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1 Parents experiences in Slovenia during the COVID-19 pandemic
No full textIntroduction: The COVID-19 pandemic emerged here in March 2020. The pandemic and lockdowns have been the cause of many parents doing both paid and unpaid work at home. Everyday life was a great challenge. Challenges, insecurities, and changes have caused people anxiety and fear, which has been and will only be reflected in the mental well-being of individuals. We wanted to find out how parents faced their fears, worries, and daily lives during the epidemic.
Methods: A cross-sectional study was conducted to gain insight into parents’ experiences during the COVID-19 pandemic in Slovenia. Casual parental sampling was used and a total of 135 parents participated. To collect data, we developed a questionnaire based on a literature review. In addition, mental well-being was measured using the Warwick-Edinburgh Mental Well-being scale. Finally, the results were analyzed in the SPSS and R programs with the help of descriptive and inferential statistics.
Results: We found that 26.0% of children had SARS-CoV-2 and that few parents worked from home; 85.0% had the opportunity to provide protective equipment to all family members. Parents and children were dissatisfied with the change of life during the epidemic; children mainly due to the lack of social contacts. Of parents74.0% spent more time with their children due to the lockdown and 56.0% had to be substitute teachers for their children using distance learning. The most common fear was that the adults would bring the infection home and get sick, the child would get hurt, or the parent would get sick. Parental mental well-being was aver-age (M= 53.20; SD = 9.61) and did not differ between the sexes (p\u3e 0.05).
Discussion: We found that parents were most afraid of bringing the infection into the home environment. Parents had to provide care and assistance to their children while working at home or at work. They had to do more unpaid work in the family and were more mentally burdened. Parents were more burdened and dissatisfied with the change of life, but they quickly adapted to these circumstances, so their mental well-being remained unchanged. The children were disappointed with the ban on socializing with their peers and distance learning.
Conclusion: With the duration of the pandemic, people were more afraid of changed life circumstances and worries about work, care, and schooling of children than they were of the infection. Despite the gradual release of measures to limit the spread ofCOVID-19, people still followed self-protection measures. Now, however, due to unclea
What Do Navy SEALs and CPAs Have in Common? Mental Toughness.
No full textWhat do accountants and Navy SEALs have in common? Navy SEALs have the ability to stay awake for a week, endure constant harassment and perform their jobs despite mental and physical hardships. While that may sound similar to final exam week, there is no comparison between college and the physical stress of military training, but there are similarities in the mental aspects. Navy SEALs use certain tools to help them succeed during times of extreme hardship, and accounting students and CPA exam candidates can use these same strategies for success. The tools fall under the broad category of “mental toughness,” and include: (1) goal setting; (2) visualization; (3) positive self-talk; and (4) emotion management
p53 Regulates the Extent of Fibroblast Proliferation and Fibrosis in Left Ventricle Pressure Overload
No full textBACKGROUND:
Cardiomyopathy is characterized by the pathological accumulation of resident cardiac fibroblasts that deposit ECM (extracellular matrix) and generate a fibrotic scar. However, the mechanisms that control the timing and extent of cardiac fibroblast proliferation and ECM production are not known, hampering the development of antifibrotic strategies to prevent heart failure. METHODS:
We used the Tcf21 (transcription factor 21)MerCreMer mouse line for fibroblast-specific lineage tracing and p53 (tumor protein p53) gene deletion. We characterized cardiac physiology and used single-cell RNA-sequencing and in vitro studies to investigate the p53-dependent mechanisms regulating cardiac fibroblast cell cycle and fibrosis in left ventricular pressure overload induced by transaortic constriction. RESULTS:
Cardiac fibroblast proliferation occurs primarily between days 7 and 14 following transaortic constriction in mice, correlating with alterations in p53-dependent gene expression. p53 deletion in fibroblasts led to a striking accumulation of Tcf21-lineage cardiac fibroblasts within the normal proliferative window and precipitated a robust fibrotic response to left ventricular pressure overload. However, excessive interstitial and perivascular fibrosis does not develop until after cardiac fibroblasts exit the cell cycle. Single-cell RNA sequencing revealed p53 null fibroblasts unexpectedly express lower levels of genes encoding important ECM proteins while they exhibit an inappropriately proliferative phenotype. in vitro studies establish a role for p53 in suppressing the proliferative fibroblast phenotype, which facilitates the expression and secretion of ECM proteins. Importantly, Cdkn2a (cyclin-dependent kinase inhibitor 2a) expression and the p16Ink4a-retinoblastoma cell cycle control pathway is induced in p53 null cardiac fibroblasts, which may eventually contribute to cell cycle exit and fulminant scar formation. CONCLUSIONS:
This study reveals a mechanism regulating cardiac fibroblast accumulation and ECM secretion, orchestrated in part by p53-dependent cell cycle control that governs the timing and extent of fibrosis in left ventricular pressure overload
Eat Sleep Console for the Management of Neonatal Abstinence Syndrome: A Process and Outcomes Evaluation
No full textIntroduction This project aimed to evaluate a practice change to Eat Sleep Console (ESC) in the postpartum unit and neonatal intensive care unit of a single Baby-Friendly tertiary hospital. Method Guided by Donabedian\u27s quality care model, a process and outcomes evaluation of ESC was conducted through a retrospective chart review and the Eat Sleep Console Nurse Questionnaire, which assessed processes of care and knowledge, attitudes and perceptions of nurses. Results Improvement in neonatal outcomes, including a decreased number of morphine doses (12.33 vs. 3.17; p = .045), was noted from preintervention to postintervention. Breastfeeding at discharge increased from 38% to 57% but did not reach statistical significance. Thirty-seven nurses (71%) completed the full survey. Discussion The use of ESC resulted in positive neonatal outcomes. Nurse-identified areas for improvement resulted in a plan for continued improvement
Abstract 2005: FSHR-mediated targeted delivery of paclitaxel immunoliposomes in receptor overexpressing ovarian cancer cells
No full textThe purpose of this study was to explore the Fabʹ fragment of anti-FSHR (Follicle Stimulating Hormone Receptor) antibody as a targeting ligand to graft on the surface of paclitaxel (PTX) liposomes (PLs) for site-specific drug delivery in ovarian cancer (OC) cells. Anti-FSHR antibody Fab’ fragment conjugated PTX encapsulated immunoliposomes (ILs) were prepared, characterized, and evaluated to determine their in vitro efficacy in FSHR receptor positive (Caov3) and negative (SKOV3) OC cells. FSHR expression was determined by confocal microscopy and flow cytometry. The results confirmed that FSHR expression levels of Caov3 were higher and no expression was detected in SKOV3. ILs were prepared by covalent conjugation of Fab’ fragments to functionalized PLs via thioether linkage which was confirmed by SDS-PAGE analysis. Immunoreactivity of the prepared ILs was determined against Fabʹ in Caov3 cells using flow cytometry and it was observed that after conjugation, Fabʹ remained intact and also maintained the binding characteristic to the receptor. In MTT assay at the end of 48 h, the IC50 value for ILs was found to be 10.8 and 3.5 folds lower than Taxol® and PLs respectively in Caov3. However, being receptor negative, there was no significant difference noticed for IC50 when PLs and ILs were compared for SKOV3. To prove, whether immune tagging improves cell-specific uptake of ILs in FSHR-expressing cells, cell uptake studies were carried out using confocal microscopy and flow cytometry which showed higher uptake of ILs in Caov3 but not in SKOV3. For assessment of anti-angiogenic activity, a wound scratch assay was performed on Caov3 cells. At an equimolar concentration of treatment given to the cells by PLs and ILs, the % recovery of the wound was 1.3 and 2.3 times lower than Taxol® respectively indicating the superior performance of ILs in inhibiting cell proliferation. The quantitation of cell death after treatment was carried out by flow cytometry after staining with propidium iodide and the highest amount of cell death was seen in ILs group for Caov3 cells. Evaluation of cell cycle in the Caov3 indicated superior results of arrest of cells in G2/M phase. Further, an increase in cell death was observed as indicated by the increase in % of cells in subG1 stage. Performance of PLs was similar in Caov3 and SKOV3 leading to almost around 22% of arrest in G2/M stage, however, for ILs, the number of cells in G2/M was 28% for Caov3 cells at the end of 24 h indicating that the targeted formulation was able to better get internalized in the cells due to receptor-mediated uptake. The results highlight the importance of FSHR as a prominent target for OC therapy and the potential of anti-FSHR Antibody Fab\u27 conjugated nanocarriers as a site-specific delivery system to reduce the limitations associated with OC chemotherapy
Antipsychotic use among older patients with dementia receiving home health care services: Prevalence, predictors, and outcomes
No full textBackground
Antipsychotic use is a safety concern among older patients in home health care (HHC), particularly for those with Alzheimer\u27s disease and related dementias (ADRD). The objective of this study was to examine the prevalence and predictors of antipsychotic use among older adults with and without ADRD who received HHC, and the association of antipsychotic use with outcomes among patients living with ADRD. Methods
In this secondary analysis of adults ≥65 years receiving care from an HHC agency in New York in 2019 (N = 6684), we used data from the Outcome and Assessment Information Set, Medicare HHC claims, and home medication review results in the electronic HHC records during a 60-day HHC episode. ADRD was identified by diagnostic codes. Functional outcome was the change in the composite activities of daily living (ADL) score from HHC admission to HHC discharge (measured in 5833 patients), where a positive score means improvement and a negative score means decline. Data were analyzed using logistic (predictors) and linear regression (association with outcome) analyses. Results
The point prevalence of antipsychotic use was 17.2% and 6.6% among patients with and without ADRD, respectively. Among patients living with ADRD, predictors of antipsychotic use included having greater ADL limitations (odds ratio [OR] = 1.30, p = 0.01), taking more medications (OR = 1.04, p = 0.02), having behavioral and psychological symptoms (OR = 5.26, p = 0.002), and living alone (OR = 0.52, p = 0.06). Among patients living with ADRD, antipsychotic use was associated with having less ADL improvement at HHC discharge (β = −0.70, p \u3c 0.001). Conclusions
HHC patients living with ADRD were more likely to use antipsychotics and to experience worse functional outcomes when using antipsychotics. Antipsychotics should be systematically reviewed and, if contraindicated or unnecessary, deprescribed. Efforts are needed to improve HHC patients\u27 access to nonpharmacological interventions and to provide education for caregivers regarding behavioral approaches to manage symptoms in ADRD
How to Deprescribe Potentially Inappropriate Medications During the Hospital-to-Home Transition: Stakeholder Perspectives on Essential Tasks
No full textPurpose Nearly all older patients receiving postacute home health care (HHC) use potentially inappropriate medications (PIMs) that carry a risk of harm. Deprescribing can reduce and optimize the use of PIMs, yet it is often not conducted among HHC patients. The objective of this study was to gather perspectives from patient, practitioner, and HHC clinician stakeholders on tasks that are essential to postacute deprescribing in HHC. Methods A total of 44 stakeholders, including 14 HHC patients, 15 practitioners (including 9 primary care physicians, 4 pharmacists, 1 hospitalist, and 1 nurse practitioner), and 15 HHC nurses, participated. The stakeholders were from 12 US states, including New York (n = 29), Colorado (n = 2), Connecticut (n = 1), Illinois (n = 2), Kansas (n = 2), Massachusetts (n = 1), Minnesota (n = 1), Mississippi (n = 1), Nebraska (n = 1), Ohio (n = 1), Tennessee (n = 1), and Texas (n = 2). First, individual interviews were conducted by experienced research staff via video conference or telephone. Second, the study team reviewed all interview transcripts and selected interview statements regarding stakeholders’ suggestions for important tasks needed for postacute deprescribing in HHC. Third, concept mapping was conducted in which stakeholders sorted and rated selected interview statements regarding importance and feasibility. A content analysis was conducted of data collected in the individual interviews, and a mixed-method analysis was conducted of data collected in the concept mapping. Findings Four essential tasks were identified for postacute deprescribing in HHC: (1) ongoing review and assessment of medication use, (2) patent-centered and individualized plan of deprescribing, (3) timely and efficient communication among members of the care team, and (4) continuous and tailored medication education to meet patient needs. Among these tasks, developing patient-centered deprescribing considerations was considered the most important and feasible, followed by medication education, review and assessment of medication use, and communication. Implications Deprescribing during the transition of care from hospital to home requires the following: continuous medication education for patients, families, and caregivers; ongoing review and assessment of medication use; patient-centered deprescribing considerations; and effective communication and collaboration among the primary care physician, HHC nurse, and pharmacist
Improved Tumor Control Following Radiosensitization with Ultrasound-Sensitive Oxygen Microbubbles and Tumor Mitochondrial Respiration Inhibitors in a Preclinical Model of Head and Neck Cancer
No full textTumor hypoxia (oxygen deficiency) is a major contributor to radiotherapy resistance. Ultrasound-sensitive microbubbles containing oxygen have been explored as a mechanism for overcoming tumor hypoxia locally prior to radiotherapy. Previously, our group demonstrated the ability to encapsulate and deliver a pharmacological inhibitor of tumor mitochondrial respiration (lonidamine (LND)), which resulted in ultrasound-sensitive microbubbles loaded with O2 and LND providing prolonged oxygenation relative to oxygenated microbubbles alone. This follow-up study aimed to evaluate the therapeutic response to radiation following the administration of oxygen microbubbles combined with tumor mitochondrial respiration inhibitors in a head and neck squamous cell carcinoma (HNSCC) tumor model. The influences of different radiation dose rates and treatment combinations were also explored. The results demonstrated that the co-delivery of O2 and LND successfully sensitized HNSCC tumors to radiation, and this was also enhanced with oral metformin, significantly slowing tumor growth relative to unsensitized controls (p \u3c 0.01). Microbubble sensitization was also shown to improve overall animal survival. Importantly, effects were found to be radiation dose-rate-dependent, reflecting the transient nature of tumor oxygenation
Occupational Firefighting: A Detriment to Good Health
No full textObjective
The purpose of the study is to evaluate the effect of an online educational module in increasing awareness of depression, substance use disorder and sleep deprivation among firefighters in Monroe County, NY. Method
Firefighters were recruited via work email and the snowball technique. A quantitative pre and post intervention study was used. Participants completed four surveys before and after completing educational online modules. Results
There was a 5.11% increase in overall knowledge about sleep deprivation, depression and substance (alcohol) use, a small decrease in the group mean for the depression and sleep deprivation scores after completion of the educational modules. Conclusion
Increasing content knowledge had a positive effect to participants’ self-awareness during the project. Incorporating educational modules into annual firefighting training could provide opportunities to improve sleep deprivation, depression, and substance use