many beverages and FF restaurant types, friends' behaviors are associated, especially FF visits for older adolescents. Nutrition education efforts may benefit by integrating knowledge of the impact of adolescents' friends on FF visits. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Associations between sugar-sweetened beverage consumption and fast food restaurant frequency among adolescents and their friends

PubMed Central

Bruening, Meg; MacLehose, Richard; Eisenberg, Marla E; Nanney, Marilyn S.; Story, Mary; Neumark-Sztainer, Dianne

2016-01-01

Objective To assess associations between adolescents and their friends with regard to sugar-sweetened beverage (SSB)/diet soda intake, and fast food (FF) restaurant visits. Design Population-based, cross-sectional survey study with direct measures from friends. Setting Twenty Minneapolis/St. Paul schools during 2009–2010. Participants Adolescents (n=2,043; mean age=14.2±1.9; 46.2% female; 80% non-white). Main outcome measures Adolescent SSB/diet soda intake and FF visits. Analysis Generalized estimating equation logistic models were used to examine associations between adolescents’ SSB/diet soda intake and FF visits and similar behaviors in nominated friends (friend groups, best friends). School-level (middle vs. high school) interactions were assessed. Results Significant associations were found between adolescents and friends behaviors for each of the beverages assessed (P<0.05), but varied by friendship type and school level. Five of six models of FF visits (including all FF visits) were significantly associated (P <0.05) among adolescents and their friends. Significant interactions by school level were present among adolescents’ and friends’ FF visits, with associations generally for high school participants compared to middle school participants (P <0.05). Conclusions and implications Findings suggest for many beverages and FF restaurant types, friends’ behaviors are associated, especially FF visits for older adolescents. Nutrition education efforts may benefit by integrating the knowledge of the impact of adolescents’ friends on FF visits. PMID:24735768

HIV/AIDS related commodities supply chain management in public health facilities of Addis Ababa, Ethiopia: a cross-sectional survey.

PubMed

Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif

2016-01-01

A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit. There was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

A new cannabinoid CB2 receptor agonist HU-910 attenuates oxidative stress, inflammation and cell death associated with hepatic ischaemia/reperfusion injury.

PubMed

Horváth, Bėla; Magid, Lital; Mukhopadhyay, Partha; Bátkai, Sándor; Rajesh, Mohanraj; Park, Ogyi; Tanchian, Galin; Gao, Rachel Y; Goodfellow, Catherine E; Glass, Michelle; Mechoulam, Raphael; Pacher, Pál

2012-04-01

Cannabinoid CB(2) receptor activation has been reported to attenuate myocardial, cerebral and hepatic ischaemia-reperfusion (I/R) injury. We have investigated the effects of a novel CB(2) receptor agonist ((1S,4R)-2-(2,6-dimethoxy-4-(2-methyloctan-2-yl)phenyl)-7,7-dimethylbicyclo[2.2.1]hept-2-en-1-yl)methanol (HU-910) on liver injury induced by 1 h of ischaemia followed by 2, 6 or 24 h of reperfusion, using a well-established mouse model of segmental hepatic I/R. Displacement of [(3) H]CP55940 by HU-910 from specific binding sites in CHO cell membranes transfected with human CB(2) or CB(1) receptors (hCB(1/2) ) yielded K(i) values of 6 nM and 1.4 µM respectively. HU-910 inhibited forskolin-stimulated cyclic AMP production by hCB(2) CHO cells (EC(50) = 162 nM) and yielded EC(50) of 26.4 nM in [(35) S]GTPγS binding assays using hCB(2) expressing CHO membranes. HU-910 given before ischaemia significantly attenuated levels of I/R-induced hepatic pro-inflammatory chemokines (CCL3 and CXCL2), TNF-α, inter-cellular adhesion molecule-1, neutrophil infiltration, oxidative stress and cell death. Some of the beneficial effect of HU-910 also persisted when given at the beginning of the reperfusion or 1 h after the ischaemic episode. Furthermore, HU-910 attenuated the bacterial endotoxin-triggered TNF-α production in isolated Kupffer cells and expression of adhesion molecules in primary human liver sinusoidal endothelial cells stimulated with TNF-α. Pretreatment with a CB(2) receptor antagonist attenuated the protective effects of HU-910, while pretreatment with a CB(1) antagonist tended to enhance them. HU-910 is a potent CB(2) receptor agonist which may exert protective effects in various diseases associated with inflammation and tissue injury. This article is part of a themed section on Cannabinoids in Biology and Medicine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-8. To view Part I of Cannabinoids in Biology and Medicine visit http://dx.doi.org/10.1111/bph.2011.163.issue-7. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

"Sounds a Bit Crazy, But It Was Almost More Personal:" A Qualitative Study of Patient and Clinician Experiences of Physical Therapist-Prescribed Exercise For Knee Osteoarthritis Via Skype.

PubMed

Hinman, R S; Nelligan, R K; Bennell, K L; Delany, C

2017-12-01

To explore the experience of patients and physical therapists with Skype for exercise management of knee osteoarthritis (OA). This was a qualitative study. The Donabedian model for quality assessment in health care (structure, process, and outcomes) informed semistructured individual interview questions. The study involved 12 purposively sampled patients with knee OA who received physical therapist-prescribed exercise over Skype, and all therapists (n = 8) who delivered the intervention in a clinical trial were interviewed about their experiences. Interviews were audio recorded and transcribed. Two investigators undertook coding and analysis using a thematic approach. Six themes arose from both patients and therapists. The themes were Structure: technology (easy to use, variable quality, set-up assistance helpful) and patient convenience (time efficient, flexible, increased access); Process: empowerment to self-manage (facilitated by home environment and therapists focusing on effective treatment) and positive therapeutic relationships (personal undivided attention from therapists, supportive friendly interactions); and Outcomes: satisfaction with care (satisfying, enjoyable, patients would recommend, therapists felt Skype more useful as adjunct to usual practice) and patient benefits (reduced pain, improved function, improved confidence and self-efficacy). A seventh theme arose from therapists regarding process: adjusting routine treatment (need to modify habits, discomfort without hands-on, supported by research environment). Patients and physical therapists described mostly positive experiences using Skype as a service delivery model for physical therapist-supervised exercise management of moderate knee OA. Such a model is feasible and acceptable and has the potential to increase access to supervised exercise management for people with knee OA, either individually or in combination with traditional in-clinic visits. © 2017, American College of Rheumatology.

Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

PubMed

Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

2010-12-01

We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Qualitative Assessment of Learning Strategies among Medical Students Using Focus Group Discussions and In-depth Interviews.

PubMed

Joshi, Anuradha Sujai; Ganjiwale, Jaishree Deepak; Varma, Jagdish; Singh, Praveen; Modi, Jyoti Nath; Singh, Tejinder

2017-12-01

Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. The objective is to identify effective learning strategies used by medical students. This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.

Acceptability, Language, and Structure of Text Message-Based Behavioral Interventions for High-Risk Adolescent Females: A Qualitative Study

PubMed Central

Ranney, Megan L.; Choo, Esther K.; Cunningham, Rebecca M.; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J.; Morrow, Kathleen

2014-01-01

Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants’ needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. PMID:24559973