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Data Protection Standards - Identity and Access Management Policy
No full textThis policy describes types of electronic identities in use for systems and applications; criteria for creating identities and accounts; how identities should be authenticated; how authorizations should be managed; and how accounts and privileges should be deprovisioned.
Applies to all active members of the University community, including faculty, students, staff, and affiliates, and to authorized visitors, guests, and others for whom University technology resources and network access are made available by the University. This policy also applies to campus visitors who avail themselves of the University’s temporary visitor wireless network access, and to those who register their computers and other devices through Conference and Event Services programs or through other offices, for use of the campus network
Limonoids: Structure–Activity Relationship Studies and Anticancer Properties
No full textPlants have evolved through time and developed numerous defense mechanisms to thwart pests and pathogens for their survival. In order to overcome this innate pressure, plants synthesize unique and diverse molecules. The biochemical synthesis of a vast array of phytochemicals is one such employed mechanisms. There are many classes of compounds with insecticidal and antifeedant activities; limonoids are prime examples of this group. Limonoids are one of the major classes of phytochemicals along with flavonoids, coumarins, and carotenoids in Meliaceae and Rutaceae families. Limonoids are oxygenated triterpenoids derived from a precursor with a furanylsteroid skeleton, which is prone to oxygenation and rearrangement reactions. It has been demonstrated in a number of secondary metabolites, including limonoids, that small changes in basic structure due to chemical transformations would result in significant alterations in their biological activities. A number of biological studies have advanced our understanding of disease prevention properties of limonoids. Due to their ability to suppress cell proliferation and induce apoptosis, limonoids have been investigated for their anticancer properties. The aim of this chapter is to analyze the chemistry, structure–activity relationships, and rational design efforts toward the development of limonoid analogs as potential anticancer molecules
Erratum for Micek et al., Risk Factors and Outcomes for Ineffective Empiric Treatment of Sepsis Caused by Gram-Negative Pathogens: Stratification by Onset of Infection
No full textSmoking Cessation Following Text Message Intervention in Pregnant Women
No full textBackground: Smoking during pregnancy has detrimental effects on mother and fetus. Text messaging has been utilized to improve patient care. Objective: To evaluate the impact of text messaging on smoking cessation rates among pregnant women in addition to standard of care (SOC) smoking cessation services. Our SOC includes pharmacist-driven education with or without nicotine patch or bupropion. Methods: This randomized, open-label, prospective trial was conducted at a maternal fetal care center from May 2014 to January 2016. Pregnant patients in the preparation stage of change were randomized to text messaging or SOC. The primary outcome was smoking cessation verified with exhaled carbon monoxide levels (eCO) 2 weeks from quit date. All received clinical pharmacist weekly calls for 3 weeks and biweekly visits until pharmacotherapy completion. The text messaging group also received predetermined motivational messages. Results: Of 49 randomized patients, 13 withdrew, and 6 were lost to follow-up. The remaining included 14 texting and 16 SOC patients. eCO-verified cessation was achieved by 57.1% in the texting group versus 31.3% in the control (P = 0.153). Overall, 64.3% of the texting group achieved an eCO below 8 ppm at ≥1 visit versus 37.5% in the control group (P = 0.143). No difference was found in birth outcomes. The study was underpowered because of slow enrollment and high drop-out rates. Conclusions and Relevance: Text messaging had minimal impact on improving smoking cessation rates in the obstetric population. However, further research is warranted because of the underpowered nature of this trial. Given the detrimental effects of smoking in pregnancy, more comprehensive cessation strategies are warranted
Pharmacotherapy for primary headache disorders in the emergency department
No full textHeadache disorders are one of the most common reasons that patients present to the emergency department (ED). For proper patient care, it is vital for the headache to be differentiated as a primary or secondary headache disorder. Primary headaches are more common than secondary headaches; however, secondary headaches are potentially life-threatening, whereas primary headaches possess straightforward treatment regimens and benign long-term outcomes. Classifying primary headaches as tension-type, cluster, or migraine headache with or without aura will guide pharmacotherapy selection in the ED setting. The pharmacist can impact the clinical management of headache disorders by providing effective medication counseling, ensuring that the medication regimen has the appropriate indication and route, and monitoring for adverse effects of treatment
General Practitioners\u27 recommendations of self-directed-exercises for musculoskeletal problems and perceived barriers and facilitators to doing so: A mixed methods study
No full textBackground: Musculoskeletal problems substantially impact the demand for and the finances of the United Kingdom\u27s National Health Service. Some of this demand and cost could be alleviated if patients use self-directed-exercises. The present study aims first to establish whether general practitioners already recommend self-directed-exercises and second to describe barriers and facilitators to making such recommendations. Method: The design of the current study included surveys and interviews. The surveys were designed to draw out participants\u27 tendency to recommend self-directed-exercises and their behavioral drivers to do so. The drivers investigated include 14 domains described by the Theoretical Domains Framework. The surveys were completed online and the responses were analyzed using descriptive reports and regression analyses. The interviews were designed to more fully understand participants\u27 experiences recommending self-directed-exercises according to the same framework. The interviews were audio-taped, transcribed, and thematically analyzed. Results: The survey found that the following domains significantly predicted participants\u27 tendency to recommend self-directed-exercises: Environmental contexts and resources, Goals, Intentions, Knowledge, Memory attention and decision processes, and Social/professional role. The interviews brought out four themes that could be leveraged to increase general practitioners\u27 tendency to recommend self-directed-exercises: (1) Practitioners\u27 beliefs about self-directed-exercises being effective, (2) Patients\u27 motivations to engage in self-directed-exercises, (3) Time constraints, and (4) The ease with which practitioners can recommend self-directed-exercises. Conclusions: Most general practitioners already recommend self-directed-exercises, though they note significant barriers that may prevent them from doing so. General practitioners\u27 tendency to recommend self-directed-exercises would be bolstered by creating a respected central resource of exercise pamphlets. These pamphlets should clearly describe how different self-directed-exercises should be performed and evidence supporting their effectiveness
Lay intuitions about epistemic normativity
No full textRecent empirical work on non-philosophers’ intuitions about epistemic normativity reveals patterns that cannot be fully accounted for by direct epistemic consequentialism. On the basis of these results, one might picture participants as “epistemic deontologists.” We present the results of two new experiments that support a more nuanced picture. We examine intuitions about guesses and hypotheses, and about beliefs. Our results suggest a two-factor model of intuitions, wherein both consequentialist and non-consequentialist considerations affect participants’ judgments about epistemic permissibility
Adropin: An endocrine link between the biological clock and cholesterol homeostasis
No full textObjective: Identify determinants of plasma adropin concentrations, a secreted peptide translated from the Energy Homeostasis Associated (ENHO) gene linked to metabolic control and vascular function. Methods: Associations between plasma adropin concentrations, demographics (sex, age, BMI) and circulating biomarkers of lipid and glucose metabolism were assessed in plasma obtained after an overnight fast in humans. The regulation of adropin expression was then assessed in silico, in cultured human cells, and in animal models. Results: In humans, plasma adropin concentrations are inversely related to atherogenic LDL-cholesterol (LDL-C) levels in men (n = 349), but not in women (n = 401). Analysis of hepatic Enho expression in male mice suggests control by the biological clock. Expression is rhythmic, peaking during maximal food consumption in the dark correlating with transcriptional activation by RORα/γ. The nadir in the light phase coincides with the rest phase and repression by Rev-erb. Plasma adropin concentrations in nonhuman primates (rhesus monkeys) also exhibit peaks coinciding with feeding times (07:00 h, 15:00 h). The ROR inverse agonists SR1001 and the 7-oxygenated sterols 7-β-hydroxysterol and 7-ketocholesterol, or the Rev-erb agonist SR9009, suppress ENHO expression in cultured human HepG2 cells. Consumption of high-cholesterol diets suppress expression of the adropin transcript in mouse liver. However, adropin over expression does not prevent hypercholesterolemia resulting from a high cholesterol diet and/or LDL receptor mutations. Conclusions: In humans, associations between plasma adropin concentrations and LDL-C suggest a link with hepatic lipid metabolism. Mouse studies suggest that the relationship between adropin and cholesterol metabolism is unidirectional, and predominantly involves suppression of adropin expression by cholesterol and 7-oxygenated sterols. Sensing of fatty acids, cholesterol and oxysterols by the RORα/γ ligand-binding domain suggests a plausible functional link between adropin expression and cellular lipid metabolism. Furthermore, the nuclear receptors RORα/γ and Rev-erb may couple adropin synthesis with circadian rhythms in carbohydrate and lipid metabolism
A qualitative exploration of healthcare providers’ perspectives on patients’ non-recreational, prescription medicines sharing behaviours
No full textBackground: Prescription medicine sharing has been associated with several negative health outcomes. Much of the research has focused on patient perspectives. In this study we explore the views and experiences of health professionals involved in medicines supply. Aim: To explore healthcare providers’ experiences of, and attitudes toward, factors influencing non-recreational, prescription medicine-sharing behaviours, the consequences of sharing, and the types of prescription medicines they believe patients commonly share. Methods: Face-to-face, semi-structured interviews were conducted with purposively sampled pharmacists (n = 8), doctors (n = 4) and nurses (n = 6) practising in a variety of community or hospital settings in Auckland, New Zealand. The interviews were audio recorded, transcribed verbatim and analysed using a general inductive approach. Results: Responses fell within three overarching themes: ‘perceived benefits of medicine sharing’ such as saving time and money, and strengthening social relationships; ‘perceived negative consequences of sharing’ such as drug resistance, adverse drug events, delay in seeking professional help, and loss of medicine instructions; ‘reasons for medicine sharing’ such as inadequate medication knowledge, forgetfulness, altruistic reasons, lack of access to health services or medicines, illness denial and embarrassment, and cultural and linguistic barriers. Conclusions: Prescription medicine sharing, as viewed by healthcare providers, is a multidimensional behaviour with both positive and negative outcomes. Any intervention to reduce the risks/harms of medicine sharing should consider both the healthcare system constraints and the psychosocial, cultural, economic and behavioural aspects of medicine use. The findings can be used to inform development of specific interventions to reduce risks/harms of sharing
Administration Rates of the Tdap Vaccine in Obstetric Patients
No full textBackground: Infants younger than 6 months of age are at high risk for contracting pertussis because of not being fully vaccinated. The Advisory Committee on Immunization Practices (ACIP) recommends vaccinating all pregnant women with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) between 27 and 36 weeks to offer passive immunity to the infant to help protect them until they are able to receive the full pertussis series. Objective: To assess and compare compliance with the 2013 ACIP recommendation of vaccinating pregnant women with Tdap at 27 to 36 weeks’ gestation in 2 obstetric clinics. Methods: This cross-sectional, retrospective chart review evaluated Tdap vaccine compliance in a random sample of obstetric patients from October 2013 to September 2014. The primary outcome evaluated the proportion of patients who received Tdap between 27 and 36 weeks’ gestation. Secondary outcomes included the proportion of patients who received Tdap at any point in pregnancy and within 30 days postpartum. Results: The charts of 573 patients were reviewed, and 237 met inclusion criteria. For the primary outcome, 142 patients (59.9%) received the Tdap vaccine. Overall, 156 patients (65.8%) received Tdap at some point during the pregnancy. Factors associated with receiving the Tdap vaccination were insurance status, prenatal care risk level and site of prenatal care, receipt of the influenza vaccine, and preterm labor in the current pregnancy. Conclusion: The Tdap vaccine rate was 65.8%, with 59.9% of patients receiving the vaccine within the recommended ACIP timeframe. Further education, improvements in documentation, and chart reminders are needed to enhance administration