Alcohol Consumption, Frailty, and the Mediating Role of C-Reactive Protein in Older Adults

Frailty is a well-established indicator of late-life decline and is accompanied by higher rates of comorbidity and disability. Meanwhile, an estimated 41% of adults over the age of 65 report consuming alcohol – an identified health risk and protective factor depending on dosage. Given that the demographic group of older Americans is projected to double by the year 2050, identification of frailty risk and protective factors is imperative. The goals of this thesis are to: (1) identify how varying levels of alcohol consumption relate to frailty, and (2) elucidate a possible mechanism that accounts for the relationship between alcohol consumption and frailty. A sample of stroke-free participants over the age of 65 was identified from the Health and Retirement Study. Study 1 utilized stepwise logistic regression models to identify predictors of prevalent frailty at baseline (2000), and of incident frailty 4, 8, and 12 years later. For both males and females, significant predictors of frailty at all years included age, depressive symptomatology, and medical burden score. In addition, BMI was a significant predictor of frailty for females at all years. With respect to alcohol use, results revealed that drinking 1-7 drinks per week had a protective effect for females at baseline (OR=0.50) and 12 years later (OR=0.75); however, no such protective effects were found for males. Given that extant research has identified CRP as a mediator between the relationship of moderate alcohol use and cardiovascular health benefits, Study 2 used a cross-sectional sample from the 2008 wave to examine the potential mediating role of CRP between moderate alcohol use and reduced frailty risk. Results from structural equation modeling support the hypothesized model that moderate alcohol is associated with less frailty, and that this relationship is partially mediated by CRP levels. Overall findings suggest that moderate alcohol use confers health benefits for females by reducing frailty risk and that CRP is one mechanism by which alcohol use may confer protective effects for frailty. These results provide a starting place in an effort to better understand the protective effects of moderate alcohol use and can assist in improving prevention and treatment efforts for older adults by preventing or prolonging the onset of age-related diseases. Future research should further examine the relationship between alcohol use and frailty and determine if CRP mediates the relationship between moderate alcohol use and other beneficial health outcomes

Day 2 - Grant Writing for Robert Wood Johnson Foundation: Building a Culture of Health: Funding and Publishing Opportunities

The Robert Wood Johnson Foundation\u27s mission is to improve the health and health care of all Americans. In 2014 the foundation announced that it will continue to work on issues it believes are key to the well-being of all Americans, but within its organization it will no longer divide its efforts into the silos of health and health care. Rather, all that it does will serve one goal: building a culture of health. Given VCU\u27s research assets and strengths, how can investigators work with the sponsor to suggest new and creative approaches to solving health and health care problems? Mona Shah, program officer in the Research-Evaluation-Learning unit, will lead this workshop and discussion to help potential grant writers learn how to best engage with RWJF. She will cover the structure of the organization and ways to connect; current foundation priorities and how to interpret them; what the foundation looks for in competitive applicants and proposals; and key differences between proposals to RWJF and proposals federal funders. The second portion of this workshop will be an intensive Q&A based on your project ideas and RWJF proposals

Diagnosis and staging of lung carcinoma with CT scan and its histopathological correlation

Background: Lung cancer is the most common cancer worldwide. Hence, timely diagnosis and accurate staging of the carcinoma is critical for the treatment and prognosis. So, this study was performed to evaluate the role of CT scan in diagnosis and staging of lung cancer.Methods: This was a prospective and observational study carried out over one and half years at a tertiary care hospital. The patients found to have abnormalities on chest X-ray suggestive of carcinoma were included in the study. Pre and post contrast CT scans were performed. Individual patient biopsies were done for histopathological staging.Results: Most patients belonged to 41-50 years age group with male preponderance (81.33%). Habit of smoking was prevalent among the lung cancer patients. Almost all masses (92%) showed heterogeneous contrast enhancement on CT. Additionally, there were calcifications, cavitation, hilar enlargement, pleural invasion, mediastinal lymphadenopathy and contiguous bone involvement. Adenocarcinoma was the most common (46.66%) form of cancer followed by squamous cell carcinoma (42.66%). For histopathological diagnosis, majority of patients (73.33%) were diagnosed using CT guided biopsy. In the remaining patients, USG guided biopsy or fibreoptic bronchoscopy were performed. The most common lobe affected by bronchogenic carcinoma was right upper lobe. The most common site of metastasis was pleura (22.66%) followed by bone (17.33%). Majority of the patients (41.33%) presented with TNM stage IV.Conclusions: CT scan as a modality for detection and staging of bronchogenic carcinoma is superior to chest radiograph. CT guided FNAC has a high success rate in evaluation of lung carcinoma.

Sodium-glucose co-transporter-2 inhibitors as anti-diabetic agents: a review

The incidence and prevalence of Type 2 diabetes mellitus (T2DM) have been increasing worldwide. However, existing therapeutic classes of anti-diabetic drugs are not adequately effective in achieving and maintaining long-term glycemic control in the most patients. The majority of the drugs control blood sugar without addressing the basic pathology of insulin resistance and relative deficiency. Moreover, side effects such as hypoglycemia and weight gain, of both new and established drugs need to be considered prior to treating a patient. An emerging anti-hyperglycemic intervention, the sodium glucose co-transporter 2 (SGLT2) inhibitor acts by a novel mechanism. Under physiological conditions, SGLT2 accounts for 90% of the glucose re-absorption in the kidney, while the SGLT2 inhibitors result in an increase in urinary excretion of glucose and lower plasma glucose levels. Here, the pros and cons of SGLT2 inhibitors are considered, while approaching a patient with T2DM. The basic biochemistry and physiology underlying the mechanisms of SGLT2 inhibitors are discussed alongside its clinical pharmacology, with a focus on metabolic changes associated with urinary glucose loss. Finally, a consideration of Food and Drug Administration safety concerns associated with acidosis due to SGLT2 inhibitor usage is presented, to allow a complete understanding of the utility of these molecules in the light of existing T2DM therapies

Primary retroperitoneal mucinous cystadenocarcinoma: a rare surgico-pathological entity

Ovarian cancer (OC) is the seventh most common cancer for females in the world. Epithelial OC is the most predominant pathologic subtype (85%-90%), with five major histotypes- serous, mucinous, endometrioid, brenner and clear cell tumour. Each have three pathological subtypes ie benign, borderline and malignant. Mucinous cystadenomas and carcinomas of the ovary are well-established and common tumors. Primary retroperitoneal mucinous cystadenomas and carcinomas are being very rare and histopathogenesis of which is still uncertain. Most pathologists suggest their origin through mucinous metaplasia in a pre-existing mesothelium-lined cyst. An accurate preoperative diagnosis of these tumors is challenging due to lack of established effective diagnostic measures. Hereby presenting a 50-year-old woman, who visited to the hospital with abdominal distension and discomfort since two months. Sonography and computed tomography scans were performed and showed large predominantly cystic lesion arising from right adnexa. Patient underwent exploratory laparotomy for removal of the tumor. Histology and immunohistochemistry revealed primary retroperitoneal mucinous cystadenocarcinoma

Tracking and debriefing birth data at scale: A mobile phone application to improve obstetric and neonatal care in Bihar, India.

AimThis analysis assessed changes over time in skill and knowledge related to the use of evidence-based practices associated with quality of maternal and neonatal care during a nurse midwife mentoring intervention at primary health clinics (PHCs) in Bihar, India.DesignNurse midwife mentors (NMMs) entered live birth observation data into a mobile App from 320 PHCs.MethodsThe NMMs completed prompted questions in the App after every live birth witnessed. The App consisted of questions around three main themes, "What went well?", "What needed improvement?" and "What can be done differently next time?".ResultsObservational data from 5,799 births was recorded by 120 NMMs in 320 PHCs. Knowledge and skill during normal spontaneous vaginal deliveries and complicated deliveries with either a postpartum haemorrhage or non-vigorous infant all showed statistically significant improvement (p < .001) over time using a Chi-squared test for trend with a mean increase of 41% across all indicators

Interprofessional education and practice in an Indian setting

AbstractWith current global healthcare trends, there is a growing need for interprofessional education (IPE) and interprofessional practice (IPP) in collaborative care of persons with chronic medical conditions. Tools and models for IPE and IPP are now available, but they are not yet in widespread use. Developmental-behavioural paediatrics is a medical discipline that is characterized by IPP with an encouraging emergence of this speciality in India and other developing countries. This article provides an overview of IPE and IPP, followed by a precise account of an Indian institution, which provides services to children suffering from neurodevelopmental disorders utilizing an IPP approach and implementing IPE to its trainees

Conversion of waste corncob to activated carbon for use of methane storage

Abstract only availableMissouri being one of the leading states in corn production has a large quantity of corn cobs. Corn cob can be used to produce activated carbon because its organic origin is similar to coconut and peach pits which have been previously used to make activated carbons. In this project, researchers at the University of Missouri Columbia are using adsorbents produced from corn cobs to store natural gas. Results have shown that a BET surface area of 800m2/g-1600m2/g can be obtained. Scanning Electron Microscope (SEM) images confirms that micro porous nature of the carbon. The main objective of this research is to develop flat low pressure high capacity natural gas tank holding no greater than 500psi of methane, allowing for more trunk space in cars. It is anticipated that the new Absorbed Natural Gas (ANG) will be the competitor with Compressed Natural Gas (CNG) which is currently stored in heavy tanks at high pressures of about 3600psi. Activated carbons obtained from the corn cob that has been through chemical activation process are used to make monoliths, in order to achieve the maximum density. The powdered form of the activated carbon is combined with a binding agent and pressed using a hydraulic press and die. By this process corn cobs can be converted into monolithic carbon and having methane uptake of 150v/v or more.NSF Program Alliance for Collaborative Research in Alternative Fuel Technology and Louis Stokes Missouri Alliance for Minority Participatio

Learning From the Opportunities and Challenges of a Philanthropy-Private Sector Partnership

Cross-sector partnerships are essential for addressing such complex social issues as improving population health. Among such partnerships, a philanthropy-private sector partnership is rare in practice; they may seem incompatible due to differences in their missions and cultures. However, these collaborations can yield positive returns for philanthropy organizations and businesses, as well as the broader community. This article draws upon an evaluation of a partnership between the Robert Wood Johnson Foundation and Humana Inc. to highlight key insights for forming and implementing a formal partnership between a philanthropy organization and an investor-owned business. Establishing and maintaining a philanthropy-private sector partnership is highly complex and challenging. For philanthropy staff interested in establishing a private-sector partnership, the findings suggest four key considerations: due diligence in exploring partnership fit, active engagement with philanthropy staff and in addressing key partnership issues, a process of co-creation on partnership activities, and continuous monitoring and assessment. Within these key considerations, this evaluation highlights unique organizational attributes that have important practical considerations for philanthropy-private sector partnerships. However, these considerations also have relevance for other types of cross-sector partnerships