Nurse Practitioner and Pharmacist Interactions: Implications for Effectiveness of Interdisciplinary Health Care Teams

The Institute of Medicine report, “The Future of Nursing: Leading Change, Advancing Health,” makes specific recommendations for removing barriers to advanced practice nursing scope of practice. The report also makes important recommendations concerning interdisciplinary teamwork. This article examines the challenges on the professional working relationship between nurse practitioners and pharmacists and provides some insight into the difficulties faced as health care practitioners attempt to work toward the goal of collaborative efforts to advance the care of our patients

Prototype Using Ultrasonic Sensor to Assist Visually Impaired Individual in the Philippines

People who are visually impaired deals with number of difficulties when exercising the most basic things in daily life. Some are frequently rely on others, which makes them less confident in an unusual setting and some use tools like white cane or simple sticks, but for some cirsumstances these could put their lives at risk while traveling. Since the Philippines has limited access to technological resources that could reduce the risk, the researchers came up with the idea of using an ultrasonic sensor to detect obstacles that are above or in front of the user. The study aims to develop a functional prototype that helps visually impaired individual and determine how well the functional prototype responds to the needs of the blind individual. Utilizing a problem-based approach to problem solving, the Design Thinking Methodology was the methodology employed in this study. As a result, using different sound and vibration frequencies the prototype can identify minimum distances of 120 cm, 80 cm, and 30 cm as an output. The study concludes that a successful tool could be a design prototype that uses sensor-equipped sticks to assist blind individuals in moving around and increasing their awareness of their surroundings. However, the scope of this study is limited as it is unable to determine the material of the obstruction or whether a hole exists in front of the user because the tool used in this work can only detect barriers above and in front of the user

Zonal circulation across 52°W in the North Atlantic

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 109 (2004): C11008, doi:10.1029/2003JC002103.In July–August 1997, a hydrographic/Acoustic Doppler Current Profiler (ADCP)/tracer section was occupied along 52°W in the North Atlantic as part of the World Ocean Circulation Experiment Hydrographic Program. Underway and lowered ADCP (LADCP) data have been used to reference geostrophic velocities calculated from the hydrographic data; additional (small) velocity adjustments provided by an inverse model, constraining mass and silicate transports in 17 neutral density layers, yield the absolute zonal velocity field for 52°W. We find a vigorous circulation throughout the entire section, with an unusually strong Gulf Stream (169 Sv) and southern Deep Western Boundary Current (DWBC; 64 Sv) at the time of the cruise. At the northern boundary, on the west side of the Grand Banks of Newfoundland, we find the westward flowing Labrador Current (8.6 Sv), whose continuity from the Labrador Sea, east of our section, has been disputed. Directly to the south we identify the slopewater current (12.5 Sv eastward) and northern DWBC (12.5 Sv westward). Strong departures from strictly zonal flow in the interior, which are found in the LADCP data, make it difficult to diagnose the circulation there. Isolated deep property extrema in the southern portion, associated with alternating bands of eastward and westward flow, are consistent with the idea that the rough topography of the Mid-Atlantic Ridge, directly east of our section, causes enhanced mixing of Antarctic Bottom Water properties into overlying waters with distinctly different properties. We calculate heat and freshwater fluxes crossing 52°W that exceed estimates based on air-sea exchanges by a factor of 1.7.This work was supported by NSF grants OCE95-29607, OCE 95-31864, OCE98-18266, and OCE-0219644

Impact of Tai Chi on Peripheral Neuropathy Revisited: A Mixed-Methods Study

Exercise may be beneficial to older persons living with peripheral neuropathy (PN), but maintaining an exercise program is challenging. After participating in a 12-week tai chi (TC) study, 12 participants requested classes continue. A mixed-methods design was used to explore long-term engagement of older persons with bilateral PN enrolled in a TC class for 18 months beyond the original 3-month study. Pre- and posttest measures of functional status and quality of life (QOL) were conducted. Focus groups were held after 18 months of twice-weekly classes. Psychosocial support was critical to participants’ long-term commitment to exercise. Participants reported, and objective assessments confirmed, increased strength, balance, and stamina beyond that experienced in the original 12-week study. Changes in QOL scores were nonsignificant; however, qualitative data supported clinical significance across QOL domains. Results from this study support psychosocial and physical benefits of TC to older persons

Tai Chi Exercise on Muscle Strength and Physical Function in Peripheral Neuropathy Patients

This poster was presented at the American College of Sports Medicine\u27s (ACSM) 63rd Annual Meeting and World Congresses, Boston, MA.https://scholarworks.uttyler.edu/fac_posters/1016/thumbnail.jp

Effect of Tai Chi on Vascular Function Among Patients with Peripheral Neuropathy

Foot pain due to Peripheral Neuropathy (PN) is one of the factors affecting walking ability. It has been reported that diminished vascular function contributes to a decrease in physical function in individuals with PN. Microvascular disturbances have been reported in humans with neuropathic pain. Tai Chi, a Chinese conditioning exercise, has been associated with enhanced endothelial function. However, the effect of Tai Chi training on microvascular function in patients with PN has not been studied. This study aimed to assess the effects of Tai Chi on vascular function (i.e., vascular reactivity) and functional exercise capacity among patients with PN. Thirty-seven participants (men = 21, women = 16) were randomly assigned to either Tai Chi exercise (Ex, n = 20, age: 71 ± 9.50 years) or control group (Con, n = 17, age: 75 ± 9.02 years). Exercise training consisted of 12-week progressive Tai Chi (i.e., Yang Style), offered 3 times per week, 60 minutes sessions. The Con group did not participate in any exercise activity. Before and after training, vascular function [finger tip digital thermal monitoring of vascular reactivity] and functional exercise capacity [Six-Minute Walk test (6MW)] were evaluated. The Ex group experienced a significant 25% increase in vascular reactivity index from baseline [1.93 ± 0.43 to 2.41 ± 0.47, (P \u3c 0.05)]. In addition, the 6MW test increased significantly in the Ex group by 28% [pre = 392 ± 93; post = 503 ± 105 m, (P \u3c 0.05)]. In the control group no significant changes were observed in either vascular function [1.83 ± 0.43 to 1.81 ± 0.37] or in the 6MW test [393 ± 142 to 398 ± 149 m]. Participants experienced no complications and/or falls as a result of the intervention. These findings demonstrated that in patients with PN, a 12-week progressive Tai Chi exercise program was capable of increasing not only vascular function, specifically vascular reactivity index, but also of increasing the distance covered during the 6MW test. Clearly, this study underlies the importance of Tai Chi as an effective and safe exercise intervention suitable for patients with PN

Spinning up the Surface: Evidence for Planetary Engulfment or Unexpected Angular Momentum Transport?

In this paper, we report the potential detection of a nonmonotonic radial rotation profile in a low-mass lower-luminosity giant star. For most low- and intermediate-mass stars, the rotation on the main sequence seems to be close to rigid. As these stars evolve into giants, the core contracts and the envelope expands, which should suggest a radial rotation profile with a fast core and a slower envelope and surface. KIC 9267654, however, seems to show a surface rotation rate that is faster than its bulk envelope rotation rate, in conflict with this simple angular momentum conservation argument. We improve the spectroscopic surface constraint, show that the pulsation frequencies are consistent with the previously published core and envelope rotation rates, and demonstrate that the star does not show strong chemical peculiarities. We discuss the evidence against any tidally interacting stellar companion. Finally, we discuss the possible origin of this unusual rotation profile, including the potential ingestion of a giant planet or unusual angular momentum transport by tidal inertial waves triggered by a close substellar companion, and encourage further observational and theoretical efforts.Comment: 18 pages, 9 figures, submitted to AAS Journal

A New Anti-Depressive Strategy for the Elderly: Ablation of FKBP5/FKBP51

The gene FKBP5 codes for FKBP51, a co-chaperone protein of the Hsp90 complex that increases with age. Through its association with Hsp90, FKBP51 regulates the glucocorticoid receptor (GR). Single nucleotide polymorphisms (SNPs) in the FKBP5 gene associate with increased recurrence of depressive episodes, increased susceptibility to post-traumatic stress disorder, bipolar disorder, attempt of suicide, and major depressive disorder in HIV patients. Variation in one of these SNPs correlates with increased levels of FKBP51. FKBP51 is also increased in HIV patients. Moreover, increases in FKBP51 in the amygdala produce an anxiety phenotype in mice. Therefore, we tested the behavioral consequences of FKBP5 deletion in aged mice. Similar to that of naïve animals treated with classical antidepressants FKBP5−/− mice showed antidepressant behavior without affecting cognition and other basic motor functions. Reduced corticosterone levels following stress accompanied these observed effects on depression. Age-dependent anxiety was also modulated by FKBP5 deletion. Therefore, drug discovery efforts focused on depleting FKBP51 levels may yield novel antidepressant therapies

Challenges to curing primary brain tumours.

Despite decades of research, brain tumours remain among the deadliest of all forms of cancer. The ability of these tumours to resist almost all conventional and novel treatments relates, in part, to the unique cell-intrinsic and microenvironmental properties of neural tissues. In an attempt to encourage progress in our understanding and ability to successfully treat patients with brain tumours, Cancer Research UK convened an international panel of clinicians and laboratory-based scientists to identify challenges that must be overcome if we are to cure all patients with a brain tumour. The seven key challenges summarized in this Position Paper are intended to serve as foci for future research and investment