Use of Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) to Determine the Health Literacy Rate of the Spanish-speaking Population in an Urban Emergency Department

Background: The Hispanic population presents a great opportunity in terms of potential improvements in clinical outcomes and cost reduction for interventions through assessing and improving health literacy. While there are various tools to assess health literacy, many do not assess comprehensive Spanish health literacy. Objectives: We sought to determine the health literacy rate of our Spanish-speaking population in the ED using the SAHLSA-50 tool. Methods: We surveyed a convenience sample of 300 patients from October to November 2012 that presented to our busy, high volume, urban ED. All subjects completed the SAHLSA-50 tool and demographic form with Spanish-speaking research assistants. Results: 63.3% were women. 8% were age 18-25, 42% were 26-40, 45% were 41-65, and 5% were 65+. 11% had less than 3 years of school, 30% had 4-6 years of school, and 59% had at least 7 years of school. Overall, 83% respondents were health literate. Those with less than 3 years of school were95% in those with 7 or more years of school. The elderly (65+) reported least years of school completed and had the lowest health literacy (56.3%). Conclusions: There was an overall health literacy rate of 83.0%. Importantly, those with lower levels of education and elderly patients were more likely to not be health literate. As a next step, targeting those with less education and the elder within the Hispanic population may yield the most impact for improving health literacy and outcomes

In vitro comparison of Ethanol Metabolism in Precision Cut Liver Slices from C57Bl/6, Balb/c, DBA/2J and 129S1/SvlmJ Mice and with the Aldeyra Product ADX-629

Alcoholic liver disease (ALD) is common consequence of excessive alcohol consumption [1]. When the liver is damaged by the intake of alcohol, repair mechanisms are deployed, which results in fibrosis or scarring of the liver. Development of this disease is due to the byproducts of ethanol metabolism. These byproducts include acetaldehyde from the metabolism of ethanol and malondialdehyde from the breakdown of cell membranes during injury. An Aldeyra product, ADX-629, is a small molecule that acts as a reactive aldehyde species (RASP) inhibitor. ADX-629 covalently binds free aldehydes, thus diminishing excessive RASP levels. To determine the aldehyde scavenging abilities of ADX-629 in attenuating fatty liver disease, precision cut liver slices (PCLS) were exposed to varying concentrations of ADX-629 as well as 25mM of ethanol. PCLS, which provide a novel in vitro/ex vivo experimental model, were then measured for triglyceride levels and supernatants were analyzed for acetaldehyde levels. It was found that ADX-629 reduced the acetaldehyde levels released from PCLS while also decreasing triglyceride levels. ADX-629 offers promising clinical uses such as in the prevention of fatty liver formation in patients with non-alcoholic steatohepatitis and in the treatment of alcoholic patients by preventing oxidative stress caused by the breakdown of ethanol thereby, preventing ALD.https://digitalcommons.unmc.edu/surp2021/1062/thumbnail.jp

Organizational identification, work engagement, and job satisfaction

Purpose Organizational identification refers to a person’s sense of belonging within the organization in which they work. Despite the importance of organizational identification for work-related attitudes and organizational behavior, little research has directly examined the mechanisms that may link these. The purpose of this paper is to provide an understanding of how organizational identification relates to job satisfaction. Design/methodology/approach Adopting a social identity perspective, the authors present and test two models that describe work engagement and its constituent dimensions (vigor, dedication, absorption) as mediating the relationship between organizational identification and job satisfaction. Findings Bootstrapped mediation analyses provided support for full mediation whereby there is an indirect (via work engagement) and positive effect of organizational identification on job satisfaction. Analyses also provided support for the mediating effects of the three dimensions of work engagement, vigor, dedication, and absorption, in this relationship. Practical implications Although cross-sectional, this study provides a needed first step toward an understanding of the important role of organizational identification for job satisfaction and the mediating role of work engagement in this relationship. Originality/value The results provide valuable insights into the effects of organizational identification and address some of the gaps in understanding social identity as the context for work behaviors. Theoretical and practical implications for strengthening employee engagement and enhancing organizational identification are discussed

Effects of selected South African plant extracts on haemolysis and coagulation

The use of herbal preparations for staunching blood flow and reducing the risk of vascular thrombosis is common worldwide. In this study, aqueous and methanolic extracts of plants used to treat blood-associated complaints were investigated to determine their effects on red blood cell haemolysis and coagulation. The extent of haemolysis was determined spectrophotometrically. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) as indicators of coagulation rate were determined using a coagulatometer. All of the plant extracts tested had a significant effect on coagulation time, prolonging the aPTT. Cassia petersiana had the greatest prolonging effect on PT compared to the control, phosphate buffered saline (PBS). As all of the herbal extracts tested had a delaying effect on coagulation, patients using herbal/plant therapies should be cautioned to stop their medication before surgery.The University of Pretoria, Department of Pharmacology.http://het.sagepub.co

Random Geometric Graphs

We analyse graphs in which each vertex is assigned random coordinates in a geometric space of arbitrary dimensionality and only edges between adjacent points are present. The critical connectivity is found numerically by examining the size of the largest cluster. We derive an analytical expression for the cluster coefficient which shows that the graphs are distinctly different from standard random graphs, even for infinite dimensionality. Insights relevant for graph bi-partitioning are included.Comment: 16 pages, 10 figures. Minor changes. Added reference

Nonlinear Modulation of Multi-Dimensional Lattice Waves

The equations governing weakly nonlinear modulations of $N$-dimensional lattices are considered using a quasi-discrete multiple-scale approach. It is found that the evolution of a short wave packet for a lattice system with cubic and quartic interatomic potentials is governed by generalized Davey-Stewartson (GDS) equations, which include mean motion induced by the oscillatory wave packet through cubic interatomic interaction. The GDS equations derived here are more general than those known in the theory of water waves because of the anisotropy inherent in lattices. Generalized Kadomtsev-Petviashvili equations describing the evolution of long wavelength acoustic modes in two and three dimensional lattices are also presented. Then the modulational instability of a $N$-dimensional Stokes lattice wave is discussed based on the $N$-dimensional GDS equations obtained. Finally, the one- and two-soliton solutions of two-dimensional GDS equations are provided by means of Hirota's bilinear transformation method.Comment: Submitted to PR

Identification of a new p53/MDM2 inhibitor motif inspired by studies of chlorofusin

Previous studies on the natural product chlorofusin have shown that the full peptide and azaphilone structure are required for inhibition of the interaction between MDM2 and p53. In the current work, we utilized the cyclic peptide as a template and introduced an azidonorvaline amino acid in place of the ornithine/azaphilone of the natural product and carried out click chemistry with the resulting peptide. From this small library the first ever non-azaphilone containing chlorofusin analogue with MDM2/p53 activity was identified. Further studies then suggested that the simple structure of the Fmoc-norvaline amino acid that had undergone a click reaction was also able to inhibit MDM2/p53 interaction. This is an example where studies of a natural product have led to the serendipitous identification of a new small molecule inhibitor of a protein-protein interaction

Emergency department utilization after hospitalization discharge for acute stroke: The COMprehensive Post-Acute Stroke Services (COMPASS) study

Each year nearly 800,000 people in the United States experience a stroke. Those that survive are at high risk for complications after hospital discharge. Providing appropriate care during the recovery from this complex condition is a challenge for patients, caregivers, and health care providers. Understanding emergency department (ED) utilization after a stroke may provide insights into long-term management of stroke, inform interventions, improve patient outcomes, and reduce medical costs. A comprehensive transitional care model for post-acute stroke care may influence the need to seek ED care for downstream events after a stroke. To date, most transitional care trials exploring post-stroke healthcare utilization were conducted outside of the U.S. health-care system. We examined data from the Comprehensive Post-Acute Stroke Services (COMPASS) study, a cluster-randomized pragmatic trial of a post-discharge transitional care model for stroke survivors and their caregivers compared with usual care

Implementation of a transitional care model for stroke: Perspectives from frontline clinicians, administrators, and COMPASS-TC implementation staff

Background and Objectives: Stroke is a chronic, complex condition that disproportionally affects older adults. Health systems are evaluating innovative transitional care (TC) models to improve outcomes in these patients. The Comprehensive Post-Acute Stroke Services (COMPASS) Study, a large cluster-randomized pragmatic trial, tested a TC model for patients with stroke or transient ischemic attack discharged home from the hospital. The implementation of COMPASS-TC in complex real-world settings was evaluated to identify successes and challenges with integration into the clinical workflow. Research Design and Methods: We conducted a concurrent process evaluation of COMPASS-TC implementation during the first year of the trial. Qualitative data were collected from 4 sources across 19 intervention hospitals. We analyzed transcripts from 43 conference calls with hospital clinicians, individual and group interviews with leaders and clinicians from 9 hospitals, and 2 interviews with the COMPASS-TC Director of Implementation using iterative thematic analysis. Themes were compared to the domains of the RE-AIM framework. Results: Organizational, individual, and community factors related to Reach, Adoption, and Implementation were identified. Organizational readiness was an additional key factor to successful implementation, in that hospitals that were not "organizationally ready" had more difficulty addressing implementation challenges. Discussion and Implications: Multifaceted TC models are challenging to implement. Facilitators of implementation were organizational commitment and capacity, prioritizing implementation of innovative delivery models to provide comprehensive care, being able to address challenges quickly, implementing systems for tracking patients throughout the intervention, providing clinicians with autonomy and support to address challenges, and adequately resourcing the intervention. Clinical Trial Registration: NCT02588664