The Effects of Atropine on the Growth and Respiration of Two Species of Bacteria Normally Inhabiting the Human Gastro-Intestinal System

It is the purpose of this study to determine whether the drug atropine has an effect on bacteria found normally inhabiting the human body, most specifically the gastrointestinal system. Atropine is one of the oldest drugs in medicine. It is derived from the roots and leaves of solanaceous plants such as henbane and Jimson weed. Atropine is often termed a belladonna alkaloid because it can also be found in the deadly nightshade plant, Atropa belladonna. Atropine is a highly competitive antagonist of acetylcholine at receptor sites in smooth muscles, cardiac muscle, and various glandular cells (5). Therefore, its effects are felt most strongly in the heart, intestine, and bronchial muscle (4). Although atropine is considered a stimulant, in reality its effects depend upon the dosage. A low dose causes sedation while a larger dose causes stimulation which may lead to delirium. Much research has been conducted on the effects of the belladonna alkaloids on the secretory and motor activity of the gastrointestinal tract. For the purpose of this study the effects of atropine upon the human gastrointestinal system are the ones considered

Psychiatric Medications: Does Education Affect Medication Prescriptions?

Background: There is a lack of research on racial challenges among underrepresented adolescents regarding prescription drug use for mental illnesses. Purpose: This study addressed the following question: In adolescent minorities, how does education about racial disparity and culture affect the stigma and number of prescriptions written for psychiatric medications? This evidence-based practice project aimed to identify if racial awareness directly impacts the amount of psychiatric medication prescribed for adolescent minorities. Methods: Literature reviews analyzed qualitative and quantitative data to provide correlating information on racial disparities and psychotropic medications. This study examined the following possible factors for decreased prescribed drugs within minority adolescents: population size, percentage of people who receive psychiatric prescriptions, cultural perspective, stigma, and social status. Results: Evidence has found that prescription psychiatric medications are highest amongst Caucasian adults; while Black, Hispanic, and Asian men were reported less likely to receive psychotropic drugs. Numerous studies highlighted the need to address factors affecting antipsychotic prescribing behaviors, interactions between the providers, and how financial sustainability affects such efforts Racial disparities regarding psychotropic prescriptions have been found to decrease through proper education. Conclusion: More research is still needed to investigate exactly how race and culture affect prescriptions and provider interactions

An Interprofessional Education Nursing Home Dining Simulation Promotes Changes in Student Attitudes

INTRODUCTION The purpose of this study was to assess changes in attitudes toward interprofessional collaborative competency attainment of undergraduate dietetics, gerontology/long term care administration, and occupational therapy assistant (OTA) students as a result of participating in a problem-based simulated nursing home dining experience. METHODS A one-group quasi-experimental post-test design, with convenience sample, was used in this study. Forty-three students completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) tool, a validated 20-item scale measuring attitudes toward interprofessional collaborative competency attainment. The ICCAS assesses six competencies: communication, collaboration, roles and responsibilities, collaborative patient/familycentered approach, conflict management/resolution and team functioning. A paired-sample t-test was conducted to evaluate the impact of the dining simulation on students’ ICCAS responses. RESULTS A statistically significant increase was found in the ICCAS summative score from the retrospective look designated as Time 1 (M=108.95; SD=19.76) to Time 2 [M=127.65; SD=17.86, t(42)= -8.63, p\u3c.0005]. CONCLUSION The results of this study have potential implications for educators, practitioners and researchers. Careful planning during case development enhanced the realism and accuracy of the simulation. This nursing home dining simulation using problem-based case scenarios was found to be an effective method of promoting interprofessional collaborative competencies with a unique group of healthcare students

Ambivalence in How to Address Adolescent Marijuana Use Among School-Based Health Center Providers

Objective: As part of a larger study to evaluate the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) at school-based health centers (SBHCs), we interviewed SBHC providers regarding their perceptions of substance use among adolescents seen at their SBHCs, experiences providing care for students with substance use and other mental health issues, and their concerns around marijuana specifically. Methods: We interviewed 12 primary and behavioral health providers who worked at five SBHCs in New Mexico. The interviews lasted approximately 1 hour and were digitally recorded and professionally transcribed. Two research team members independently analyzed the transcripts. We undertook iterative comparative analysis of qualitative data specifically related to marijuana and substance use, coding segments of text on key sensitizing concepts. Results. Six key themes emerged from the provider interviews: (1) marijuana use is indicative of underlying mental health issues; (2) normalization of marijuana use; (3) hesitance to endorse marijuana as a medical treatment for youth; (4) risks of marijuana use relative to alcohol use; (5) tension between building trust with adolescent patients and asserting authority; and (6) knowledge and skills gaps that impact counseling. Conclusion: Our findings elucidate key domains to address to support providers in their efforts to increase the health and safety of adolescents in a state that is rapidly expanding legislation and acceptance of marijuana. These findings may benefit providers in states that are enacting policies favorable to marijuana use

Clinical and serological features of systemic sclerosis in a multicenter African American cohort: Analysis of the genome research in African American scleroderma patients clinical database.

Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort).African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987-2016), from 18 academic centers throughout the United States. The cross-sectional prevalence of sociodemographic, clinical, and serological features was evaluated. Factors associated with clinically significant manifestations of SSc were assessed using multivariate logistic regression analyses.The study population included a total of 1009 African American SSc patients, comprised of 84% women. In total, 945 (94%) patients met the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc, with the remaining 64 (6%) meeting the 1980 ACR or CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) criteria. While 43% were actively employed, 33% required disability support. The majority (57%) had the more severe diffuse subtype and a young age at symptom onset (39.1 ± 13.7 years), in marked contrast to that reported in cohorts of predominantly European ancestry. Also, 1 in 10 patients had a severe Medsger cardiac score of 4. Pulmonary fibrosis evident on computed tomography (CT) chest was present in 43% of patients and was significantly associated with anti-topoisomerase I positivity. 38% of patients with CT evidence of pulmonary fibrosis had a severe restrictive ventilator defect, forced vital capacity (FVC) ≤50% predicted. A significant association was noted between longer disease duration and higher odds of pulmonary hypertension, telangiectasia, and calcinosis. The prevalence of potentially fatal scleroderma renal crisis was 7%, 3.5 times higher than the 2% prevalence reported in the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) cohort.Our study emphasizes the unique and severe disease burden of SSc in African Americans compared to those of European ancestry

Efectos de un programa de eliminación de sujeciones físicas sobre personas mayores con demencia en residencias

Objetivo: Analizar los resultados de eliminar las sujeciones físicas en mayores con demencia que viven en residencias. Este objetivo se enmarca en un proceso más amplio de modificación del modelo de atención residencial. Método: Estudio cuasi experimental en dos residencias desde mayo de 2010 hasta mayo de 2012. Se recoge información en 7 momentos temporales y se efectúa un análisis longitudinal. Tras formar al personal se retiraron progresivamente las sujeciones físicas en el centro El Puig, mientras que en el centro Conarda se mantuvieron las sujeciones. Las variables principales medidas fueron: caídas, psicofármacos administrados, así como diversos indicadores de estado mental y funcional (Norton, NPI, Minimental,Tinetti, Barthel).Resultados: En el centro en el que se eliminan todas las sujeciones físicas (El Puig), se observa una ligera mejoría en el número de caídas y sus consecuencias mejoran levemente, aunque no son estadísticamente significativas. Los ANOVA mostraron mejoras significativas en el centro que ha eliminado las sujeciones respecto a la prescripción de psicofármacos, al deterioro cognitivo y a las alteraciones de conducta.Discusión: Se constata que retirar sujeciones físicas no repercute negativamente en las caídas y sin embargo mejora ciertos aspectos del bienestar y la autonomía de los mayores (alteraciones de conducta y deterioro mental). Además, se evidencia que este programa debe ser complementado con un programa de desatar químico (retirada de psicofármacos)

APOE genotype and sex modulate Alzheimer’s disease pathology in aged EFAD transgenic mice

Increasing evidence supports that age, APOE and sex interact to modulate Alzheimer’s disease (AD) risk, however the underlying pathways are unclear. One way that AD risk factors may modulate cognition is by impacting amyloid beta (Aβ) accumulation as plaques, and/or neuroinflammation Therefore, the goal of the present study was to evaluate the extent to which age, APOE and sex modulate Aβ pathology, neuroinflammation and behavior in vivo. To achieve this goal, we utilized the EFAD mice, which express human APOE3 or APOE4 and have five familial AD mutations (FAD) that result in Aβ42 overproduction. We assessed Aβ levels, reactive glia and Morris water maze performance in 6-, 10-, 14-, and 18-month-old EFAD mice. Female APOE4 mice had the highest Aβ deposition, fibrillar amyloid deposits and neuroinflammation as well as earlier behavior deficits. Interestingly, we found that female APOE3 mice and male APOE4 mice had similar levels of pathology. Collectively our data support that the combination of APOE4 and female sex is the most detrimental combination for AD, and that at older ages, female sex may be equivalent to APOE4 genotype

Disruptive lysosomal-metabolic signaling and neurodevelopmental deficits that precede Purkinje cell loss in a mouse model of Niemann-Pick Type-C disease.

Purkinje cell (PC) loss occurs at an early age in patients and animal models of Niemann-Pick Type C (NPC), a lysosomal storage disease caused by mutations in the Npc1 or Npc2 genes. Although degeneration of PCs occurs early in NPC, little is known about how NPC1 deficiency affects the postnatal development of PCs. Using the Npc1nmf164 mouse model, we found that NPC1 deficiency significantly affected the postnatal development of PC dendrites and synapses. The developing dendrites of Npc1nmf164 PCs were significantly deficient in mitochondria and lysosomes. Furthermore, anabolic (mTORC1) and catabolic (TFEB) signaling pathways were not only perturbed but simultaneously activated in NPC1-deficient PCs, suggesting a loss of metabolic balance. We also found that mice with conditional heterozygous deletion of the Phosphatase and Tensin Homolog Deleted on Chromosome 10 gene (Pten-cHet), an inhibitor of mTORC1, showed similar early dendritic alterations in PCs to those found in Npc1-deficient mice. However, in contrast to Npc1nmf164 mice, Pten-cHet mice exhibited the overactivation of the mTORC1 pathway but with a strong inhibition of TFEB signaling, along with no dendritic mitochondrial reductions by the end of their postnatal development. Our data suggest that disruption of the lysosomal-metabolic signaling in PCs causes dendritic and synaptic developmental deficits that precede and promote their early degeneration in NPC

The Role of Histone Methyltransferases and Long Non-coding RNAs in the Regulation of T Cell Fate Decisions

T cell lineage decisions are critical for the development of proper immune responses to pathogens as well as important for the resolution of inflammatory responses. This differentiation process relies on a combination of intrinsic and extrinsic factors converging upon epigenetic regulation of transcriptional networks relevant to specific T cell lineages. As these biochemical modifications represent therapeutic opportunities in cancer biology and autoimmunity, implications of writers and readers of epigenetic marks to immune cell differentiation and function are highly relevant. Given the ready adoption of histone methyltransferase inhibitors in the clinic, we focus this review on the role of three histone modifying complexes: PRC-1, PRC-2, and G9A in modulating T cell fate decisions. Furthermore, we explore the role of long non-coding RNAs in regulating these processes, and discuss recent advances and challenges of implementing epigenetic therapies into clinical practice