Evaluation and implications of natural product use in preoperative patients: a retrospective review

<p>Abstract</p> <p>Background</p> <p>Medication Reconciliation and Medication Safety are two themes emphasized in a variety of healthcare organizations. As a result, health care facilities have established methods for obtaining a patient's medication history. However, these methods may vary among institutions or even among the health care professionals in a single institution, and studies have shown that patients are reluctant to disclose their complementary and alternative medicine use to any health care professional. This lack of disclosure is important in surgical patients because of potential herbal interactions with medications and drugs used during the surgical procedure; and the potential for adverse reactions including effects on coagulation, blood pressure, sedation, electrolytes or diuresis. Therefore, the objectives of this study are to identify patterns of natural product use, to identify potential complications among patients scheduled for surgery, to improve existing medication reconciliation efforts, and to develop discontinuation guidelines for the use of these products prior to surgery.</p> <p>Methods</p> <p>A retrospective review of surgery patients presenting to the Anesthesia Preoperative Evaluation Clinic (APEC) at the University of Kansas Hospital was conducted to identify the prevalence of natural product use. The following data was collected: patient age; gender; allergy information; date of medication history; number of days prior to surgery; source of medication history; credentials of person obtaining the history; number and name of prescription medications, over-the-counter medications and natural products; and natural product dosage. Following the collection of data and analysis of the most common natural products used, possible complications and interactions were identified, and a protocol regarding the pre-operative use of natural products was developed and implemented.</p> <p>Results</p> <p>Approximately one-fourth of patients seen in the APEC indicated the use of natural products. Patients taking natural products were significantly older, were more likely to undergo cardiac or chest surgery, and were more likely to be taking more prescription and non-prescription medications (all p < 0.001).</p> <p>Conclusion</p> <p>Based on the results of this study, it is concluded that there is a need for established guidelines regarding discontinuation of selected natural products prior to surgery and further education is needed concerning the perioperative implications of natural products.</p

Complementary and alternative medicine use among US Navy and Marine Corps personnel

<p>Abstract</p> <p>Background</p> <p>Recently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown.</p> <p>Methods</p> <p>To investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population.</p> <p>Results and discussion</p> <p>Of 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use.</p> <p>Conclusion</p> <p>These data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data.</p

A novel formulation technology for baculoviruses protects biopesticide from degradation by ultraviolet radiation

Biopesticides are biological pest control agents that are viewed as safer alternatives to the synthetic chemicals that dominate the global insecticide market. A major constraint on the wider adoption of biopesticides is their susceptibility to the ultraviolet (UV: 290–400 nm) radiation in sunlight, which limits their persistence and efficacy. Here, we describe a novel formulation technology for biopesticides in which the active ingredient (baculovirus) is micro-encapsulated in an ENTOSTAT wax combined with a UV absorbant (titanium dioxide, TiO2). Importantly, this capsule protects the sensitive viral DNA from degrading in sunlight, but dissolves in the alkaline insect gut to release the virus, which then infects and kills the pest. We show, using simulated sunlight, in both laboratory bioassays and trials on cabbage and tomato plants, that this can extend the efficacy of the biopesticide well beyond the few hours of existing virus formulations, potentially increasing the spray interval and/or reducing the need for high application rates. The new formulation has a shelf-life at 30 °C of at least 6 months, which is comparable to standard commercial biopesticides and has no phytotoxic effect on the host plants. Taken together, these findings suggest that the new formulation technology could reduce the costs and increase the efficacy of baculovirus biopesticides, with the potential to make them commercially competitive alternatives to synthetic chemicals

Search for a decay of Te-104 with a novel recoil-decay scintillation detector

A search for superallowed α decay of N=Z nuclei Te104 and Xe108 was carried out using a novel recoil-decay scintillator detector at the tandem accelerator facility at the Japan Atomic Energy Agency (JAEA). Inorganic crystal scintillation material YAP:Ce (yttrium aluminum perovskite) coupled to a position-sensitive photomultiplier tube (PSPMT) was implemented for the first time in a radioactive decay experiment. Residues from the fusion-evaporation reaction Ni58+Fe54→Xe∗112 were separated by the JAEA Recoil Mass Separator (RMS) and implanted into the YAP:Ce crystal. α decays of neutron-deficient tellurium isotopes were identified and proton emission of I109 was observed. The α-decay chain Xe109→Te105→Sn101 was recorded with a time interval of 960 ns between two α pulses. Position localization in the crystal for decays and ions in the energy range from hundreds of keV to 60 MeV was achieved with an accuracy of 0.67 mm, proving that this detector is capable of making temporal and spatial correlations for fast decay events. No conclusive evidence was found for the decay chain Xe108→Te104→Sn100 within 3 days of experiment. However, two events were observed with properties consistent with the reported observation at the Fragment Mass Analyzer (FMA), but with a separation between signals of less than 4 ns. The cross section limit of 130 pb was obtained for production of two events of Xe108, about an order of magnitude below the expectation based on earlier cross section measurements and the hivap fusion-evaporation code

Dendritic Spikes Amplify the Synaptic Signal to Enhance Detection of Motion in a Simulation of the Direction-Selective Ganglion Cell

The On-Off direction-selective ganglion cell (DSGC) in mammalian retinas responds most strongly to a stimulus moving in a specific direction. The DSGC initiates spikes in its dendritic tree, which are thought to propagate to the soma with high probability. Both dendritic and somatic spikes in the DSGC display strong directional tuning, whereas somatic PSPs (postsynaptic potentials) are only weakly directional, indicating that spike generation includes marked enhancement of the directional signal. We used a realistic computational model based on anatomical and physiological measurements to determine the source of the enhancement. Our results indicate that the DSGC dendritic tree is partitioned into separate electrotonic regions, each summing its local excitatory and inhibitory synaptic inputs to initiate spikes. Within each local region the local spike threshold nonlinearly amplifies the preferred response over the null response on the basis of PSP amplitude. Using inhibitory conductances previously measured in DSGCs, the simulation results showed that inhibition is only sufficient to prevent spike initiation and cannot affect spike propagation. Therefore, inhibition will only act locally within the dendritic arbor. We identified the role of three mechanisms that generate directional selectivity (DS) in the local dendritic regions. First, a mechanism for DS intrinsic to the dendritic structure of the DSGC enhances DS on the null side of the cell's dendritic tree and weakens it on the preferred side. Second, spatially offset postsynaptic inhibition generates robust DS in the isolated dendritic tips but weak DS near the soma. Third, presynaptic DS is apparently necessary because it is more robust across the dendritic tree. The pre- and postsynaptic mechanisms together can overcome the local intrinsic DS. These local dendritic mechanisms can perform independent nonlinear computations to make a decision, and there could be analogous mechanisms within cortical circuitry

"Choice set" for health behavior in choice-constrained settings to frame research and inform policy : examples of food consumption, obesity and food security

ABSTRACT: Objectives: Using the nexus between food consumption, food security and obesity, this paper addresses the complexity of health behavior decision-making moments that reflect relational social dynamics in context-specific dialogues, often in choice-constrained conditions. Methods: A pragmatic review of literature regarding social determinants of health in relation to food consumption, food security and obesity was used to advance this theoretical model. Results and discussion: We suggest that health choice, such as food consumption, is based on more than the capacity and volition of individuals to make "healthy" choices, but is dialogic and adaptive. In terms of food consumption, there will always be choice-constrained conditions, along a continuum representing factors over which the individual has little or no control, to those for which they have greater agency. These range from food store geographies and inventories and food availability, logistical considerations such as transportation, food distribution, the structure of equity in food systems, state and non-government food and nutrition programs, to factors where the individual exercises a greater degree of autonomy, such as sociocultural foodways, family and neighborhood shopping strategies, and personal and family food preferences. At any given food decision-making moment, many factors of the continuum are present consciously or unconsciously when the individual makes a decision. These health behavior decision-making moments are mutable, whether from an individual perspective, or within a broader social or policy context. We review the construct of "choice set", the confluence of factors that are temporally weighted by the differentiated and relationally-contextualized importance of certain factors over others in that moment. The choice transition represents an essential shift of the choice set based on the conscious and unconscious weighting of accumulated evidence, such that people can project certain outcomes. Policies and interventions should avoid dichotomies of "good and bad" food choices or health behaviors, but focus on those issues that contribute to the weightedness of factors influencing food choice behavior at a given decision-making moment and within a given choice set

Job-Related Emotional Labor and Its Relationship to Work-Family Conflict and Facilitation

Emotional labor, Family-to-work conflict, Family-to-work facilitation, Work-to-family conflict, Work-family facilitation,

The importance of wellness among users of complementary and alternative medicine: findings from the 2007 National Health Interview Survey

BACKGROUND: This study developed and tested a sociobehavioral wellness model of complementary and alternative medicine (CAM) to differentiate predisposing factors, enabling resources, need, and personal health practices according to use for wellness, for combined wellness and treatment, or for treatment alone. METHODS: Data were from the 2007 National Health Interview Survey (NHIS), a cross-sectional, nationally representative sample of 23,393 adult Americans. This analysis included people who used at least one CAM modality in the past 12 months (n = 7003 adult users). Prevalence estimates and multinomial logistic regression results were weighted and adjusted for complex sample design. RESULTS: Overall, 86 % of CAM users reported reason for use as wellness (51 %) or wellness combined with treatment (35 %). White women had the lowest (48 %) and Asian men (66 %) had the highest wellness use. Compared to treatment only users, wellness users were significantly more likely to be older, more educated, in better health, and engaged in multiple healthy behaviors. There was support that those with health conditions were using methods for both treatment and to maintain health. CONCLUSIONS: The findings underscore the central role of CAM in health self-management and wellness lifestyle. At a time of national health care reform highlighting the importance of health and wellness and employers turning to wellness programs to improve worker performance and well-being, these findings suggest a central role of CAM in those public health endeavors