Impact of medication stressors on emotional health of informal caregivers of demented patients

Purpose: To better understand the medication-related concerns of dementia caregivers, their impact on caregiver emotional health and to identify potential areas for interventions that might assist them with medication management and reduce their overall stress and burden. Scope: Since demented patients lose their cognitive ability to manage their own medications early in the disease process, informal caregivers are involved with this sometimes complex process for an extended period of time which has the potential to cause a great deal of burden, anxiety and frustration. Methods: This research study was conducted using a sample of 139 caregivers of persons with memory problems recruited from caregiver support groups, clinic settings and an online listserv. Results: Caregivers who reported lower levels of social support and had more difficulty handling the medication effects reported higher depression scores. Less than half of the caregivers surveyed believed that their pharmacist was proactive in communicating drug information or that there was a private place within the pharmacy to do this. Conclusions: The findings suggest that medication-related stressors are associated with poorer emotional health outcomes in caregivers. The descriptive analysis of caregiver's attitudes about pharmacists and pharmacy services also suggests that there are things that can be done to assist caregivers to improve the relationship and communication with their pharmacist

Results of Universal Prenatal Screening for Hepatitis C Infection in a Remote American Indian Primary Care Population

BACKGROUND: Although chronic liver disease remains a major area of health disparity for American Indian (AI) people, the epidemiology of hepatitis C virus (HCV) infection among AI people is poorly documented. Because of suspected high local prevalence, two remote AI clinics in the Northern Plains implemented universal prenatal HCV screening in 2005. When this screening program reported an unexpectedly high prenatal anti-HCV (anti-HCV antibody) positivity rate, we conducted a case-control study to determine risks for infection and opportunities for community intervention. MAIN FINDINGS: The clinics screened a total of 205 pregnant women (median age, 22 years). Of these 205 women, a total of 13 (6.3%; 95% confidence interval, 3.4–10.6) had anti-HCV confirmed. Of the anti-HCV-positive women, 10 (76.9%) were aged 15–24 years. We included 10 cases and 40 anti-HCV-negative prenatal controls in a case-control study. On multivariate analysis, only injection-drug use (IDU) remained associated with HCV seropositivity. CONCLUSIONS: Universal prenatal screening revealed a high prevalence of anti-HCV at these remote AI clinics. This population has not been previously described at being at elevated risk for HCV infection. In order to reduce health disparities, young, rural AI populations seeking prenatal care need to be included in interventions to reduce HCV transmission

Recent Cases

Civil Procedure--Attorney-Client Privilege-- Privilege Protects Communications Made by Corporate Employee To Secure Legal Advice and a Matter Committed to a Professional Legal Advisor Is Prima Facie Committed To Secure Legal Advice James S. Hutchinson attorney-client privilege, the predominance test, legal activities In summary, courts have not yet resolved how to determine who may qualify as the corporate client for purposes of the attorney-client privilege... - - - - - - - - - - - - - - - - - - - - Constitutional Law-- Confrontation Clause-Admission at Trial of Slain Informant\u27s Prior Grand Jury Testimony Against Defendants Does Not Violate Confrontation Guarantee Despite Lack of Cross-Examination James Robert Newson III Although the trend in the law of evidence is toward greater admissibility of hearsay, the sixth amendment confrontation clause presents a countervailing consideration in the criminal law. - - - - - - - - - - - - - - - - - - Constitutional Law-Equal Protection-- Federal Statutes Differentiating Between Sentence Credit for Probation and Parole Time Satisfy Rational Basis Test Andrew W. Byrd Since its decision in Bolling v. Sharpe, which invalidated racial segregation in the public schools of the District of Columbia, the Supreme Court has utilized the due process clause of the fifth amendment to prohibit arbitrary discrimination by the federal government in much the same manner that it has employed the fourteenth amendment to limit similar state action.\u27 Through the 1950\u27sand 1960\u27s equal protection cases challenging both state and federal action fell within two distinct analytical categories-those subjected to a rational basis test and those required to withstand strict scrutiny. - - - - - - - - - - - - - - - - - - Labor Law-Taft-Hartley Section 301- Union May Be Liable for Sympathy Strike Damages When It Has Failed To Use Reasonable Care To Prevent Spread of Wildcat Strike Judith Miller Janssen Citing the national policy of promoting peaceful settlement of labor disputes and avoiding the violence resulting from wildcat strikes in the coal mining industry, the court found that the international union had a duty to prevent the spread of wildcat strikes of the sort that caused the work stoppage at plaintiff\u27s two mines. The court distinguished, however, between the liability of the inter-national union and that of the subdivisions of the union on the basis of ability to control both the underlying and sympathy strikers. - - - - - - - - - - - - - - - - - - - Uniform Commercial Code--Secured Transactions-- Article Nine Does Not Permit Unsecured Claims To Achieve Secured and Perfected Status by a Post-Bankruptcy Assignment to a Senior Secured Creditor John Eric Tavss The instant court\u27s refusal to sanction floating secured parties demonstrates the unwillingness of courts to expand permissible floating arrangements beyond those clearly allowed by the Code.This case further illustrates the struggle that courts face when confronted with the competing principles of floating arrangements, the notice requirements of the Code, and the Bankruptcy Act

Studies in Dye-Tracing Technologies in Karst Hydrogeology

Information on fluorescent dyes used for water tracing and the results of six studies are reported. Optical brightener, direct yellow, fluorescein, rhodamine (WT), and other dyes are described and the procedures employed in their use ·in the field and in equilibration experiments are discussed. Three of the six studies consisted of investigations of the equilibration with passive detectors of three of the dyes. The absorption of optical brightener on fabric detectors was apparently linear with concentration and with immersion time, while detectors became rapidly saturated with direct yellow. Equilibrium of fluorescein on charcoal detectors with an elutriating solution was not achieved. Several data processing tasks were performed, including the creation of a computer file for field data and the writing-of programs to sort the field data and generate plotted maps, and to display the total fluorescence of samples. A fifth study was based. on a series of dye traces into Royal Spring and Russell Cave Spring in the Inner Bluegrass Karst Region. Samples were collected with an automatic water sampler and the resulting flow velocity determinations combined with discharge data provided values at a number of aquifer parameters. The most interesting result was the very small value for depth of flow. A final study was of fracture traces identified on topographic maps and aerial photographs in the Inner Bluegrass Karst Region. It was found that while more such features were visible on the photographs, some were only apparent on maps

Raising a Small Flock of Sheep in Ohio

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Instabilities of one-dimensional stationary solutions of the cubic nonlinear Schrodinger equation

The two-dimensional cubic nonlinear Schrodinger equation admits a large family of one-dimensional bounded traveling-wave solutions. All such solutions may be written in terms of an amplitude and a phase. Solutions with piecewise constant phase have been well studied previously. Some of these solutions were found to be stable with respect to one-dimensional perturbations. No such solutions are stable with respect to two-dimensional perturbations. Here we consider stability of the larger class of solutions whose phase is dependent on the spatial dimension of the one-dimensional wave form. We study the spectral stability of such nontrivial-phase solutions numerically, using Hill's method. We present evidence which suggests that all such nontrivial-phase solutions are unstable with respect to both one- and two-dimensional perturbations. Instability occurs in all cases: for both the elliptic and hyperbolic nonlinear Schrodinger equations, and in the focusing and defocusing case.Comment: Submitted: 13 pages, 3 figure

Solutions of the sDiff(2)Toda equation with SU(2) Symmetry

We present the general solution to the Plebanski equation for an H-space that admits Killing vectors for an entire SU(2) of symmetries, which is therefore also the general solution of the sDiff(2)Toda equation that allows these symmetries. Desiring these solutions as a bridge toward the future for yet more general solutions of the sDiff(2)Toda equation, we generalize the earlier work of Olivier, on the Atiyah-Hitchin metric, and re-formulate work of Babich and Korotkin, and Tod, on the Bianchi IX approach to a metric with an SU(2) of symmetries. We also give careful delineations of the conformal transformations required to ensure that a metric of Bianchi IX type has zero Ricci tensor, so that it is a self-dual, vacuum solution of the complex-valued version of Einstein's equations, as appropriate for the original Plebanski equation.Comment: 27 page

The Cytotoxicity and Mode of Action of 2,3,4-Trisubstituted Pyrroles and Related Derivatives in Human Tmolt4 Leukemia Cells

4-Carbechoxy-l-methyl-2-phenacyl-3-phenylpyrrole (9), 4-carbethoxy-2-(4-methoxybcnzoyl)-3-(4-methoxyphcnyl)pyrrole (10) and 2-(4-methoxybenzoyl)-3,4-bis-(4-methoxyphenyl)pyrrole (11) proved to be potent cytotoxic agents against the growth of murine and human leukemias and lymphomas. Selective toxicity was demonstrated against the growth of solid tumors, e.g. human adenocarcinoma of the colon SW480 and ileum HCT-8, glioma U-87-MG, and rat UMR-106 osteosarcoma. A mode of action study in Tmolt4 leukemia cells demonstrated that the agents inhibited de novo purine synthesis at the regulatory sites PRPP-amido transferase, IMP dehydrogenase as well as dihydrofolate reductase resulting in significant inhibition of DNA synthesis in 60 min. Other biochemical sites which were affected significantly were thymidylate synthetase, DNA polymerase a, RNA polymerases, nucleoside kinase and ribonucleoside reductase

Contemporary evidence: baseline data from the D2B Alliance

© 2008 Bradley et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Uncertainty in United States coastal wetland greenhouse gas inventorying

© The Author(s), 2018. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Environmental Research Letters 13 (2018): 115005, doi:10.1088/1748-9326/aae157.Coastal wetlands store carbon dioxide (CO2) and emit CO2 and methane (CH4) making them an important part of greenhouse gas (GHG) inventorying. In the contiguous United States (CONUS), a coastal wetland inventory was recently calculated by combining maps of wetland type and change with soil, biomass, and CH4 flux data from a literature review. We assess uncertainty in this developing carbon monitoring system to quantify confidence in the inventory process itself and to prioritize future research. We provide a value-added analysis by defining types and scales of uncertainty for assumptions, burial and emissions datasets, and wetland maps, simulating 10 000 iterations of a simplified version of the inventory, and performing a sensitivity analysis. Coastal wetlands were likely a source of net-CO2-equivalent (CO2e) emissions from 2006–2011. Although stable estuarine wetlands were likely a CO2e sink, this effect was counteracted by catastrophic soil losses in the Gulf Coast, and CH4 emissions from tidal freshwater wetlands. The direction and magnitude of total CONUS CO2e flux were most sensitive to uncertainty in emissions and burial data, and assumptions about how to calculate the inventory. Critical data uncertainties included CH4 emissions for stable freshwater wetlands and carbon burial rates for all coastal wetlands. Critical assumptions included the average depth of soil affected by erosion events, the method used to convert CH4 fluxes to CO2e, and the fraction of carbon lost to the atmosphere following an erosion event. The inventory was relatively insensitive to mapping uncertainties. Future versions could be improved by collecting additional data, especially the depth affected by loss events, and by better mapping salinity and inundation gradients relevant to key GHG fluxes. Social Media Abstract: US coastal wetlands were a recent and uncertain source of greenhouse gasses because of CH4 and erosion.Financial support was provided primarily by NASA Carbon Monitoring Systems (NNH14AY67I) and the USGS Land Carbon Program, with additional support from The Smithsonian Institution, The Coastal Carbon Research Coordination Network (DEB-1655622), and NOAA Grant: NA16NMF4630103