3,017 research outputs found

    Neural regulation of cancer: from mechanobiology to inflammation.

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    Despite recent progress in cancer research, the exact nature of malignant transformation and its progression is still not fully understood. Particularly metastasis, which accounts for most cancer death, is a very complex process, and new treatment strategies require a more comprehensive understanding of underlying regulatory mechanisms. Recently, the sympathetic nervous system (SNS) has been implicated in cancer progression and beta-blockers have been identified as a novel strategy to limit metastasis. This review discusses evidence that SNS signaling regulates metastasis by modulating the physical characteristics of tumor cells, tumor-associated immune cells and the extracellular matrix (ECM). Altered mechanotype is an emerging hallmark of cancer cells that is linked to invasive phenotype and treatment resistance. Mechanotype also influences crosstalk between tumor cells and their environment, and may thus have a critical role in cancer progression. First, we discuss how neural signaling regulates metastasis and how SNS signaling regulates both biochemical and mechanical properties of tumor cells, immune cells and the ECM. We then review our current knowledge of the mechanobiology of cancer with a focus on metastasis. Next, we discuss links between SNS activity and tumor-associated inflammation, the mechanical properties of immune cells, and how the physical properties of the ECM regulate cancer and metastasis. Finally, we discuss the potential for clinical translation of our knowledge of cancer mechanobiology to improve diagnosis and treatment

    Coronations and Colonial Control

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    Surface Waves on a Semi-toroidal Water Ring

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    We study the dynamics of surface waves on a semi-toroidal ring of water that is excited by vertical vibration. We create this specific fluid volume by patterning a glass plate with a hydrophobic coating, which confines the fluid to a precise geometric region. To excite the system, the supporting plate is vibrated up and down, thus accelerating and decelerating the fluid ring along its toroidal axis. When the driving acceleration is sufficiently high, the surface develops a standing wave, and at yet larger accelerations, a traveling wave emerges. We also explore frequency dependencies and other geometric shapes of confinement

    2000-2020 NHIS Studies: Factors affecting medication adherence rate in the pediatric population with medical complexity

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    Introduction Children with medical complexity belong to a vulnerable patient population group that is defined by the interplay of chronic health conditions, high healthcare utilization, and severe limitations in cognitive and/or physical functioning. Members of this patient population often require a complex management and/or treatment regimen with the use of more than one medication. Pediatric nonadherence in medication can lead to increases in microbial resistance, adverse drug reactions, morbidity, and mortality. The consequences of this medication nonadherence may also cause slower recovery times, increased number of emergency department visits, and hospitalizations, which subsequently substantiates higher medical costs for families along with the healthcare system. General factors for pediatric medical adherence include age, culture, family structure, socioeconomic status, schedule of medication therapy, and taste/formulation of therapy. Continual studies on these medical adherence factors are of the utmost importance to mitigate nonadherence improving quality of life and reducing medical costs. This study examines the variables and confounding factors that may be responsible for the prevalence of nonadherence in this patient population. Methods Twelve primary articles using data collected through the National Health Interview Survey (NHIS) – focused on medication adherence secondary to medication therapy management (MTM) in the pediatric population across various chronic disease states –were examined and analyzed to collect the variables and factors of interest. Each article in the review was chosen to analyze a national representation of U.S. children between the years 2000-2020. The age perimeter was between ages zero (infants) to eighteen. Results Among the fifteen NHIS papers measuring medication adherence outcomes, three addressed financial and family disparities, three focused on the racial disparities’ association, and the remaining nine papers address other confounding factors (including but not limited to geographic location, patient education, and healthcare access). Results from the analysis confirmed the influence that racial/ethnic and/or socioeconomic disparities have on the medication adherence rate of the US pediatric population with medical complexity. Conclusion The medication adherence rate is affected by racial and ethnic disparities, financial hardships, socioeconomic status, family background education, poverty status, children’s health status, quality of patient education, and religious beliefs. This calls for more public health policies to alleviate the financial burden of medication costs, as well as efforts to improve medication education for the caregivers of children with medical complexity population in the U.S. The data-collecting phase of this research reveals the scarcity of studies on this topic – as reflected in the small number of articles found and reviewed. For a better understanding of the medication adherence rate among the medically complex pediatric population of the U.S., further research on this topic should be conducted

    Exploring the Power of Victorian Narratives

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    The impact of medication therapy management services on pediatric patients with medical complexities

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    Introduction Medication Therapy Management (MTM) is a service provided by healthcare providers to ensure the best medical outcomes, particularly for those with multiple chronic conditions. It is often provided for senior populations supported under the Centers for Medicare & Medicaid Services. Studies show that patients provided with MTM services have higher medication adherence rates and experience fewer complications. However, there are few studies on MTM counseling in pediatric populations. In this literature review study, we investigated the potential impact of MTM services for underserved pediatric populations with chronic conditions or disabilities who are likely to benefit from MTM services. Methods A multivariate review analysis was performed. Data was sourced from National Library of Medicine Pubmed and Google Scholar for the collection of primary literature. Inclusion criteria included terms such as pediatric population (patients less than 20 years of age), children with medical complexities or children with disabilities. MTM eligibility, MTM intervention, medication adherence, barriers to adherence were also included in search criteria. The chronic disease states this study included are: epilepsy, cystic fibrosis, leukemia, asthma, and diabetes. Exclusion criteria were the adult population over 20 years old, and ‘acute care’. Results A total of 17 primary research articles that met the criteria were identified in this literature review study. The articles were sorted into four criteria based on whether they included: children with disabilities, chronic diseases and medical complexities, multiple medication use complications and interventions, and population health disparities. Thirteen articles satisfied children with disabilities as the target population (age less than 18 years old with chronic physical/developmental/behavioral/emotional conditions that require health interventions). Eleven articles satisfied population health disparities: featuring notable differences in opportunities to achieve optimal health experienced by socially disadvantaged populations. Eight articles satisfied medication use complications and interventions, presenting an ongoing need and use of multiple prescriptions. Seven articles represented chronic diseases and medical complexities: chronic conditions with functional limitations lasting more than a year. Conclusion In total, there were seven articles found that discussed MTM service and medication adherence in the special population that required multiple medication therapy. The disease states that were focused on included epilepsy, cystic fibrosis, leukemia, asthma, and diabetes. Of the articles, two had documented MTM services and adherence monitoring for their patient population. The papers demonstrated that patients with chronic diseases, such as asthma and diabetes in adolescents, received benefits from MTM service and an increased rate of medication adherence. Therefore, our review emphasizes the need for further research on the impact of MTM service in a socially vulnerable population

    Medication Management Program Among Elderly at a Residential Facility

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    Abstract This quality improvement project aimed to address medication management-related issues at a residential facility. The project\u27s population was elderly residents who self- administered their medications. A root cause analysis and SWOT analysis identified multiple factors contributing to medication management errors, including lack of resident education, resident competency, and technology limitations. An intervention plan was developed and implemented in two phases. Phase 1 involved conducting medication reconciliation, assessing resident competency, and 1:1 educational sessions with the residents. Educational retention was assessed by using a pre-test and a post-test. Phase 2, to be implemented in the future, will address technology limitations, incorporate an electronic medical records (EMR) system, and provide ongoing staff education. Results from Phase 1 include 80% recalled new information while 20% showed no change after completion of the educational session and the pre/post-test; from those residents assessed with the Medi-Cog, 55% scored above 8 out of 10 while 45% scored below the cutoff score of 8, and last 100% of the Medication Administration Records (MAR) were reviewed. Although time constraints prevented Phase 2 interventions from being implemented, implementing an EMR system and a professional development plan for staff education are expected to contribute to further improvements in medication management at the residential facility. Continued monitoring and collaboration with the residents and staff are vital for sustained success
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