Perspectives of College Students on their Childhood ADHD

Purpose: To determine what successful young adults perceive was helpful to them when they were struggling with their attention-deficit hyperactivity disorder (ADHD) symptoms as children. Study Design and Methods: Sixteen young adult college students with a history of ADHD participated in semi-structured interviews that asked them which people and what strategies they had found most helpful to them during their childhood. Data were analyzed using content analysis. Results: The most helpful people were parents and teachers; the most helpful strategies were caring behaviors and active teaching/learning strategies. Participants remembered helpful people as ?giving me strategies to help me keep my mind focused on something; keep me involved, keep me interested.? Clinical Implications: Children with ADHD need the support of caring adults who use active teaching strategies. Nurses working with children and adolescents in any setting can educate parents about the best ways to help children with ADHD succeed, using some of the results of this research

Enclosed Versus Open Nursing Stations in Adult Acute Care Psychiatric Settings: Does the Design Affect the Therapeutic Milieu?

Specific efforts by hospital accreditation organizations encourage renovation of nursing stations, so nurses can better see, attend, and care for their patients. The purpose of this study was to examine the effect of nursing station design on the therapeutic milieu in an adult acute care psychiatric unit. A repeated cross-sectional, pretest-posttest design was used. Data were collected from a convenience sample of 81 patients and 25 nursing staff members who completed the Ward Atmosphere Scale. Pretest data were collected when the unit had an enclosed nursing station, and posttest data were collected after renovations to the unit created an open nursing station. No statistically significant differences were found in patient or staff perceptions of the therapeutic milieu. No increase in aggression toward staff was found, given patients' ease of access to the nursing station. More research is needed about the impact of unit design in acute care psychiatric settings

Exploring Child Welfare Workers' Attitudes and Practice With Fathers

This cross-sectional study explored child welfare agency workers' attitudes and practice regarding working with fathers whose children are at-risk for abuse and neglect. Agency workers completed a questionnaire about their attitudes towards working with fathers, their knowledge of barriers to fathers' engagement, and their experiences with their own fathers. They also completed open-ended items about services and supports they felt would be most helpful to fathers. A content analysis of the data revealed critical themes for four areas that workers felt could be enhanced to effectively engage fathers: (a) use diligent efforts that ensure fathers are present to contribute, (b) provide equitable services, supports, and policies for fathers, (c) address father-specific needs, and (d) promote a positive worker-father relationship. The findings provide insight into ways that social workers can maximize fathers' strengths and reduce their challenges

Relationship skills building with older adults

Relationship skills building is the focus of an innovative clinical experience with older adults for junior level nursing students in a psychiatric mental health course. The clinical experience is designed to help students apply, integrate, and validate previously learned therapeutic communication skills and experience discovery of self and others. This article describes a clinical experience that introduces students to older adults, who will make up the majority of health care recipients in the students’ future careers, and helps students explore the nurse’s role in mental health care for older adults. Not only did students engaged in the clinical experience learn to develop a relationship with the older adults, but they learned much more— they learned to appreciate the value of life, the importance of listening, and the rich and varied life stories of older adults

Integrating students into interdisciplinary health and health disparities research teams

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities researchers or how their research experiences impact their views about addressing social determinants of health as a career goal. The purpose of this paper is to describe how health and human sciences students were integrated into three minority HIV prevention and testing projects using the lifelong learning for health professionals (LLHP) principles and activities framework, which entails a focus on: (a) education, (b) community, and (c) organization in the planning, development, implementation, and evaluation of interdisciplinary research

Circulating Tumor DNA Markers for Early Progression on Fulvestrant With or Without Palbociclib in ER+ Advanced Breast Cancer.

Background There are no established molecular biomarkers for patients with breast cancer receiving combination endocrine and CDK4/6 inhibitor (CDK4/6i). We aimed to determine whether genomic markers in circulating tumor DNA (ctDNA) can identify patients at higher risk of early progression on fulvestrant therapy with or without palbociclib, a CDK4/6i.Methods PALOMA-3 was a phase III, multicenter, double-blind randomized controlled trial of palbociclib plus fulvestrant (n = 347) vs placebo plus fulvestrant (n = 174) in patients with endocrine-pretreated estrogen receptor-positive (ER+) breast cancer. Pretreatment plasma samples from 459 patients were analyzed for mutations in 17 genes, copy number in 14 genes, and circulating tumor fraction. Progression-free survival (PFS) was compared in patients with circulating tumor fraction above or below a prespecified cutoff of 10% and with or without a specific genomic alteration. All statistical tests were 2-sided.Results Patients with high ctDNA fraction had worse PFS on both palbociclib plus fulvestrant (hazard ratio [HR] = 1.62, 95% confidence interval [CI] = 1.17 to 2.24; P = .004) and placebo plus fulvestrant (HR = 1.77, 95% CI = 1.21 to 2.59; P = .004). In multivariable analysis, high-circulating tumor fraction was associated with worse PFS (HR = 1.20 per 10% increase in tumor fraction, 95% CI = 1.09 to 1.32; P < .001), as was TP53 mutation (HR = 1.84, 95% CI = 1.27 to 2.65; P = .001) and FGFR1 amplification (HR = 2.91, 95% CI = 1.61 to 5.25; P < .001). No interaction with treatment randomization was observed.Conclusions Pretreatment ctDNA identified a group of high-risk patients with poor clinical outcome despite the addition of CDK4/6 inhibition. These patients might benefit from inclusion in future trials of escalating treatment, with therapies that may be active in these genomic contexts

From the Bloch sphere to phase space representations with the Gottesman-Kitaev-Preskill encoding

In this work, we study the Wigner phase-space representation of qubit states encoded in continuous variables (CV) by using the Gottesman-Kitaev-Preskill (GKP) mapping. We explore a possible connection between resources for universal quantum computation in discrete-variable (DV) systems, i.e. non-stabilizer states, and negativity of the Wigner function in CV architectures, which is a necessary requirement for quantum advantage. In particular, we show that the lowest Wigner logarithmic negativity of qubit states encoded in CV with the GKP mapping corresponds to encoded stabilizer states, while the maximum negativity is associated with the most non-stabilizer states, H-type and T-type quantum states.Comment: (v1) Accepted for publication in the Springer's "Mathematics for Industry" series. (v2) Typo in the abstract fixed; URL of the conference where the paper has been presented added: International Symposium on Mathematics, Quantum Theory, and Cryptography (MQC), held in September 2019 in Fukuoka, Japan (https://www.mqc2019.org/mqc2019/program

Palbociclib in Combination With Fulvestrant in Women With Hormone Receptor-Positive/HER2-Negative Advanced Metastatic Breast Cancer: Detailed Safety Analysis From a Multicenter, Randomized, Placebo-Controlled, Phase III Study (PALOMA-3).

Background Palbociclib enhances endocrine therapy and improves clinical outcomes in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC). Because this is a new target, it is clinically important to understand palbociclib's safety profile to effectively manage toxicity and optimize clinical benefit.Materials and methods Patients with endocrine-resistant, HR-positive/HER2-negative MBC (n = 521) were randomly assigned 2:1 to receive fulvestrant (500 mg intramuscular injection) with or without goserelin with oral palbociclib (125 mg daily; 3 weeks on/1 week off) or placebo. Safety assessments at baseline and day 1 of each cycle included blood counts on day 15 for the first 2 cycles. Hematologic toxicity was assessed by using laboratory data.Results A total of 517 patients were treated (palbociclib, n = 345; placebo, n = 172); median follow-up was 8.9 months. With palbociclib, neutropenia was the most common grade 3 (55%) and 4 (10%) adverse event; median times to onset and duration of grade ≥3 episodes were 16 and 7 days, respectively. Asian ethnicity and below-median neutrophil counts at baseline were significantly associated with an increased chance of developing grade 3-4 neutropenia with palbociclib. Dose modifications for grade 3-4 neutropenia had no adverse effect on progression-free survival. In the palbociclib arm, febrile neutropenia occurred in 3 (<1%) patients. The percentage of grade 1-2 infections was higher than in the placebo arm. Grade 1 stomatitis occurred in 8% of patients.Conclusion Palbociclib plus fulvestrant treatment was well-tolerated, and the primary toxicity of asymptomatic neutropenia was effectively managed by dose modification without apparent loss of efficacy. This study appears at ClinicalTrials.gov, NCT01942135.Implications for practice Treatment with palbociclib in combination with fulvestrant was generally safe and well-tolerated in patients with hormone receptor (HR)-positive metastatic breast cancer. Consistent with the drug's proposed mechanism of action, palbociclib-related neutropenia differs in its clinical time course, patterns, and consequences from those seen with chemotherapy. Neutropenia can be effectively managed by a dose reduction, interruption, or cycle delay without compromising efficacy. A significant efficacy gain and a favorable safety profile support the consideration of incorporating palbociclib into the routine management of HR-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer

DNA Ligase C and Prim-PolC participate in base excision repair in mycobacteria

Prokaryotic Ligase D is a conserved DNA repair apparatus processing DNA double-strand breaks in stationary phase. An orthologous Ligase C (LigC) complex also co-exists in many bacterial species but its function is unknown. Here, we show that the LigC complex interacts with core BER enzymes in vivo and demonstrate that together these factors constitute an excision repair apparatus capable of repairing damaged bases and abasic sites. The polymerase component, which contains a conserved C-terminal structural loop, preferentially binds to and fills-in short gapped DNA intermediates with RNA and LigC ligates the resulting nicks to complete repair. Components of the LigC complex, like LigD, are expressed upon entry into stationary phase and cells lacking either of these pathways exhibit increased sensitivity to oxidising genotoxins. Together, these findings establish that the LigC complex is directly involved in an excision repair pathway(s) that repairs DNA damage with ribonucleotides during stationary phase

Long-term Pooled Safety Analysis of Palbociclib in Combination With Endocrine Therapy for HR+/HER2- Advanced Breast Cancer.

Background Palbociclib administered with endocrine therapy was tolerable when the overall incidence of toxicities was assessed separately for three PALOMA studies. This study analyzed pooled, longer-term PALOMA safety data longitudinally.Methods Data were pooled from three randomized phase II and III studies (ClinicalTrials.gov: NCT00721409, NCT01740427, NCT01942135) of hormone receptor-positive/human epidermal growth factor receptor 2‒negative advanced breast cancer patients. Front-line patients were randomly assigned to receive letrozole with/without palbociclib (PALOMA-1) or letrozole plus palbociclib/placebo (PALOMA-2). In PALOMA-3, patients with prior endocrine resistance received fulvestrant plus palbociclib/placebo. The cumulative event rates of adverse events (AEs), reporting up to 50 months of treatment, were assessed over time.Results Patients who received endocrine therapy (n = 1343) were included in this pooled analysis (872 were also treated with palbociclib, and 471 were not). The most common AEs with palbociclib plus endocrine therapy were neutropenia and infections (any grade, 80.6% and 54.7%, respectively), which were higher than in the endocrine monotherapy arm (any grade, 5.3% and 36.9%). The most common hematologic AEs (≥15.0% in the palbociclib arm) were more likely to be reported in the initial months of the study, after which time the cumulative event rate did not substantially increase. With palbociclib plus endocrine therapy, any grade AEs leading to permanent discontinuation over three years occurred in only 8.3% of patients.Conclusions Based on these long-term safety analyses, there is no evidence of specific cumulative or delayed toxicities with palbociclib plus endocrine therapy, supporting the ongoing investigation of palbociclib plus endocrine therapy in early breast cancer (NCT02513394)