Salicylate hepatitis

A case report of salicylate hepatitis is discussed and a predictable direct drug dosage mechanism is suggested as the pathogenesis. However, a striking eosinophilia and eosinophil infiltration of the portal tract also raises the possibility of a hypersensitivity cholestatic mechanism. Raised transaminase levels in patients on salicylate therapy appear to be a fairly frequent phenomenon which has not been widely stressed. It would seem that a sustained blood salicylate level of 25 mgjl00 ml is required to cause an elevated transaminase level, and a level in excess of 30 mgjl00 ml is necessary to cause actual hepatitis. Rapid reversal of the elevated transaminases occurs on cessation of salicylate therapy.S. Afr. Med. J., 48, 1998 (1974)

Correlation Between Plaque and Gingivitis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141522/1/jper0424.pd

A non-pharmacologic approach to address challenging behaviors of Veterans with dementia: description of the tailored activity program-VA randomized trial

BACKGROUND: Behavioral symptoms accompanying dementia are associated with increased health care costs, reduced quality of life and daily functioning, heightened family caregiver burden, and nursing home placement. Standard care typically involves pharmacologic agents, but these are, at best, modestly effective, carry serious risks, including mortality, and do not address behavioral symptoms families consider most distressful and which may prompt nursing home placement. Given dementia’s devastating effects and the absence of an imminent cure, the Veterans Administration has supported the development and testing of new approaches to manage challenging behaviors at home. METHODS/DESIGN: The Tailored Activity Program – Veterans Administration is a Phase III efficacy trial designed to reduce behavioral symptoms in Veterans with dementia living with their caregivers in the community. The study uses a randomized two-group parallel design with 160 diverse Veterans and caregivers. The experimental group receives a transformative patient-centric intervention designed to reduce the burden of behavioral symptoms in Veterans with dementia. An occupational therapist conducts an assessment to identify a Veteran’s preserved capabilities, deficit areas, previous roles, habits, and interests to develop activities tailored to the Veteran. Family caregivers are then trained to incorporate activities into daily care. The attention-control group receives bi-monthly telephone contact where education on topics relevant to dementia is provided to caregivers. Key outcomes include reduced frequency and severity of behavioral symptoms using the 12-item Neuropsychiatric Inventory (primary endpoint), reduced caregiver burden, enhanced skill acquisition, efficacy using activities, and time spent providing care at 4 months; and long-term effects (8 months) on the Veteran’s quality of life and frequency and severity of behavioral symptoms, and caregiver use of activities. The programs’ impact of Veterans Administration cost is also examined. Study precision will be increased through face-to-face research team trainings with procedural manuals and review of audio-taped interviews and intervention sessions. DISCUSSION: The Tailored Activity Program – Veterans Administration is designed to improve the quality of life of Veterans with dementia and lessen the burden of care on caregivers. Activities are tailored to reflect the Veteran’s preserved capabilities and interests to enhance active engagement, while not taxing areas of cognition that are most impaired. TRIAL REGISTRATION: ClinicalTrials.gov, NCT0135756

Development of the Risk Appraisal Measure: A Brief Screen to Identify Risk Areas and Guide Interventions for Dementia Caregivers

To develop and validate a brief screening measure for use in research, healthcare, and community settings to systematically assess well-being and identify needed areas of support for caregivers of patients with dementia. DESIGN : This study used data from Resources for Enhancing Alzheimer's Caregiver Health (REACH II), a multisite randomized clinical trial of a behavioral intervention designed to improve the quality of life of caregivers in multiple domains. SETTING : REACH II. PARTICIPANTS : Two hundred twelve Hispanic, 211 black, and 219 white family caregivers providing in-home care to patients with dementia. MEASUREMENT : Based on conceptual and psychometric analyses, a 16-item measure was developed that assesses six domains linked to caregiver risk and amenable to intervention: depression, burden, self-care and health behaviors, social support, safety, and patient problem behaviors. The reliability and validity of the instrument was evaluated with 642 dementia caregiver dyads from the REACH II program. RESULTS : The measure was found to have acceptable internal consistency for a multidimensional scale and similar measurement properties for each of the racial and ethnic groups. Concurrent validity was also demonstrated for the measure. CONCLUSION : The REACH Risk Appraisal Measure developed in this study shows promise as an assessment tool that can be used in research, clinical, and community settings to guide, prioritize, and target needed areas of support for caregivers of patients with dementia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66234/1/j.1532-5415.2009.02260.x.pd

Comparing international coverage of 9/11 : towards an interdisciplinary explanation of the construction of news

This article presents an interdisciplinary model attempting to explain how news is constructed by relying on the contributions of different fields of study: News Sociology, Political Communications, International Communications, International Relations. It is a first step towards developing a holistic theoretical approach to what shapes the news, which bridges current micro to macro approaches. More precisely the model explains news variation across different media organization and countries by focusing on the different way the sense of newsworthiness of journalists is affected by three main variables: national interest, national journalistic culture, and editorial policy of each media organization. The model is developed on the basis of an investigation into what shaped the media coverage of 9/11 in eight elite newspapers across the US, France, Italy and Pakistan

International journalism and the emergence of transnational publics: between cosmopolitan norms, the affirmation of identity and market forces

Much has been written about transnational public spheres, though our understanding of their shape and nature remains limited. Drawing on three alternative conceptions of newswork as public communication, this article explores the role of international journalists in shaping transnational publics. Based on a series of original interviews, it asks how journalists are oriented in their newswork (e.g. are they cosmopolitan or parochial in their orientation) and how they ‘imagine’ the public. It finds that interviewees imagine a polycentric transnational public and variously frame their work as giving voice to those affected by an issue (imagining the public as a cosmopolitan community of fate), performing and reaffirming a particular kind of identity and belonging (imagining the public as a nation) or pursuing audiences wherever they may be (imagining the public as the de facto audience)

The polygenic nature of telomere length and the anti-ageing properties of lithium

Telomere length is a promising biomarker for age-related disease and a potential anti-ageing drug target. Here, we study the genetic architecture of telomere length and the repositioning potential of lithium as an anti-ageing medication. LD score regression applied to the largest telomere length genome-wide association study to-date, revealed SNP-chip heritability estimates of 7.29%, with polygenic risk scoring capturing 4.4% of the variance in telomere length in an independent cohort (p = 6.17 × 10-5). Gene-enrichment analysis identified 13 genes associated with telomere length, with the most significant being the leucine rich repeat gene, LRRC34 (p = 3.69 × 10-18). In the context of lithium, we confirm that chronic use in a sample of 384 bipolar disorder patients is associated with longer telomeres (p = 0.03). As complementary evidence, we studied three orthologs of telomere length regulators in a Caenorhabditis elegans model of lithium-induced extended longevity and found all transcripts to be affected post-treatment (p  0.05). Consequently, this suggests that lithium may be catalysing the activity of endogenous mechanisms that promote telomere lengthening, whereby its efficacy eventually becomes limited by each individual's inherent telomere maintenance capabilities. Our work indicates a potential use of polygenic risk scoring for the prediction of adult telomere length and consequently lithium's anti-ageing efficacy

Implementation of a Family Intervention for Individuals with Schizophrenia

Families are rarely included in clinical care despite research showing that family involvement has a positive effect on individuals with schizophrenia by reducing relapse, improving work functioning, and social adjustment. The VA QUERI study, EQUIP (Enhancing QUality of care In Psychosis), implemented family services for this population. At two VA medical centers, veterans with schizophrenia and their clinicians were interviewed separately at baseline and 15 months. A family intervention was implemented, and a process evaluation of the implementation was conducted. Veterans with schizophrenia (n = 173) and their clinicians (n = 29). Consent to contact family was obtained, mailers to engage families were sent, families were prioritized as high need for family services, and staff volunteers were trained in a brief three-session family intervention. Of those enrolled, 100 provided consent for family involvement. Seventy-three of the 100 were sent a mailer to engage them in care; none became involved. Clinicians were provided assessment data on their patients and notified of 50 patients needing family services. Of those 50, 6 families were already involved, 34 were never contacted, and 10 were contacted; 7 new families became involved in care. No families were referred to the family psychoeducational program. Uptake of the family intervention failed due to barriers from all stakeholders. Families did not respond to the mailer, patients were concerned about privacy and burdening family, clinicians had misperceptions of family-patient contact, and organizations did not free up time or offer incentives to provide the service. If a full partnership with patients and families is to be achieved, these barriers will need to be addressed, and a family-friendly environment will need to be supported by clinicians and their organizations. Applicability to family involvement in other disorders is discussed