Feasibility Study of the Health Empowerment Intervention to Evaluate the Effect on Self-Management, Functional Health, and Well-Being in Older Adults with Heart Failure

abstract: ABSTRACT The population of older adults in the United States is growing disproportionately, with corresponding medical, social and economic implications. The number of Americans 65 years and older constitutes 13.7% of the U.S. population, and is expected to grow to 21% by 2040. As the adults age, they are at risk for developing chronic illness and disability. According to the Centers for Disease Control and Prevention, 5.7 million Americans have heart failure, and almost 80% of these are 65 years and older. The prevalence of heart failure will increase with the increase in aging population, thus increasing the costs associated with heart failure from 34.7 billion dollars in 2010 to 77.7 billion dollars by 2020. Of all cardiovascular hospitalizations, 28.9% are due to heart failure, and almost 60,000 deaths are accounted for heart failure. Marked disparities in heart failure persist within and between population subgroups. Living with heart failure is challenging for older adults, because being a chronic condition, the responsibility of day to day management of heart failure principally rests with patient. Approaches to improve self-management are targeted at adherence, compliance, and physiologic variables, little attention has been paid to personal and social contextual resources of older adults, crucial for decision making, and purposeful participation in goal attainment, representing a critical area for intervention. Several strategies based on empowerment perspective are focused on outcomes; paying less attention to the process. To address these gaps between research and practice, this feasibility study was guided by a tested theory, the Theory of Health Empowerment, to optimize self-management, functional health and well-being in older adults with heart failure. The study sample included older adults with heart failure attending senior centers. Specific aims of this feasibility study were to: (a) examine the feasibility of the Health Empowerment Intervention in older adults with heart failure, (b) evaluate the effect of the health empowerment intervention on self-management, functional health, and well-being among older adults with heart failure. The Health Empowerment Intervention was delivered focusing on strategies to identify and building upon self-capacity, and supportive social network, informed decision making and goal setting, and purposefully participating in the attainment of personal health goals for well-being. Study was feasible and significantly increased personal growth, and purposeful participation in the attainment of personal health goals.Dissertation/ThesisDoctoral Dissertation Nursing and Healthcare Innovation 201

Additional file 4: Table S4. of Transcriptome profiling of Kentucky bluegrass (Poa pratensis L.) accessions in response to salt stress

Prioritized differentially expressed transcripts from shoot tissue, BLASTx-based annotation, GO terms, and average normalized expression values of two Kentucky bluegrass accessions under control and salt treated conditions. (XLSX 90 kb

Additional file 3: Table S3. of Transcriptome profiling of Kentucky bluegrass (Poa pratensis L.) accessions in response to salt stress

Prioritized differentially expressed transcripts from root tissue, BLASTx-based annotation, GO terms, and average normalized expression values of two Kentucky bluegrass accessions under control and salt treated conditions. (XLSX 44 kb

Comparative Genome Analysis between <i>Agrostis stolonifera</i> and Members of the Pooideae Subfamily, including <i>Brachypodium distachyon</i>

<div><p>Creeping bentgrass (<i>Agrostis stolonifera</i>, allotetraploid 2n = 4x = 28) is one of the major cool-season turfgrasses. It is widely used on golf courses due to its tolerance to low mowing and aggressive growth habit. In this study, we investigated genome relationships of creeping bentgrass relative to the Triticeae (a consensus map of <i>Triticum aestivum</i>, <i>T. tauschii</i>, <i>Hordeum vulgare</i>, and <i>H. spontaneum</i>), oat, rice, and ryegrass maps using a common set of 229 EST-RFLP markers. The genome comparisons based on the RFLP markers revealed large-scale chromosomal rearrangements on different numbers of linkage groups (LGs) of creeping bentgrass relative to the Triticeae (3 LGs), oat (4 LGs), and rice (8 LGs). However, we detected no chromosomal rearrangement between creeping bentgrass and ryegrass, suggesting that these recently domesticated species might be closely related, despite their memberships to different Pooideae tribes. In addition, the genome of creeping bentgrass was compared with the complete genome sequence of <i>Brachypodium distachyon</i> in Pooideae subfamily using both sequences of the above-mentioned mapped EST-RFLP markers and sequences of 8,470 publicly available <i>A. stolonifera</i> ESTs (AgEST). We discovered large-scale chromosomal rearrangements on six LGs of creeping bentgrass relative to <i>B. distachyon</i>. Also, a total of 24 syntenic blocks based on 678 orthologus loci were identified between these two grass species. The EST orthologs can be utilized in further comparative mapping of Pooideae species. These results will be useful for genetic improvement of <i>Agrostis</i> species and will provide a better understanding of evolution within Pooideae species.</p></div

Comparative genome relationships on creeping bentgrass linkage groups 5–7 relative to rice, the Triticeae, oat, and ryegrass.

<p>Comparative genome relationships between creeping bentgrass genetic linkage map and the genetic maps of rice (R), the Triticeae (W), oat (O), and ryegrass (Rg), respectively, represented by a colored box. The markers shown on the right or left side of each linkage group correspond to those mapped in the creeping bentgrass linkage map shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0079425#pone-0079425-g001" target="_blank">Figure 1</a>. The number or letter inside the color boxes represents the segments of chromosomes or linkage groups from each of the genomes (R, W, O, Rg) that are syntenic to the bentgrass linkage groups. The arrowheads indicate the deduced location of the centromere in bentgrass from the comparisons with Triticeae chromosomes. The total map distances (cM) are shown on the bottom of each linkage group.</p

Duplicate RFLP loci mapped in the 549×372 mapping population of creeping bentgrass.

<p>Duplicate RFLP loci derived from 159 heterologous cereal and creeping bentgrass EST-RFLP probes that were mapped in the 549×372 mapping population of creeping bentgrass.</p>a<p>Ast, BCD, CDO, and RZ probes derived from creeping bentgrass, barley, oat, and rice cDNAs, respectively.</p

EST-RFLP genetic linkage map of creeping bentgrass.

<p>Two different creeping bentgrass diploid genomes are indicated by seven pairs of the homoeologous linkage groups (LGs) followed by “.1” or “.2”. The total map length in cM is shown on the bottom of each LG. The creeping bentgrass, barley, oat and rice cDNA probes used as RFLP markers are indicated as Ast, BCD, CDO and RZ, respectively followed by the probe number. The probe numbers plus ‘.1’, ‘.2’, ‘.3’ or ‘.4’ show duplicate loci detected by the same hybridization probe, which are connected by a dashed black line. Loci connected by a dashed bold blue line are detected between different LGs by the same hybridization probe. The segment on LGs 6.1 and 6.2, spanning three RFLP markers (CDO1380, CDO1158 and CDO534) superimposed by an orange arrow indicates an inversion and translocation between the two homoeologous LGs.</p

Comparative genome relationship on creeping bentgrass linkage groups 1–4 relative to <i>Brachypodium distachyon</i>.

<p>Comparative genome relationship between creeping bentgrass genetic linkage map and chromosomes of <i>B. distachyon</i> by determining the chromosomal location of sequences of the EST-RFLP markers mapped on the creeping bentgrass linkage map. The black bar represents each of the bentgrass linkage groups (total length in cM, below the bar) as shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0079425#pone-0079425-g001" target="_blank">Figure 1</a>. The colored bars represent each of <i>B. distachyon</i> chromosomes (Bd). The collinearity is represented by a dashed black line that links the RFLP markers with the highly similar sequences located in <i>B. distachyon</i> chromosomes. Markers in red have no significant sequences similarity with <i>B. distachyon</i> genome. Underlined markers have significant sequences similarity with <i>B. distachyon</i> chromosomes indicated in parenthesis. Markers in bold and italics are duplicated between <i>B. distachyon</i> chromosomes indicated in parenthesis. The grey scale bar on the left bottom of the Figure is 10 Mbp of <i>B. distachyon</i> genome.</p

Creeping bentgrass ESTs orthologous to <i>Brachypodium distachyon</i>.

<p>Creeping bentgrass ESTs (AgEST) orthologous to <i>B. distachyon</i> genome and their location in the physical map of <i>B. distachyon</i> (in base pairs). Bd1, Bd2, Bd3, Bd4 and Bd5 represent the <i>B. distachyon</i> chromosomes (1 to 5) and horizontal lines denote the position of the 678 AgEST orthologs. The segments of a seven-color code (LGs 1–7) indicate the creeping bentgrass linkage groups that have synteny with a specific region of <i>B. distachyon</i> chromosomes. The arrowheads indicate the centromeric region.</p

Comparative genome relationship on creeping bentgrass linkage groups 5–7 relative to <i>Brachypodium distachyon</i>.

<p>Comparative genome relationship between creeping bentgrass genetic linkage map and chromosomes of <i>B. distachyon</i> by determining the chromosomal location of sequences of the EST-RFLP markers mapped on the creeping bentgrass linkage map. The black bar represents each of the bentgrass linkage groups (total length in cM, below the bar) as shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0079425#pone-0079425-g001" target="_blank">Figure 1</a>. The colored bars represent each of <i>B. distachyon</i> chromosomes (Bd). The collinearity is represented by a dashed black line that links the RFLP markers with the highly similar sequences located in <i>B. distachyon</i> chromosomes. Markers in red have no significant sequences similarity with <i>B. distachyon</i> genome. Underlined markers have significant sequences similarity with <i>B. distachyon</i> chromosomes indicated in parenthesis. Markers in bold and italics are duplicated between <i>B. distachyon</i> chromosomes indicated in parenthesis. The grey scale bar on the left bottom of the Figure is 10 Mbp of <i>B. distachyon</i> genome.</p