bluuebunny/crossref_metadata_2025 huggingface dataset:
Osthole: A Review on Its Bioactivities, Pharmacological Properties, and Potential as Alternative Medicine
Authors: Zhang Zhong-Rong , Leung Wing Nang , Cheung Ho Yee , Chan Chun Wai
Published: July 2015

This paper reviews the latest understanding of biological and pharmacological properties of osthole (7-methoxy-8-(3-methyl-2-butenyl)-2H-1-benzopyran-2-one), a natural product found in several medicinal plants such asCnidium monnieriandAngelica pubescens.In vitroandin vivoexperimental results have revealed that osthole demonstrates multiple pharmacological actions including neuroprotective, osteogenic, immunomodulatory, anticancer, hepatoprotective, cardiovascular protective, and antimicrobial activities. In addition, pharmacokinetic studies showed osthole uptake and utilization are fast and efficient in body. Moreover, the mechanisms of multiple pharmacological activities of osthole are very likely related to the modulatory effect on cyclic adenosine monophosphate (cAMP) and cyclic adenosine monophosphate (cGMP) level, though some mechanisms remain unclear. This review aims to summarize the pharmacological properties of osthole and give an overview of the underlying mechanisms, which showcase its potential as a multitarget alternative medicine.
A Multilayer Secure Biomedical Data Management System for Remotely Managing a Very Large Number of Diverse Personal Healthcare Devices
Authors: Park KeeHyun , Lim SeungHyeon
Published: July 2015

In this paper, a multilayer secure biomedical data management system for managing a very large number of diverse personal health devices is proposed. The system has the following characteristics: the system supports international standard communication protocols to achieve interoperability. The system is integrated in the sense that both a PHD communication system and a remote PHD management system work together as a single system. Finally, the system proposed in this paper provides user/message authentication processes to securely transmit biomedical data measured by PHDs based on the concept of a biomedical signature. Some experiments, including the stress test, have been conducted to show that the system proposed/constructed in this study performs very well even when a very large number of PHDs are used. For a stress test, up to 1,200 threads are made to represent the same number of PHD agents. The loss ratio of the ISO/IEEE 11073 messages in the normal system is as high as 14% when 1,200 PHD agents are connected. On the other hand, no message loss occurs in the multilayered system proposed in this study, which demonstrates the superiority of the multilayered system to the normal system with regard to heavy traffic.
Costus aferPossesses Carbohydrate Hydrolyzing Enzymes Inhibitory Activity and Antioxidant CapacityIn Vitro
Authors: Tchamgoue Armelle D. , Tchokouaha Lauve R. Y. , Tarkang Protus A. , Kuiate Jules-Roger , Agbor Gabriel A.
Published: July 2015

Diabetes mellitus is a metabolic disorder of glucose metabolism which correlates with postprandial hyperglycemia and oxidative stress. Control of blood glucose level is imperative in the management of diabetes. The present study tested the hypothesis thatCostus afer, an antihyperglycemic medicinal plant, possesses inhibitory activity against carbohydrate hydrolyzing enzymes. Hexane, ethyl acetate, methanol, and water extracts were prepared from the leaf, stem, and rhizome ofC. aferand subjected to phytochemical screening, assayed forα-amylase andα-glucosidase inhibitory activities and antioxidant capacity (determined by total phenolic and total flavonoids contents, ferric reducing antioxidant power (FRAP), and DPPH radical scavenging activity). All extracts inhibitedα-amylase andα-glucosidase activities. Ethyl acetate rhizome and methanol leaf extracts exhibited the best inhibitory activity againstα-amylase andα-glucosidase (IC50: 0.10 and 5.99 mg/mL), respectively. Kinetic analysis revealed two modes of enzyme inhibition (competitive and mixed). All extracts showed antioxidant capacity, with hexane extracts exhibiting the best activity. DPPH assay revealed that methanol leaf, rhizome, and ethyl acetate stem extracts (IC50< 5 mg/mL) were the best antioxidants. The presence of bioactive compounds such as flavonoids, alkaloids, phenols, and tannins may account for the antioxidant capacity and carbohydrate hydrolyzing enzyme inhibitory activity ofC. afer.
Platycodin D Blocks Breast Cancer-Induced Bone Destruction by Inhibiting Osteoclastogenesis and the Growth of Breast Cancer Cells
Authors: Lee Sun Kyoung , Park Kwang-Kyun , Kim Hyun-Jeong , Kim Ki Rim , Kang Eun Ji , Kim Yu Li , Yoon Heein , Kim Yeong Shik , Chung Won-Yoon
Published: July 2015

Background: Metastatic breast cancer cells are frequently associated with osteoclast-mediated bone resorption, resulting in severe bone destruction and increased mortality in patients. Platycodin D (PD) isolated from Platycodon grandiflorum is a triterpenoid saponin with anti-cancer and anti-angiogenic potential. Methods: The in vivo activity was determined in mice with the intratibial injection of human metastatic breast cancer cells. Osteoclast formation and activity were detected using tartrate-resistant acid phosphatase staining and calcium phosphate-coated plates. The expression of osteoclastogenesis-inducing molecules was detected by RT-PCR and western blotting in RANKL-treated bone marrow macrophages (BMMs). Cell viability and DNA synthesis were measured with MTT and BrdU incorporation assays. The induction of apoptosis was estimated using TUNEL staining and a caspase-3 activity assay. Results: The oral administration of PD inhibited MDA-MB-231 cell-induced osteolysis in an intratibial mouse model. PD treatment blocked RANKL-induced osteoclast formation by inhibiting the expression and nuclear translocation of NFATc1 and c-Fos in BMMs and consequently reduced osteoclast-mediated bone resorption. Furthermore, PD treatment induced apoptosis in osteoclasts and inhibited the growth of MDA-MB-231 cells. Conclusion: PD may block breast cancer-induced bone loss by suppressing the formation, activity, and survival of osteoclasts, as well as the growth of metastatic breast cancer cells.
Acetylcholine Attenuated TNF-α-Induced Apoptosis in H9c2 Cells: Role of Calpain and the p38-MAPK Pathway
Authors: Zhao Ming , Yang Yang , Bi Xueyuan , Yu Xiaojiang , Jia Hanghuan , Fang Huanle , Zang Weijin
Published: July 2015

Background: Previous studies have shown that inflammation is associated with excessive activation of calpains. Acetylcholine (ACh) has been reported to inhibit pro-inflammatory cytokine release and protect against cardiomyocyte injury. However, there is no direct evidence regarding whether ACh can regulate calpains to exert cardioprotection. To this end, we investigated the effect of ACh on tumour necrosis factor alpha (TNF-α)-induced cardiomyocyte injury and further explored the underlying mechanism. Methods: Flow cytometry and transmission electron microscopy were performed to evaluate apoptosis and cellular ultrastructure. Western blotting was performed to assess changes in protein expression. siRNA was employed to silence specific proteins. Results: TNF-α treatment increased the expression of cleaved caspase-3, calpain-1 and p38-mitogen-activated protein kinase (p38-MAPK). The calpain inhibitor PD150606 and the p38-MAPK inhibitor SB203580 inhibited apoptosis induced by TNF-α. Moreover, SB203580 decreased the expression and activity of calpain-1, possibly related to the up-regulation of calpastatin. ACh significantly inhibited TNF-α-induced cell apoptosis, as evidenced by decreases in caspase-3 cleavage, p38-MAPK phosphorylation, and calpain-1 expression and activity as well as increases in calpastatin expression. These beneficial effects of ACh were abolished by atropine or M2AChR siRNA. Conclusion: Our results suggest that ACh ameliorated TNF-α-induced calpain activation by decreasing p38-MAPK phosphorylation and enhancing calpastatin expression, indicating that calpain may be an important link between inflammatory factors and myocardial cell apoptosis.
Multimodal, Intraoperative Monitoring during Paddle Lead Placement for Cervicothoracic Spinal Cord Stimulation
Authors: Choi Jin-gyu , Ha Sang-woo , Son Byung-chul
Published: July 2015

Background and Objective: We investigated the efficacy of combined somatosensory evoked potentials (SSEP) and electromyography monitoring during paddle lead placement through cervicothoracic laminectomy under general anesthesia in a retrospective review of data from 25 patients. Methods: Muscle motor evoked potentials (MEP) recordings and SSEP monitoring were used for surveillance of the spinal cord. Collision testing of SSEP and threshold amplitudes of compound muscle action potentials (CMAP) in the bilateral upper and lower extremities evoked by electrode contacts of the paddle lead were checked to determine the laterality of the lead in the mediolateral direction. Results: A significant decrease in amplitudes of muscle MEP in spite of stable SSEP occurred in 2 patients: 1 patient with a retrograde C1-C2 insertion and another patient with an anterograde C4/C5 insertion. Repositioning of leads based on significantly asymmetrical collision testing of SSEP and thresholds of CMAP in bilateral extremities was needed in 6 and 8 patients, respectively. In 22 patients, paresthesia coverage of the painful area was consistently located in the painful side, either unilaterally or bilaterally. There was no episode of revision for suboptimal lead placement. Conclusions: Intraoperative neurophysiological guidance using SSEP and muscle MEP was useful for the safe and accurate placement of paddle leads for cervicothoracic SCS.
Randomized Controlled Study to Evaluate the Efficacy of a Preoperative Respiratory Rehabilitation Program to Prevent Postoperative Pulmonary Complications after Esophagectomy
Authors: Yamana Ippei , Takeno Shinsuke , Hashimoto Tatsuya , Maki Kenji , Shibata Ryosuke , Shiwaku Hironari , Shimaoka Hideki , Shiota Etsuji , Yamashita Yuichi
Published: July 2015

Background/Aims: Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer patients. Methods: This study was a prospective randomized controlled study. Thirty patients in the PR group and 30 patients in the no preoperative respiratory rehabilitation (NPR) group were included. The PR group received preoperative rehabilitation for more than 7 days, while the NPR group did not receive any preoperative rehabilitation. All patients underwent postoperative rehabilitation from the first postoperative day. The postoperative pulmonary complications were evaluated using the Clavien-Dindo classification (CDC) and the Utrecht Pneumonia Scoring System (UPSS). Results: The CDC grade in the PR group was significantly lower than that in the NPR group (p = 0.014). The UPSS score in the PR group was significantly lower than that in the NPR group at postoperative day 1 (p = 0.031). In the multivariate analysis, NPR was an independent risk factor for postoperative pulmonary complications greater than CDC grade II (OR: 3.99, 95% CI: 1.28-12.4, p = 0.017). Conclusions: This study showed that the intensive PR program was capable of reducing the postoperative pulmonary complications in esophageal cancer patients.
Relationships between Cognitive Performance, Neuroimaging and Vascular Disease: The DHS-MIND Study
Authors: Hsu Fang-Chi , Raffield Laura M. , Hugenschmidt Christina E. , Cox Amanda , Xu Jianzhao , Carr J. Jeffery , Freedman Barry I. , Maldjian Joseph A. , Williamson Jeff D. , Bowden Donald W.
Published: July 2015

Background: Type 2 diabetes mellitus increases the risk of cognitive decline and dementia, and elevated burdens of vascular disease are hypothesized to contribute to this risk. These relationships were examined in the Diabetes Heart Study-MIND using a battery of cognitive tests, neuroimaging measures and subclinical cardiovascular disease (CVD) burden assessed by coronary artery calcified (CAC) plaque. We hypothesized that CAC would attenuate the association between neuroimaging measures and cognition performance. Methods: Associations were examined using marginal models in this family-based cohort of 572 European Americans from 263 families. All models were adjusted for age, gender, education, type 2 diabetes and hypertension, with some neuroimaging measures additionally adjusted for intracranial volume. Results: Higher total brain volume was associated with better performance on the Digit Symbol Substitution Task and Semantic Fluency (both p ≤ 7.0 × 10-4). Higher gray matter volume was associated with better performance on the Modified Mini-Mental State Examination and Semantic Fluency (both p ≤ 9.0 × 10-4). Adjusting for CAC caused minimal changes to the results. Conclusions: Relationships exist between neuroimaging measures and cognitive performance in a type 2 diabetes-enriched European American cohort. Associations were minimally attenuated after adjusting for subclinical CVD. Additional work is needed to understand how subclinical CVD burden interacts with other factors and impacts relationships between neuroimaging and cognitive testing measures.
Clinical Presentation of General Paralysis of the Insane in a Dutch Psychiatric Hospital, 1924-1954
Authors: Daey Ouwens Ingrid M. , Lens C. Elisabeth , Fiolet Aernoud T.L. , Ott Alewijn , Koehler Peter J. , Verhoeven Willem M.A.
Published: July 2015

General paralysis of the insane (GPI) or dementia paralytica was once a fatal complication of syphilitic infection and a major reason for psychiatric hospitalization. Nowadays, physicians consider GPI to be exceptional. It should be noted, however, that syphilis re-emerged worldwide at the turn of the 20th to 21st century and a revival of GPI can, therefore, be expected. Advanced diagnosis is crucial in that treatment in the early, inflammatory phase is warranted before irreversible tissue damage occurs. Therefore, a renewed clinical awareness of the broad spectrum of psychiatric and neurologic signs and symptoms of GPI is needed. In this historical cohort study, comprising 105 patients with GPI admitted to the Dutch Vincent van Gogh Psychiatric Hospital in the period 1924-1954, the clinical presentation of this invalidating disorder is investigated and described in detail.
Primary and Secondary Thrombotic Microangiopathy Referred to a Single Plasma Exchange Center for Suspected Thrombotic Thrombocytopenic Purpura: 2000-2011
Authors: Dahlan Randah , Sontrop Jessica M. , Li Lihua , Ghadieh Omar , Clark William F.
Published: July 2015

Background: Patients who present with unexplained thrombocytopenia, that is, hemolytic anemia with end-organ dysfunction with a normal coagulation profile are suspected to have thrombotic thrombocytopenic purpura (TTP) and are usually referred to a plasma exchange (PE) center for immediate treatment to prevent mortality. Here, we describe the distribution and outcomes of patients with suspected TTP referred to a single center for PE therapy. Methods: In this retrospective cohort study, we reviewed the data of all consecutive patients who were treated with PE for suspected TTP at our center between January 2000 and December 2011 (Canada). Patients were followed for a median of 73 months. Results: Of 137 patients, 70 (51%) were determined to have primary (idiopathic) TTP and 67 (49%) secondary TTP or hemolytic uremic syndrome (HUS). Patients with primary TTP were twice as likely to be refractory than those with secondary TTP or HUS: 27 vs. 12%; p = 0.03. Patients with primary TTP were more likely to experience remission (61/70 (87%) vs. 45/67 (67%); p = 0.01); however, the relapse rate was higher in patients with primary versus secondary TTP-HUS: 11 vs. 1.5%, respectively (p = 0.03). The overall mortality rate was 23% (13 vs. 33% in those with primary vs. secondary TTP-HUS; p = 0.007). After excluding deaths from scleroderma renal crisis (100% mortality), malignancy (75% mortality) and stem cell transplant (50% mortality), the survival rate for secondary TTP was 85%. Conclusions: In contrast to patients with secondary TTP or HUS, those with primary TTP have a higher refractory and relapse rate, but are also more likely to achieve remission and survive.
Thermally Induced Convective Circulation and Precipitation over an Isolated Volcano
Authors: Poulidis Alexandros P. , Renfrew Ian A. , Matthews Adrian J.
Published: July 2015

Intense rainfall over active volcanoes is known to trigger dangerous volcanic hazards, from remobilizing loose volcanic surface material into lahars or mudflows to initiating explosive activity including pyroclastic flows at certain dome-forming volcanoes. However, the effect of the heated volcanic surface on the atmospheric circulation, including any feedback with precipitation, is unknown. This is investigated here, using the Weather Research and Forecasting (WRF) Model. The recent activity at the Soufrière Hills Volcano (SHV), Montserrat, is a well-documented case of such rainfall–volcano interaction and is used as a template for these experiments. The volcano is represented in the model by an idealized Gaussian mountain, with an imposed realistic surface temperature anomaly on the volcano summit. A robust increase in precipitation over the volcano is simulated for surface temperature anomalies above approximately 40°C, an area-average value that is exceeded at the SHV. For wind speeds less than 4 m s−1 and a range of realistic atmospheric conditions, the precipitation increase is well above the threshold required to trigger volcanic hazards (5–10 mm h−1). Hence, the thermal atmospheric forcing due to an active, but nonerupting, volcano appears to be an important factor in rainfall–volcano interactions and should be taken account of in future hazard studies.
Collaborative Concept Mapping and Critical Thinking in Fourth-Year Medical Students
Authors: Bixler G. Michael , Brown Amy , Way David , Ledford Cynthia , Mahan John D.
Published: July 2015

Objective. To test the hypothesis that small group concept mapping of 4 core neonatal topics as part of a fourth-year allopathic medical student elective would improve critical thinking (CT) as measured by the California Critical Thinking Skills Test (CCTST). To describe any correlations between scores on the CCTST and the step 1 and step 2 Clinical Knowledge parts of the United States Medical Licensing Exam. Methods. Twenty-seven students participated in this pilot study during a 1-month elective. A pretest CCTST, California Critical Thinking Disposition Inventory (CCTDI), and multiple choice knowledge test (MCKT) were completed immediately before the elective began. Four weekly group sessions were held with assigned reading on each of the 4 neonatal topics. Concept mapping was performed in small groups of 4 to 6 students with a group concept map collected at the end of the exercise. A posttest CCTST and MCKT was completed after the 4 group sessions. Results. Pre-CCTST overall score was 83.9 ± 6, and post-CCTST overall score was 85.6 ± 6.9 ( P = .57). Pearson correlation of USMLE step 1 and pre-CCTST showed r(25) = .276, P = .164. Pearson correlation of USMLE step 2 CK and pre-CCTST revealed r(25) = .214, P = .482. The precourse MCKT average was 35%, and the postcourse average 50% ( P ≤ .001). Conclusions. A recent meta-analysis confirms this is the first report of a comparison between the increasingly common CCTST and the USMLE. We confirmed that concept mapping is a valid mechanism to teach content knowledge. Although the difference in the CCTST scores was not significant, this study could serve as an important start toward development of a curriculum devoted to teaching content and improving CT. The small number of students may have prevented us from defining a significant impact.
Parentally Bereaved Children and Adolescents
Authors: LaFreniere Lucas , Cain Albert
Published: July 2015

This study investigates peer interaction and peer support for parentally bereaved children and adolescents. Using data from an extensive bereavement study, transcribed semistructured interviews on peer relationships from a sample of 35 parentally bereaved children aged 6 to 15 were systematically coded. Exploratory dimensions of inquiry included incidence counts of teasing, peer interaction regarding bereavement, and preference for interaction, among 12 other dimensions. Hypotheses related to age, gender, and parental death type (anticipated vs. sudden) differences on peer support reception were also tested. Major findings included the following: 71.4% of the sample received support from peers, although 71.4% preferred not to have bereavement-related peer interaction. A significantly greater percentage of females versus males experienced peer support and a positive emotional response, and a significantly greater percentage of children bereaved by anticipated deaths versus sudden deaths had received bereavement-related peer interaction and support. No significant differences were found between younger and older children.
“Is Grief a Disease?”
Authors: Stroebe Margaret
Published: July 2015

In 1961, George Engel (1913–1999), founder of the innovative general theory of illness and healing known as the biopsychosocial model, wrote a classic paper entitled “Is Grief a Disease? A Challenge for Medical Research.” This article fuelled debate about the status of grief as a medical condition, with Engel’s question frequently taken as the starting point. But what did Engel really say: Was he actually arguing that grief is a disease? Has his position been accurately represented? Given that grief complications are currently under research investigation for potential diagnostic categorization as a mental disorder, it seems timely to reassess Engel’s historic contribution. I outline Engel’s arguments and illustrate the ensuing impact and interpretations of his position. I end with a personal communication from Engel, in which he elaborated why he posed this question, his purpose in writing the article, and his reason for considering that his “provocative title misfired.”
Trends and Patterns in Age Discrimination in Employment Act (ADEA) Charges
Authors: von Schrader Sarah , Nazarov Zafar E.
Published: July 2015

The Age Discrimination in Employment Act (ADEA) protects individuals aged 40 years and over from discrimination throughout the employment process. Using data on ADEA charges from the Equal Employment Opportunity Commission from 1993 to 2010, we present labor force–adjusted charge rates demonstrating that the highest charge rates are among those in the preretirement age range, and only the rate of charges among those aged 65 years and older has not decreased. We examine characteristics of ADEA charges including the prevalence of different alleged discriminatory actions (or issues) and highlight the increasing proportion of age discrimination charges that are jointly filed with other antidiscrimination statutes. Through a regression analysis, we find that the likelihood of citing various issues differs by charging party characteristics, such as age, gender, and minority status, and on charges that cite only age discrimination as compared to those that are jointly filed. Implications of these findings for employers are discussed.
Global Meat Market
Authors: Ali Jabir , Pappa Evangelia
Published: July 2015

This article provides a comprehensive overview of the global meat sector and examines significant food processing sub-sectors that are a major contributor to the global economy. Structural changes in global meat production, consumption and trade are analysed using recent Food and Agriculture Organisation statistical databases, in terms of geographic concentration or relocation of production or markets and temporal changes across major geographical regions. The findings indicate significant recent shifts in production, consumption and trade of different kinds of meat. While developing markets still focus on red meat, the developed markets are moving faster towards white meat due to increasing health and environmental concerns among consumers in recent years. The implications of such trends for South Asia are examined, too, and call for further research.
Overlapping Territorial Claims and Ethnic Conflict in Manipur
Authors: Piang L. Lam Khan
Published: July 2015

The current engagement of the government of India with various insurgent groups in Manipur’s hill areas makes it imperative to revisit certain problems related to local ethnicity construction and, more importantly, to specifically address burning issues of overlapping territorial demands. The article argues that such overlapping territorial claims, which have their roots in colonial processes of ethnicisation, need to be tackled as a matter of urgency. Such competing claims arose only after colonially constructed categories of local people who shared local living spaces began to claim exclusive ownership of the entire territory of certain administrative units. Challenging the presence of other groups by settlerising these respective ‘others’ has resulted in recent attempts at ethnic cleansing, which violates basic principles of India’s ‘unity in diversity’. Since local land ownership was traditionally neither attached to a tribe or ethnic group, but rather to the entire village community, a return to that pattern seems advisable. Thus, it is argued, shifting from a ‘tribe–district’ approach to ‘village community/village land’ approaches in dealing with the impasse of overlapping territorial claims offers scope for a sustainable reconciliation.
Domestic Space and Socio-spatial Relationships in Rural Pakistan
Authors: Mughal Muhammad Aurang Zeb
Published: July 2015

This article explores the changing use and management of domestic space and socio-spatial relationships constructed in a Pakistani rural setting. It offers a case study which highlights the central position of domestic space as a residential and social unit in rural Pakistan. It discusses how domestic space is appropriated in multiple ways into a social unit through social practice. Given that changes in the physical structure of any place lead to negotiation of social relationships, it is shown how recent modifications in design and structure of houses are indicative of, and to some extent facilitate, social change in rural Pakistan.
Hindu–Muslim Relations in the Work of Rabindranath Tagore and Rokeya Sakhawat Hossain
Authors: Quayum Mohammad A.
Published: July 2015

Rabindranath Tagore (1861–1941) and Rokeya Sakhawat Hossain (1880–1932) are two stalwarts of twentieth century Bengali literature. Born and raised in very different socio-cultural and religious environments, both lacked formal education, yet both went on to become ardent champions of education. Despite their different religious identities, both writers stepped out of their cultural and gendered borders to embrace the ‘other’ in a spirit of fellowship and unity, against a backdrop of turbulent Hindu–Muslim relationships and recurrent communal riots, throughout most of their adult lives. The present article investigates this cross-cultural, dialogic-inclusive vision of Hindu–Muslim unity as reflected in the literary works of these two writers. It seeks to explain why and how they espoused such a bold vision, going against the grain of religious feuds that characterised the history of the period. The current relevance of such cross-cultural navigation is evident.
How Current Law Might Apply to Drone Journalism
Authors: McIntyre Karen
Published: July 2015

This study finds that current FAA regulations do not permit private drone use for commercial purposes, including journalism. Privacy concerns about the use of drones in journalism may be addressed by existing law that finds reporters can legally record people who are in public or can be easily seen from a public place.
Traditional Reporting More Credible than Citizen News
Authors: Swasy Alecia , Tandoc Edson , Bhandari Manu , Davis Rachel
Published: July 2015

In an experiment comparing traditional news reporting to citizen blogs, university students rated traditional journalism as more credible than citizen journalism. Also, participants assessed straight news articles as more credible than opinionated reports of the same news.
Adverse Effects Associated With Newer Diabetes Therapies
Authors: Akiyode Oluwaranti F. , Adesoye Adebola A.
Published: July 2015

The increasing number of newer type 2 diabetes therapies has allowed providers an increased armamentarium for the optimal management of patients with diabetes. In fact, these newer agents have unique benefits in the management of type 2 diabetes. However, they are also associated with certain adverse effects. This review article aims to describe the notable adverse effects of these newer antidiabetic therapies including the glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors. The adverse effects reviewed herein include pancreatitis, medullary thyroid carcinoma, heart failure, gastrointestinal disturbances, renal impairment, and genitourinary infections. More clinical data are necessary to solidify the association of some of these adverse effects with the newer diabetes agents. However, it is important for health care practitioners to be well informed and prepared to properly monitor patients for these adverse effects.
Predictors of Preference for Hospice Care Among Diverse Older Adults
Authors: Cagle John G. , LaMantia Michael A. , Williams Sharon W. , Pek Jolynn , Edwards Lloyd J.
Published: July 2015

The purpose of this study was to identify predictors of preference for hospice care and explore whether the effect of these predictors on preference for hospice care were moderated by race.

Methods:

An analysis of the North Carolina AARP End of Life Survey (N = 3035) was conducted using multinomial logistic modeling to identify predictors of preference for hospice care. Response options included yes, no, or don’t know.

Results:

Fewer black respondents reported a preference for hospice (63.8% vs 79.2% for white respondents, P < .001). While the proportion of black and white respondents expressing a clear preference against hospice was nearly equal (4.5% and 4.0%, respectively), black individuals were nearly twice as likely to report a preference of “don’t know” (31.5% vs 16.8%). Gender, race, age, income, knowledge of Medicare coverage of hospice, presence of an advance directive, end-of-life care concerns, and religiosity/spirituality predicted hospice care preference. Religiosity/spirituality however, was moderated by race. Race interacted with religiosity/spirituality in predicting hospice care preference such that religiosity/spirituality promoted hospice care preference among White respondents, but not black respondents.

Conclusions:

Uncertainties about hospice among African Americans may contribute to disparities in utilization. Efforts to improve access to hospice should consider pre-existing preferences for end-of-life care and account for the complex demographic, social, and cultural factors that help shape these preferences.
An Initial Investigation of Do Not Resuscitate Acceptance in Egypt
Authors: Hassanin Fetouh S. , Schaalan Mona F. , Kamal Karim M. , Miller F. DeWolfe
Published: July 2015

Background:

The aim of this work was to obtain objective data on the extent of knowledge and attitudes of the do not resuscitate (DNR) concept in an Egyptian urban setting.

Methods:

This survey was conducted in Cairo, Egypt, using a structured questionnaire including 23 questions. Questions and questionnaire were developed from literature on DNR in the region and from pilot testing.

Results:

A total of 461 persons participated. In all, 48 participants (10.4%, 95% confidence interval [CI]: 7.8-13.7) agreed on the concept of DNR, 226 (49%, 95% CI: 36.1-45.2) stated that it depends on the patient condition, and 187 (40.5%, 95% CI: 44.4-53.7) rejected DNR. Combining the first 2 categories, agree and depends on patient condition, over 60% of the respondents in effect supported DNR. Family members (35.6%, 95% CI: 31.4-40.3) and attending physicians (43.3%, 95% CI: 30.1-39.0) were selected over religious leaders (21%, 95% CI: 17.5-25.2) and representatives from state institutions (4.6%, 95% CI: 2.9-7.0) as to who should have authority for making a DNR decisions.

Discussion:

These and additional results provide objective evidence that DNR will not be rejected outright in Egypt. More formal surveys are justified and will provide needed guidance for implementing DNR and related end-of-life medical care in Egypt.
Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator Deactivation
Authors: Pasalic Dario , Gazelka Halena M. , Topazian Rachel J. , Buchhalter Lillian C. , Ottenberg Abigale L. , Webster Tracy L. , Swetz Keith M. , Mueller Paul S.
Published: July 2015

The presence of cardiac pacemakers and defibrillators complicates making end-of-life (EOL) medical decisions. Palliative care/medicine consultation (PCMC) may benefit patients and primary providers, but data are lacking. We retrospectively reviewed 150 charts of patients who underwent device deactivation at our tertiary care center (between November 1, 2008, and September 1, 2012), assessing for PCMC and outcomes. Overall, 42% of patients received a PCMC, and 68% of those PCMCs specifically addressed device deactivation. Median survival following deactivation was 2 days, with 42% of deaths occurring within 1 day of deactivation. There was no difference in survival between the groups. The EOL care for patients with implanted cardiac devices is complex, but PCMC may assist with symptom management and clarification of goals of care for such patients.
Gynandroblastoma With Juvenile Granulosa Cell Tumor and Concurrent Renal Cell Carcinoma
Authors: Wilberger Adam , Yang Bin
Published: July 2015

Gynandroblastoma is an extremely rare primary tumor of the ovary showing morphological evidence of both female (granulosa cell tumor) and male (Sertoli or Sertoli–Leydig tumor) differentiation. We report an unusual case of a 32-year-old female who presented with hyperandrogenism and was found on imaging to have concurrent ovarian and renal masses. Following surgical excision, the ovarian mass was diagnosed as gynandroblastoma, which consisted of 45% juvenile granulosa cell tumor and 55% intermediately differentiated Sertoli–Leydig tumor. The renal mass was diagnosed as a conventional renal clear cell carcinoma. Gynandroblastoma, especially with juvenile granulosa cell tumor, is an extremely rare ovarian tumor. Concurrent gynandroblastoma with another malignant neoplasm has not been reported in the literature.
Talent Versus Payroll as Strategic Variables in Game Theoretic Models of Sports Leagues
Authors: Driskill Robert , Vrooman John
Published: July 2015

This is a response to Madden’s comment on our original article: It’s Not Over ‘til the Fat Lady Sings: Game-Theoretic Analyses of Sports Leagues.
Staging Workers' Use of Hearing Protection Devices
Authors: Raymond Delbert M. , Lusk Sally L.
Published: July 2015

The threat of noise-induced hearing loss is a serious concern for many workers. This study explores use of the transtheoretical model as a framework for defining stages of workers' acceptance of hearing protection devices. A secondary analysis was performed using a cross-section of data from a randomized, controlled clinical trial of an intervention to increase use of hearing protection. Use of hearing protection devices was well distributed across the theorized stages of change. Chi-square analysis and analysis of variance revealed significant differences between stages for the variables studied. Discrete stages of hearing protection device use can be identified, laying the foundation for further work investigating use of the transtheoretical model for promoting hearing protection device use. The model can provide a framework for tailoring interventions and evaluating their effects. With further development of the transtheoretical model, nurses may be able to easily identify workers' readiness to use hearing protection devices and tailor training toward that goal.
Juggling Work and Elder Caregiving
Authors: Pitsenberger D. Jeanne
Published: July 2015

As the American work force ages, the demands of caring for aging relatives increase. Family caregiving often interferes with workplace responsibilities, creating physical, emotional, and financial stress for caregivers. Employers must address the productivity losses created by absenteeism of workers who struggle with work–life issues created by caregiving roles. Occupational health nurses must understand the factors that affect workers in their caregiving roles and make appropriate nursing interventions. They are in key positions to help aging employees and their employers face the increased demands on work–life balance created by elder caregiving.
Determinants of Employee Participation in Physical Activity
Authors: Kaewthummanukul Thanee , Brown Kathleen C.
Published: July 2015

The purpose of this article is to provide a review of research literature related to factors that influence employee participation in physical activity. Eleven published studies investigating physical activity in samples of adult employees were included in this review. Across these studies, self-efficacy, or belief in personal ability to perform this health behavior, was the best predictor of physical activity among employees. Perceived benefits of physical activity and perceived health status were also found to influence participation in physical activity. Occupational health nurses could offer self-care classes and intervention programs that assist employees in improving their perceptions of self-efficacy to perform physical activity. Additionally, occupational health nurses should continue to reinforce the benefits of physical activity in all health promotion venues.
Promoting Personal Safety of Building Service Workers
Authors: Chen Shelley I. , Skillen D. Lynn
Published: July 2015

This exploratory, descriptive study conducted at a large western Canadian university solicited perceptions of personal safety among building service workers who perform night shift work alone. Ten semi-structured interviews were conducted at approximately 10:00 p.m. or 7:00 a.m with a convenience sample of night building service workers in private or semi-private locations on the university campus. Transcribed interview data were subjected to inductive content analysis using descriptive, interpretive, and pattern coding (Miles & Huberman, 1994). Results suggest that building service night shift workers are exposed to personal safety hazards in their physical and psychosocial work environments. In addition, culturally and linguistically appropriate delivery of safety training and education about policies and procedures is required for culturally diverse building service workers. Promotion of personal safety in this heterogeneous worker population requires due diligence, assessment, and advocacy.
Assessment of Wastewater Treatment Plant Workers Exposed to Biosolids
Authors: Robinson Carolyn , Robinson Kevin , Tatgenhorst Connie , Campbell Deborah , Webb Colleen
Published: July 2015

The purpose of this study was to develop and pilot test a health survey for wastewater treatment workers exposed to biosolids, using an upstream framework for environmental health. The questionnaire included items about health status, symptoms, frequency of contact with biosolids, use of personal protective equipment, and demographic data. A majority of workers regularly exposed to biosolids reported at least one health-related symptom, although some attributed their symptoms to contact with materials other than biosolids. All 11 participants took unnecessary health risks such as periodically neglecting to wear masks, respirators, gloves, or goggles to protect themselves from potential exposure to biosolids. However, those who reported symptoms were the least compliant with personal protective equipment use. Survey results highlighted that occupational health nurses must effectively communicate to their clients the need for proper use of personal protective equipment when working with potentially hazardous material.
A Worksite Diabetes Prevention Program
Authors: Aldana Steven , Barlow Marilyn , Smith Rebecca , Yanowitz Frank , Adams Ted , Loveday LaDonne , Merrill Ray M.
Published: July 2015

The purpose of this study was to determine the 2-year impact of a worksite-based diabetes prevention program. Thirty-seven pre-diabetic and previously undiagnosed diabetic employees participating in a 12-month worksite diabetes prevention program were included. Weight, body mass index, waist circumference, oral glucose tolerance testing, fasting insulin, blood lipids, and aerobic fitness had improved significantly after 6 months. Much of this improvement continued through 12 months. One year following the intervention, oral glucose tolerance and aerobic fitness had improved significantly. Of the 22 employees remaining in the study through 24 months, more than half had normal results on glucose tolerance testing. Worksite diabetes prevention programs may reduce blood glucose below pre-diabetic and diabetic levels. Improvements in diabetes risk factors persisted for at least 2 years in most of these employees.
Non-Physical Violence
Authors: Lanza Marilyn L. , Zeiss Robert A. , Rierdan Jill
Published: July 2015

This research study assessed the extent to which non-physical violence is a risk factor for physical violence against workers in health care settings. More than 600 nursing staff, other clinical providers, and non-clinical staff in two health care settings completed a cross-sectional survey. For the preceding 12-month period, 72.8% of workers reported at least one incident of non-physical violence and 21.3% reported at least one incident of physical violence. Workers who had experienced non-physical violence were 7.17 times more likely to experience physical violence than those who had not. Both patients and employees were perpetrators of non-physical and physical violence. These results indicate efforts to prevent or reduce physical violence against health care workers need to focus on non-physical as well as physical violence and employee as well as patient perpetrators.
Use of a Violence Risk Assessment Tool in an Acute Care Hospital
Authors: Kling Rakel , Corbière Marc , Milord Rebecca , Morrison Janet G. , Craib Kevin , Yassi Annalee , Sidebottom Claire , Kidd Catherine , Long Victoria , Saunders Sharon
Published: July 2015

This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.
What Resources are Available for Creating Documents Describing Essential Job Functions?
Authors: Brown Norman DePaul , Tourigian Robin
Published: July 2015

The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members and do not necessarily represent the views of AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the panel. This month's panel members include Norman DePaul Brown and Robin Tourigian.
The Impact of Hearing Impairment, Perceptions and Attitudes about Hearing Loss, and Noise Exposure Risk Patterns on Hearing Handicap among Farm Family Members
Authors: Carruth Ann , Robert Ashly E. , Hurley Annette , Currie Paula S.
Published: July 2015

Farm noise exposure is the major cause of noise-induced hearing loss among farmers. Hearing impairment associated with hearing loss, however, may not adequately represent communication handicap and the impact on quality of life. This descriptive correlational study examines the impact of hearing impairment, perceptions and attitudes about hearing loss, and noise exposure risk patterns on hearing handicap among farm family members. A convenience sample of 56 farmers and family members recruited from community-based agricultural events was studied. A hearing impairment was noted in the majority of the participants (80.4%). Fewer than 10 reported regularly wearing protection during work or recreational activities. High-frequency hearing loss in the left ear ( F = 10.30, p < .002), the attitude that wearing hearing protection prevents others from getting one's attention ( F = 11.90, p < .001), and the self-reported description of hearing ( F = 6.66, p < .013) significantly predicted hearing handicap using multiple regression analysis. Farmers and family members do not use hearing protection because they are concerned they will not hear others who are trying to communicate with them. The findings of this study confirm that this attitude, along with hearing loss in the left ear, is associated with a communication handicap in work settings. Although being able to hear others on a day-to-day basis is important, this attitude may contribute to behaviors leading to hearing loss and decreased communication over time.
Promoting Heart Health in Women
Authors: Jones Deborah E. , Weaver Michael T. , Friedmann Erika
Published: July 2015

The purpose of this study was to evaluate the effectiveness of a 5-week, 1 hour per week heart disease prevention program for sedentary female municipal workers with known heart disease risk factors. The program was designed to improve participants' knowledge and perceptions of their personal susceptibility to heart disease. In targeting an ethnically diverse, lower income working population, the researchers also sought to contribute to one of the goals of Healthy People 2010, the elimination of health disparities, specifically the reduction of health disparities in heart disease by 25% by the year 2010. A one-group, repeated measures, quasi-experimental design was employed. Forty-eight women 25 to 66 years old responded to the solicitation and participated in the program. Seventy-five percent were African American, 23% were White, and 2% were Latino. Participants completed a 33-item heart disease knowledge questionnaire, demographic questions, and a single visual analog scale statement to assess perceived susceptibility. Fifty-eight percent of the participants improved their knowledge of heart disease and 50% of the participants increased their perception of susceptibility to heart disease from pre- to post-intervention. The greatest improvement in knowledge and awareness of susceptibility occurred for those with limited knowledge and low perceptions of susceptibility. The gains from this workplace health education project for largely minority female municipal workers were modest, but notable. A workplace health education program for women targeted at increasing their knowledge of heart disease may also increase their perceptions of susceptibility to heart disease.