Dealing with the Problem of Lack of Interest in Evangelism at Freedom Hill Community Church

To deal with the problem of lack of interest in evangelism at Freedom Hill Community Church, a curriculum was designed as an intervention. Given the existence of many barriers to evangelism, this curriculum aimed at addressing only two of them, namely fear and biblical illiteracy. The curriculum was taught to ten participants over the course of six weeks over Zoom. Data collection tools that were used include a pre-course survey, a post-course survey, and a feedback survey. Analysis of the data has shown a positive change in attitude post-intervention in the areas of the relevancy of the intervention to participants’ faith, and participants’ biblical literacy. Further research in a similar study should consider redesigning the data collection tools to collect more data and aiming for a much larger random sample to arrive at a better conclusion

Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities

Objective: the study aimed to determine the prevalence of and risk factors for inappropriate prescribing (IP) and prescribing omission (PO) in elderly with mental co-morbidities. Participants: one hundred fifty consecutive inpatients with mental co-morbidities hospitalised for acute medical illness (mean age 80 ± 9, 70% of women) were considered for the study. Measurements: IP and PO were prospectively indentified according to STOPP/START criteria at hospital admission. Results: over 95% were taking ≥1 medication (median = 7) which amounted to 1,137 prescriptions. The prevalence of IP was 77% and PO was 65%. The most frequent encountered IP concerned drugs adversely affecting fallers (25%) and antiaggregants therapy without atherosclerosis (14%). PO concerned antidepressants with moderate/severe depression (20%) and calcium-vitamin D supplementation (18%). Independent predictors for IP were increased number of concomitant drugs (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.13-1.89), being cognitively impaired (OR 1.83, 95% CI 1.55-2.24), and having fallen in the preceding 3 months (OR 2.03, 95% CI 1.52-2.61) or hospitalised in the preceding year (OR 1.09, 95% CI 1.02-1.23). Concerning PO, psychiatric disorder (OR 1.64, 95% CI 1.42-2.01) and increase level of co-morbidities (OR 1.79, 95% CI 1.48-1.99) were identified. Living in an institutional setting was a predictive maker for both IP (OR 1.45, 95% CI 1.27-1.74) and PO (OR 1.67, 95% CI 1.32-1.91). Conclusion: IP and PO were highly prevalent raising the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly as well as in the community, in hospital and institutional settings for improving quality and safety in prescribing medicatio

Iatrogenia associated with prescription of psychotropics in aged subjects

Les sujets âgés sont souvent atteints de nombreuses comorbidités. Leur prise en charge thérapeutique selon les recommandations en vigueur peut être à l’origine d’une polymédication. La prescription de psychotropes est fréquemment retrouvée dans les traitements des sujets âgés. Cette classe thérapeutique est à haut risque iatrogène potentiel dans cette population vulnérable. Les effets indésirables médicamenteux les plus notables sont les chutes, les fractures et les troubles confusionnels. L’identification des psychotropes potentiellement inappropriés (PPI) chez les sujets âgés à l’aide de la liste de Beers a fait l’objet de peu de travaux.Les objectifs de cette thèse étaient d’identifier les prescriptions de psychotropes potentiellement inappropriés (PPI) à l’aide des listes de Beers actualisées dans les traitements de sujets hospitalisés ou vivant en Etablissement d’hébergement pour personnes âgées dépendantes (EHPAD). Les facteurs liés à ces prescriptions ont aussi été recherchés.La polymédication, ainsi que les troubles neuropsychiatriques du sujet âgé doivent rendre le prescripteur de psychotropes particulièrement vigilant dans cette population particulièrement vulnérable.L’usage des listes de médicaments potentiellement inappropriés (MPI) pourrait permettre d’identifier les psychotropes au rapport bénéfice risque défavorable chez les sujets âgés. Et orienter le choix du prescripteur vers des traitements plus favorables au patient.Elderly people often have many comorbidities. Therapeutic management according to the recommendations in force may be at the origin of a polymedication. The prescription of psychotropic drugs is frequently found in the treatment of elderly patients. This therapeutic class is at high potential iatrogenic risk in this vulnerable population. The most notable adverse drug reactions are falls, fractures and confusion. The identification of potentially inappropriate psychotropic medications (PIP) in elderly subjects using the Beers list has received little attention.The objective of this thesis was to identify the prescriptions of potentially inappropriate psychotropic drugs (PIP) using the updated Beers lists in the treatment of subjects hospitalized or living in the nursing home. Factors related to these treatment s were also investigated.Polymedication, as well as neuropsychiatric disorders in the elderly, should make the prescriber of psychotropic drugs particularly vigilant in this particularly vulnerable population.The use of lists of potentially inappropriate medications (PIM) could identify psychotropic drugs with an unfavorable risk-benefit ratio in elderly subjects. And direct the choice of the prescriber towards treatments more favorable to the patient

Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities

OBJECTIVE: the study aimed to determine the prevalence of and risk factors for inappropriate prescribing (IP) and prescribing omission (PO) in elderly with mental co-morbidities. PARTICIPANTS: One hundred fifty consecutive inpatients with mental co-morbidities hospitalised for acute medical illness (mean age 80 +/- 9, 70% of women) were considered for the study. MEASUREMENTS: IP and PO were prospectively identified according to STOPP/START criteria at hospital admission. RESULTS: over 95% were taking ≥ 1 medication (median = 7) which amounted to 1,137 prescriptions. The prevalence of IP was 77% and PO was 65%. The most frequent encountered IP concerned drugs adversely affecting fallers (25%) and antiaggregants therapy without atherosclerosis (14%). PO concerned antidepressants with moderate/severe depression (20%) and calcium-vitamin D supplementation (18%). Independent predictors for IP were increased number of concomitant drugs (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.13-1.89), being cognitively impaired (OR 1.83, 95% CI 1.55-2.24), and having fallen in the preceding 3 months (OR 2.03, 95% CI 1.52-2.61) or hospitalised in the preceding year (OR 1.09, 95% CI 1.02-1.23). Concerning PO, psychiatric disorder (OR 1.64, 95% CI 1.42-2.01) and increase level of co-morbidities (OR 1.79, 95% CI 1.48-1.99) were identified. Living in an institutional setting was a predictive maker for both IP (OR 1.45, 95% CI 1.27-1.74) and PO (OR 1.67, 95% CI 1.32-1.91). CONCLUSION: IP and PO were highly prevalent raising the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly as well as in the community, in hospital and institutional settings for improving quality and safety in prescribing medication

MultiCode-PLx System for Multiplexed Detection of Seventeen Respiratory Viruses▿

The MultiCode-PLx system (EraGen Biosciences, Inc., Madison, WI) for the detection of respiratory viruses uses an expanded genetic alphabet, multiplex PCR chemistry, and microsphere flow cytometry to rapidly detect and specifically identify 17 different respiratory viruses directly in clinical specimens. The MultiCode-PLx system was tested in parallel with direct fluorescent-antibody (DFA) staining and rapid shell vial culture (R-mix cells; Diagnostic Hybrids, Inc. Athens, OH) with 354 respiratory specimens from adult patients that were submitted to the clinical virology laboratory at the Emory University Hospital. Single-target PCRs were performed with retained samples to confirm the positive results obtained with the MultiCode-PLx system for viruses not covered by DFA and R-mix culture (metapneumovirus, coronaviruses [CoV], parainfluenza viruses 4a and 4b, and rhinoviruses) and to resolve any discrepancies between the DFA and R-mix culture and the MultiCode-PLx results for viruses common to both systems. Respiratory viruses were detected in 77 (21.8%) and 116 (32.7%) specimens by DFA and R-mix culture and with the MultiCode-PLx system, respectively. Among the viruses common to both systems, the MultiCode-PLx system detected significantly more influenza A viruses (P = 0.0026). An additional increased diagnostic yield with the MultiCode-PLx system resulted from the detection of human metapneumovirus (HMPV) in 9 specimens, human CoV (HCoV) in 3 specimens, and human rhinovirus (HRV) in 16 specimens. Also, two mixed viral infections were detected by the MultiCode-PLx system (HCoV OC43 and HRV infections and HMPV and HRV infections), but none were detected by DFA and R-mix culture. Single-target PCRs verified the results obtained with the MultiCode-PLx system for 73 of 81 (90.1%) specimens that had discordant results or that were not covered by DFA and R-mix culture. The MultiCode-PLx system provides clinical laboratories with a practical, rapid, and sensitive means for the massively multiplexed molecular detection of common respiratory viruses

Identification of polyoxometalates as nanomolar noncompetitive inhibitors of protein kinase CK2.

International audienceProtein kinase CK2 is a multifunctional kinase of medical importance that is dysregulated in many cancers. In this study, polyoxometalates were identified as original CK2 inhibitors. [P2Mo18O62](6-) has the most potent activity. It inhibits the kinase in the nanomolar range by targeting key structural elements located outside the ATP- and peptide substrate-binding sites. Several polyoxometalate derivatives exhibit strong inhibitory efficiency, with IC50 values < or = 10 nM. Furthermore, these inorganic compounds show a striking specificity for CK2 when tested in a panel of 29 kinases. Therefore, polyoxometalates are effective CK2 inhibitors in terms of both efficiency and selectivity and represent nonclassical kinase inhibitors that interact with CK2 in a unique way. This binding mode may provide an exploitable mechanism for developing potent drugs with desirable properties, such as enhanced selectivity relative to ATP-mimetic inhibitors

Interdisciplinary geriatric and psychiatric care reduces potentially inappropriate prescribing in the hospital: interventional study in 150 acutely ill elderly patients with mental and somatic comorbid conditions

Potentially inappropriate medications and prescription omissions (PO) are highly prevalent in older patients with mental comorbidities