120 research outputs found
Exploratory Study of the Caregivers\u27 Perceived Barriers to Healthy Eating in the Mississippi Delta
The Mississippi Delta has been recognized for its poverty level and high rate of obesity. As an effort to combat the obesity issue while also considering the poverty issue of the population, a descriptive analysis was developed to understand what intervention might be beneficial. Focus groups were conducted to determine barriers to healthy eating behaviors for children, grades K-2. Focus groups (n=6) with parents or guardians of children from the six elementary schools in the Mississippi Delta were conducted in the Spring of 2007. The emergent themes included, perceived healthy foods, where diet information had been retrieved, and the efforts associated with meal preparation. Participants also voiced concern regarding the school policy on vending and coke machines that provide high-calorie non-nutritious foods
Partial cloning and characterization of an arginine decarboxylase in the kidney
Partial cloning and characterization of an arginine decarboxylase in the kidney. Using homology-based polymerase chain reaction (PCR) amplification, we demonstrate the presence of arginine decarboxylase mRNA in tissues involved in arginine metabolism (brain, kidney, gut, adrenal gland, and liver of the rat) but not in organs (lung, heart, and spleen) in which arginine metabolism is low or absent. The polymerase chain reaction product from the kidney had a nucleotide sequence 61% identical to that of the E. coli biosynthetic arginine decarboxylase. On a whole tissue basis, kidney homogenates were three times more active than brain homogenates at decarboxylating [1-14C]arginine. Subcellular fractionation localized the arginine decarboxylase activity of the kidney to the mitochondria fraction. Agmatine, one of the products of arginine decarboxylation, was found to inhibit nitric oxide formation by post-mitochon-drial supernatants of the brain or kidney. We propose that arginine is metabolized to two structurally different signaling molecules, nitric oxide and agmatine. Furthermore, agmatine can influence the nitric oxide synthase pathway
The impact of geomagnetic spikes on the production rates of cosmogenic 14C and 10Be in the Earth's atmosphere
We seek corroborative evidence of the geomagnetic spikes detected in the Near East ca. 980 BC and 890 BC in the records of the past production rates of the cosmogenic nuclides 14C and 10Be. Our forward modeling strategy rests on global, time-dependent, geomagnetic spike field models feeding state-of-the-art models of cosmogenic nuclide production. We find that spike models with an energy budget in line with presently inferred large-scale flow at Earth's core surface fail to produce a visible imprint in the nuclide record. Spike models able to reproduce the intensity changes reported in the Near East require an unaccountably high-magnitude core flow, yet their computed impact on cosmogenic isotope production rates remains ambiguous. No simple and unequivocal agreement is obtained between the observed and modeled nuclide records at the epochs of interest. This indicates that cosmogenic nuclides cannot immediately be used to confirm the occurrence of these two geomagnetic spikes
The Bulletin, School of Nursing Alumnae Association, 1977
A Letter from the President
Progress - The New Jefferson Hospital/Clinical Teaching Facility 1977
School of Nursing
A Comprehensive Approach to Hand Rehabilitation
Parking Garage
Your Sesquicentennial Campaign
Social Report
Scholarship Report
Sick and Welfare Committee
Program Committee
Resource Committee of the Board of Trustees
Bulletin
Administration
Ways and Means Committee Report
Resume of Minutes of Alumnae Association Meetings
Duke University Distinguished Alumna Award to Col. Catherine T. Betz (Ret.)
Patient Representatives
The Joys and Sorrows of a Director of Geriatric Nursing
Highlights 1976 P.N.A Convention
Class News
Marriages
Births
In Memoriam
A Letter from the Former President
Help Us - Help Yo
Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological flexibility and acceptance.
The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78 - .88), and the 3- and 12-month test-retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates,that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I (r = .97), but with better psychometric consistency
The solar particle event of July 16–19, 1966 and its possible association with a flare on the invisible solar hemisphere
An energetic solar proton and electron event was observed by particle detectors aboard Explorer 33 (AIMP-1) and OGO-3 during the period July 16–19, 1966. Optical and radio observations of the sun suggest that these particles were produced by a flare which may have occurred on July 16 near the central meridian of the invisible hemisphere. The active region to which the flare is assigned is known to have produced the energetic particle events of July 7 and 28 , 1966. The propagation of the particles in the July 16–19 event over the ∼180° extent of solar longitude from the flare to the earth is discussed, and it is concluded that there must exist a means of rapidly distributing energetic particles over a large area of the sun. Several possible mechanisms are suggested.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43748/1/11207_2004_Article_BF00150955.pd
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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
Reality beckons: metamodernist depthiness beyond panfictionality
It is often argued that postmodernism has been succeeded by a new dominant cultural logic. We conceive of this new logic as metamodernism. Whilst some twenty-first century texts still engage with and utilise postmodernist practices, they put these practices to new use. In this article, we investigate the metamodern usage of the typically postmodernist devices of metatextuality and ontological slippage in two genres: autofiction and true crime documentary. Specifically, we analyse Ruth Ozeki’s A Tale for the Time Being and the Netflix mini-series The Keepers, demonstrating that forms of fictionalisation, metafictionality and ontological blurring between fiction and reality have been repurposed. We argue that, rather than expand the scope of fiction, overriding reality, the metamodernist repurposing of postmodernist textual strategies generates a kind of ‘reality-effect’
Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND) : a multicentre, parallel, randomised controlled trial in the UK
Background Motor neuron disease is a progressive, fatal neurodegenerative disease for which there is no cure. Acceptance and Commitment Therapy (ACT) is a psychological therapy incorporating acceptance, mindfulness, and behaviour change techniques. We aimed to evaluate the effectiveness of ACT plus usual care, compared with usual care alone, for improving quality of life in people with motor neuron disease. Methods We conducted a parallel, multicentre, two-arm randomised controlled trial in 16 UK motor neuron disease care centres or clinics. Eligible participants were aged 18 years or older with a diagnosis of definite or laboratory-supported probable, clinically probable, or possible familial or sporadic amyotrophic lateral sclerosis; progressive muscular atrophy; or primary lateral sclerosis; which met the World Federation of Neurology's El Escorial diagnostic criteria. Participants were randomly assigned (1:1) to receive up to eight sessions of ACT adapted for people with motor neuron disease plus usual care or usual care alone by a web-based system, stratified by site. Participants were followed up at 6 months and 9 months post-randomisation. Outcome assessors and trial statisticians were masked to treatment allocation. The primary outcome was quality of life using the McGill Quality of Life Questionnaire-Revised (MQOL-R) at 6 months post-randomisation. Primary analyses were multi-level modelling and modified intention to treat among participants with available data. This trial was pre-registered with the ISRCTN Registry (ISRCTN12655391). Findings Between Sept 18, 2019, and Aug 31, 2022, 435 people with motor neuron disease were approached for the study, of whom 206 (47%) were assessed for eligibility, and 191 were recruited. 97 (51%) participants were randomly assigned to ACT plus usual care and 94 (49%) were assigned to usual care alone. 80 (42%) of 191 participants were female and 111 (58%) were male, and the mean age was 63·1 years (SD 11·0). 155 (81%) participants had primary outcome data at 6 months post-randomisation. After controlling for baseline scores, age, sex, and therapist clustering, ACT plus usual care was superior to usual care alone for quality of life at 6 months (adjusted mean difference on the MQOL-R of 0·66 [95% CI 0·22–1·10]; d=0·46 [0·16–0·77]; p=0·0031). Moderate effect sizes were clinically meaningful. 75 adverse events were reported, 38 of which were serious, but no adverse events were deemed to be associated with the intervention. Interpretation ACT plus usual care is clinically effective for maintaining or improving quality of life in people with motor neuron disease. As further evidence emerges confirming these findings, health-care providers should consider how access to ACT, adapted for the specific needs of people with motor neuron disease, could be provided within motor neuron disease clinical services
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