bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Status of the Rural Elderly
Authors: Kumar Vinod , Acanfora Miguel 
Published: April 2008

ABSTRACT:An enormous proportion of the world's elderly live in rural areas and show wide variations in health status. Many, particularly those in the developing countries, are vulnerable to greater socioeconomic and health marginalization mainly due to inadequate provision of services and economic deprivation. As with the urban elderly, locomotor, visual and hearing disabilities, as well as life‐threatening conditions of coronary heart disease, diabetes and hypertension are common among rural elders also. Infections continue to take a heavy toll in many parts of the world. Higher prevalence of health and functioning impairments and of risk factors like sedentarism and current smoking have been reported for the rural elderly in developed countries like the United States, where less frequent use of certain preventive services also has been observed among the rural elderly. The positive association of well‐being and health with variables such as living with family, having children, and community involvement, which has been reported from developing countries like Ghana and India, supports the usefulness of the time‐honored value of joint family systems and lifelong social and physical activity–all known to foster healthy aging. Such traditional virtues therefore need to be preserved and strengthened. Effective geriatric health care services need to stress a community approach to primary health care, with provision of support and training for both family caregivers and professionals. In addition, emphasis on health promotion, cost‐effective indigenous systems of medicine and gender‐sensitive programs is needed.
Training to Provide for Healthy Rural Aging
Authors: Troisi Joseph 
Published: April 2008

ABSTRACT:More than 60 percent of the world's aged population is in developing countries, the majority living in rural and remote areas. Resources in these areas are scarce and there is a lack of services and programs, especially in the areas of health, housing and social welfare. The most serious deficiency faced by many countries in meeting the challenges of population aging is the pronounced scarcity of trained caregivers. Little attention has been given to developing effective training policies and programs. Most of the people providing a service to older people lack basic training and this is more so in rural and remote areas. The processes for extending liealthy aging and postponing the onset of chronic diseases and disabling conditions exist already. Unfortunately, these processes are not disseminated in appropriate ways. It is therefore imperative to disseminate this information by training people at the grass roots level to reach the most vulnerable and isolated older people. Primary care workers should have the necessary skills, knowledge and techniques to facilitate good care of older people in their environment. This article reviews and analyzes attempts being made by a number of countries to meet this need. Though the basic issues dealt with are often the same, the approach used differs.
Long‐term Care in Rural West Virginia: Managed Care and Future Roles for the Aging Network
Authors: Brown David K. , Goins R. Turner , Briggs Rick 
Published: April 2008

ABSTRACT:The managed care movement emphasizes the rationalization of health care delivery through fixed price or capitation of service and the utilization of a preferred physician or health gatekeeper. These features are advanced as measures of cost control in health care delivery. This approach presents the aging network, established under the Older Americans Act, with a number of daunting challenges which are particularly acute to service providers in rural areas. How this network responds will determine its future efficacy in the delivery of health and long‐term care services. This article examines these concerns among eight rurally based senior centers and two Area Agencies on Aging in Southern West Virginia. Issues of management capacity, present and future positioning, and receptivity to managed care are emphasized. These providers stand on the strengths of a long tradition of serving clients, knowledge of their needs and face‐to‐face interactions with them–capabilities managed care organizations do not have. However, little outreach to managed care in these areas has occurred.
Vision, Visual Needs, and Quality of Life of Older People in Rural Environments: A Report and Synthesis of a Meeting
Authors: Odom J. Vernon 
Published: April 2008

ABSTRACT:Vision as an aspect of rural aging was a major portion of the First International Conference on Rural Aging. Various perspectives on the relationship of vision to rural aging were presented in two symposia, two paper sessions, one workshop and the poster session (a total of 28 presentations). In summarizing this rich and varied material, the author emphasizes that: (a) vision is important to maintaining a healthy, active life as one ages; (b) impaired vision is generally preventable or treatable; (c) well‐designed community programs can assist in prevention and treatment; and (d) assessing the effects of these programs requires evaluation of patients’quality of life. More research is needed to refine strategies for creating, maintaining and evaluating community‐based eye care programs and integrating them with existing public health or other community programs.
The Public Health Perspective in Health Promotion and Disability Prevention for Older Adults: The Role of the Centers for Disease Control and Prevention
Authors: Hennessy Catherine Hagan , Buchner David M. , Jordan Joanne M. , Leveille Suzanne G. , Shefer Abigail M. , Stevens Judy A. 
Published: April 2008

ABSTRACT:As the United States federal public health agency, the role of the Centers for Disease Control and Prevention (CDC) in health promotion and disability prevention with older adults encompasses research, surveillance and program activities in aging. This article characterizes the objectives and context of prevention in later life and summarizes CDC's functions, collaborative partnerships with public health agencies and other organizations, and range of activities in older adult health. As a major focus of these efforts, chronic disease risk reduction is examined through CDC's efforts in the area of physical activity; a longitudinal investigation of osteoarthritis in an older biracial rural population; and chronic illness self‐management programs as a prototype for secondary prevention. Other CDC activities highlighted include addressing the burden of vaccine‐preventable diseases through CDC‐funded programs to improve immunization coverage in older adults, and falls prevention interventions and resources. Future directions in aging at CDC are also outlined.
Telepsychiatry: Challenges in Rural Aging
Authors: Sumner Calvin R. 
Published: April 2008

ABSTRACT:A significant health care dilemma for older individuals living in rural areas is that at a time in life when there is, predictably, a greater need for medical services, the ability to access those limited services is markedly reduced. Telepsychiatry presents an innovative and cost‐effective strategy for the provision of improved local access to quality mental health services for the underserved rural elderly. Telepsychiatry has demonstrated the potential to improve access to mental health services, provide those services in an affordable and cost‐effective manner and deliver those services at a quality nearly equal to traditional face‐to‐face services. Advances in telepsychiatry technology allow a core group of skilled mental health providers in a central location to provide timely local access to quality services for the rural elderly over a broad geographic area.
Conclusions and Recommendations for Policies on Rural Aging in the First Decades of the 21st Century
Authors: Hermanova Hana M. , Richardson Sally K. 
Published: April 2008

ABSTRACT:The 2000 Forum on Rural Aging: Policy Debates was one of the main tracks of the first International Conference on Rural Aging held in Charleston, W.Va., in June 2000. The 2000 Forum was a follow‐up to the Expert Group Meeting on Rural Aging, which met at Shepherdstown, W.Va., in May 1999. That group considered policy implications of the 1999 International Year of Older Persons for rural aging in four key areas: the situation of older people, multigenerational relationships, lifelong development, and the development and aging of rural populations. As a direct follow‐up of the Shepherdstown Expert Group Meeting, the 2000 Forum on Rural Aging formulated the Conclusions and Recommendations for Policies on Rural Aging through a series of working groups. The Conclusions and Recommendations were endorsed by the Conference Plenary Session on June 11, 2000. The Draft Recommendations for Policies on Rural Aging were available for comments on the Internet in the remaining part of the year 2000. Many comments were received. Hana Hermanova and Sally Richardson incorporated the comments into the finalized version.
A National Call to Action: CDC's 2001 Urban and Rural Health Chartbook
Authors: Morgan Alan 
Published: April 2008

SummaryIt remains to be seen i f Congress will recognize the CDC report as a national call to action, or whether future CDC reports will simply record the ongoing health disparities of rural America. Regardless of the Congressional outcome in 2002, the CDC report clearly succeeds in moving the national debate on rural concerns beyond the political rhetoric and into a datadriven debate.
Understanding Rural Hospital Bypass Behavior
Authors: Radcliff Tiffany A. , Brasure Michelle , Moscovice Ira S. , Stensland Jeffrey T. 
Published: April 2008

Abstract: Context: Though many rural hospitals offer a broad array of services, local residents may choose more distant facilities for inpatient care services. Depending on the extent of the bypass phenomenon, hospitals may experience financial distress, reduced service offerings, or closure Purpose:This study provides a descriptive analysis of rural hospital bypass behavior in 7 states. Methods: We examine hospital discharge data for calendar years 1991 and 1996 to determine the extent to which patients admitted from rural areas are bypassing local facilities. We also assess whether there are trends in bypass patterns over time. Our primary specification of bypass is defined as a discharge from a hospital between 15 and 1000 miles from the closest facility. Findings: We found an overall bypass rate of 30%. This overall rate changed little between 1991 and 1996. Subgroups of patients, defined by payer and diagnosis, had differing propensities to bypass local rural facilities. Patients with managed care or commercial insurance had higher bypass rates compared to patients who relied on other payer sources. Medicare and uninsured (self‐pay) patients had lower bypass rates. Payer type differences persisted when cases were divided into emergent and scheduled categories. Patients seeking general medical or obstetrical care had lower bypass rates than patients discharged with a diagnosis related group (DRG) related to complex medical, general surgery, or specialty sergery services. With the exception of normal delivery, DRG codes frequently associated with bypass discharges involved procedures or surgery that may not be offered by smaller rural facilities Conclusions:Our results indicate that rural patients, or their admitting physicians, perceive local rural hospitals as a viable option for many inpatient care services but prefer other facilities for treatments beyond the scope of general medical or surgical treatment
Anti‐O6‐Methylguanine‐Methyltransferase (MGMT) Immunohistochemistry in Glioblastoma Multiforme: Observer Variability and Lack of Association with Patient Survival Impede Its Use as Clinical Biomarker*
Authors: Preusser Matthias , Charles Janzer Robert , Felsberg Jörg , Reifenberger Guido , Hamou Marie‐France , Diserens Annie‐Claire , Stupp Roger , Gorlia Thierry , Marosi Christine , Heinzl Harald , Hainfellner Johannes A , Hegi Monika 
Published: April 2008

AbstractSilencing of O6‐methylguanine‐DNA methyltransferase (MGMT) protein expression because of MGMT gene promoter hypermethylation is considered to be associated with postoperative chemoradiotherapy benefits in glioblastoma multiforme (GBM) patients. The objective of this study was to clarify the usability of MGMT immunohistochemistry (IHC) as a clinical biomarker.We immunostained a tissue microarray containing biopsy samples of 164 GBM patients from the European Organization for Research and Treatment of Cancer and the National Cancer Institute of Canada (EORTC/NCIC) trial 26981/22981 using two commercial anti‐MGMT antibodies (clones MT3.1 and MT23.2). Immunostaining results were semiquantitatively evaluated by four observers from three neuropathological laboratories using a predefined algorithm. We analyzed (i) inter‐ and intraobserver agreement on MGMT expression (kappa statistics); (ii) correlation of MGMT expression with MGMT promoter methylation status (kappa statistics); and (iii) correlation of MGMT expression with patient outcome (log‐rank test). Interobserver agreement on MGMT expression varied from slight to almost perfect, whereas intraobserver agreement ranged from substantial to almost perfect. MGMT expression showed poor to moderate correlation with MGMT promoter methylation status. We found no significant association of MGMT expression with patient outcome. In our hands, observer variability as well as lack of association with the MGMT promoter methylation status and patient survival impeded the use of anti‐MGMT immunohistochemistry as a clinical biomarker for routine diagnostic purposes.
Genetic Environment of 16S rRNA Methylase Gene
rmtD
Authors: Doi Yohei , Adams-Haduch Jennifer M. , Paterson David L. 
Published: April 2008

ABSTRACT

The genetic environment of the 16S rRNA methylase gene
rmtD
was investigated.
rmtD
was flanked by a novel IS
CR
motif located downstream of class I integron In
163
in the original
Pseudomonas aeruginosa
strain.
rmtD
found in
Klebsiella pneumoniae
appeared to have been mobilized from
P. aeruginosa
by an IS
26
-mediated event.
Increasing Incidence of Linezolid-Intermediate or -Resistant, Vancomycin-Resistant
Enterococcus faecium
Strains Parallels Increasing Linezolid Consumption
Authors: Scheetz Marc H. , Knechtel Stephanie A. , Malczynski Michael , Postelnick Michael J. , Qi Chao 
Published: April 2008

ABSTRACT

Clinical enterococcal resistance to linezolid is defined by the presence of the G2576T mutation. We evaluated the incidence of genetically proven linezolid resistance among vancomycin-resistant
Enterococcus faecium
strains and linezolid consumption for a possible association. A relationship was found (
r
2
= 0.73,
P
= 0.03) and predicts increasing resistance with current trends of linezolid use.
Mechanism of Inhibition of Human Immunodeficiency Virus Type 1 Reverse Transcriptase by a Stavudine Analogue, 4′-Ethynyl Stavudine Triphosphate
Authors: Yang Guangwei , Wang Jimin , Cheng Yao , Dutschman Ginger E. , Tanaka Hiromichi , Baba Masanori , Cheng Yung-Chi 
Published: April 2008

ABSTRACT

2′,3′-Didehydro-3′-deoxy-4′-ethynylthymidine (4′-Ed4T), a recently discovered nucleoside reverse transcriptase (RT) inhibitor, exhibits 5- to 10-fold-higher activity against human immunodeficiency virus type 1 (HIV-1) and less cytotoxicity than does its parental compound d4T (stavudine). Using steady-state kinetic approaches, we have previously shown that (i) 4′-ethynyl-d4T triphosphate (4′-Ed4TTP) inhibits HIV-1 RT more efficiently than d4TTP does and (ii) its inhibition efficiency toward the RT M184V mutant is threefold less than that toward wild-type (wt) RT. In this study we used pre-steady-state kinetic approaches in an attempt to understand its mechanism of inhibition. With wt and the M184V mutant RTs, 4′-Ed4TTP has three- to fivefold-lower

K
d

(dissociation constant) values than d4TTP, while d4TTP has up to eightfold-higher

K
d

values than dTTP. Inhibition is more effective in DNA replication with RNA template than with DNA template. In general, the M184V mutant exhibits poorer binding for all three nucleoside triphosphates than does wt RT. The structural basis for the lower binding affinity of d4TTP than of dTTP could be the lack of hydrogen bonds from the missing 3′-hydroxyl group in d4TTP to the backbone amide of Y115 and also to the side chain of Q151. The structural basis for the higher binding affinity of 4′-Ed4TTP than of d4TTP could be the additional binding of the 4′-ethynyl group in a preformed hydrophobic pocket by A114, Y115, M184, F160, and part of D185.
In Vitro Activities of Linezolid against Clinical Isolates of
Mycobacterium tuberculosis
Complex Isolated in Taiwan over 10 Years
Authors: Huang Tsi-Shu , Liu Yung-Ching , Sy Cheng-Len , Chen Yao-Shen , Tu Hui-Zin , Chen Bao-Chen 
Published: April 2008

ABSTRACT

Significant increases in the MIC
90
s of linezolid in multidrug-resistant
Mycobacterium tuberculosis
isolates were seen between the baseline period of 2001 to 2003 (0.5 μg/ml) and 2004 (2 μg/ml). The MICs were 4 μg/ml in three strains. Both fluoroquinolones (except levofloxacin) and kanamycin were found to have statistically significant degrees of concordance with linezolid.
RNAIII-Inhibiting Peptide Enhances Healing of Wounds Infected with Methicillin-Resistant
Staphylococcus aureus
Authors: Simonetti Oriana , Cirioni Oscar , Ghiselli Roberto , Goteri Gaia , Scalise Alessandro , Orlando Fiorenza , Silvestri Carmela , Riva Alessandra , Saba Vittorio , Madanahally Kiran D. , Offidani Annamaria , Balaban Naomi , Scalise Giorgio , Giacometti Andrea 
Published: April 2008

ABSTRACT

Quorum sensing is a mechanism through which a bacterial population receives input from neighboring cells and elicits an appropriate response to enable survival within the host. Inhibiting quorum sensing by RNAIII-inhibiting peptide (RIP) has been demonstrated as a very effective mode of prevention and therapy for device-associated staphylococcal infections and was tested here for healing of wounds that are otherwise resistant to conventional antibiotics. Wounds, established through the panniculus carnosus of BALB/c mice, were inoculated with 5 × 10
7
CFU of methicillin-resistant
Staphylococcus aureus
. Mice were treated with Allevyn, RIP-soaked Allevyn (containing 20 μg RIP), daily intraperitoneal teicoplanin (7 mg/kg of body weight), Allevyn and teicoplanin, and RIP-soaked Allevyn and daily intraperitoneal teicoplanin. The main outcome measures were quantitative bacterial culture and histological examination with assessment of microvessel density and of vascular endothelial growth factor (VEGF) expression in tissue sections. Treatment with RIP-soaked Allevyn together with teicoplanin injection greatly reduced the bacterial load to 13 CFU/g (control untreated animals had 10
8
CFU/g bacteria). All other treatments were also significantly effective but only reduced the bacterial load to about 10
3
CFU/ml. Histological examination indicated that only treatment with RIP-soaked Allevyn with teicoplanin injection restored epithelial, granulation, and collagen scores, as well as microvessel density and VEGF expression, to the levels found with uninfected mice. In conclusion, we observed that RIP may be useful for the management of infected wounds and that it could represent an exciting and future alternative to the conventional antibiotics, at present considered the gold-standard treatments for methicillin-resistant
S. aureus
infections.
Lack of an Effect of Human Immunodeficiency Virus Coinfection on the Pharmacokinetics of Entecavir in Hepatitis B Virus-Infected Patients
Authors: Zhu Min , Bifano Marc , Xu Xu , Wang Yonghua , LaCreta Frank , Grasela Dennis , Pfister Marc 
Published: April 2008

ABSTRACT

Entecavir is a guanosine nucleoside analogue approved for the treatment of chronic hepatitis B virus (HBV) infection. The impact of human immunodeficiency virus (HIV) coinfection on the pharmacokinetics (PK) of entecavir was examined by nonlinear mixed-effects modeling. Plasma concentration data from HIV- and HBV-coinfected patients were analyzed in conjunction with data from HBV-monoinfected patients, and HIV coinfection was tested as a covariate on oral clearance (CL/
F
). The estimated population averages of intercompartmental clearance and the volumes of distribution in the central and peripheral compartments obtained with a 1-mg dose were 34.2 liters/h (interindividual variability, 30.2%), 115 liters (interindividual variability, 39.2%), and 1,830 liters (interindividual variability, 74%), respectively. CL/
F
was found to be a function of creatinine clearance, but HIV confection did not show any effect on CL/
F
. The geometric mean (GM) of individual Bayesian estimates of the steady-state area under the concentration-time curve following 1-mg daily doses were 39.3 and 38.8 ng·h/ml in HIV- and HBV-coinfected and HBV-monoinfected patients, respectively. The adjusted GM ratio (1.01; 90% confidence interval, 0.91 to 1.12) was within the bioequivalence criteria boundary (0.80 to 1.25). In conclusion, the proposed model adequately described the entecavir PK in HBV- and HIV-coinfected patients and HBV-monoinfected patients, and the entecavir exposures were comparable in the two patient populations.
Effects of Mutagenic and Chain-Terminating Nucleotide Analogs on Enzymes Isolated from Hepatitis C Virus Strains of Various Genotypes
Authors: Heck Julie A. , Lam Angela M. I. , Narayanan Nirupama , Frick David N. 
Published: April 2008

ABSTRACTThe development of effective therapies for hepatitis C virus (HCV) must take into account genetic variation among HCV strains. Response rates to interferon-based treatments, including the current preferred treatment of pegylated alpha interferon administered with ribavirin, are genotype specific. Of the numerous HCV inhibitors currently in development as antiviral drugs, nucleoside analogs that target the conserved NS5B active site seem to be quite effective against diverse HCV strains. To test this hypothesis, we examined the effects of a panel of nucleotide analogs, including ribavirin triphosphate (RTP) and several chain-terminating nucleoside triphosphates, on the activities of purified HCV NS5B polymerases derived from genotype 1a, 1b, and 2a strains. Unlike the genotype-specific effects on NS5B activity reported previously for nonnucleoside inhibitors (F. Pauwels, W. Mostmans, L. M. Quirynen, L. van der Helm, C. W. Boutton, A. S. Rueff, E. Cleiren, P. Raboisson, D. Surleraux, O. Nyanguile, and K. A. Simmen, J. Virol.81:6909-6919, 2007), only minor differences in inhibition were observed among the various genotypes; thus, nucleoside analogs that are current drug candidates may be more promising for treatment of a broader variety of HCV strains. We also examined the effects of RTP on the HCV NS3 helicase/ATPase. As with the polymerase, only minor differences were observed among 1a-, 1b-, and 2a-derived enzymes. RTP did not inhibit the rate of NS3 helicase-catalyzed DNA unwinding but served instead as a substrate to fuel unwinding. NS3 added to RNA synthesis reactions relieved inhibition of the polymerase by RTP, presumably due to RTP hydrolysis. These results suggest that NS3 can limit the incorporation of ribavirin into viral RNA, thus reducing its inhibitory or mutagenic effects.