Driving Habits of Older Adults: A Look at Rural vs. Urban Drivers in Kansas

BACKGROUND: The older adult population is the fastest growing cohort in Kansas, resulting in a growing number of older drivers. With age, changes in the ability to drive can compromise safety. Although it is challenging for health care providers to identify unsafe older drivers, it would be helpful to know what common driving habits they share. This exploratory study evaluated differences in the self-reported driving behaviors of older drivers in urban and rural settings of Kansas. METHODS: A one-page, 19-item survey was administered to patients over age 65 in the waiting rooms of two physician medical offices in urban Kansas City and rural Junction City, Kansas. RESULTS: A total of 105 surveys were completed. Rural drivers reported they were involved in approximately 9% more accidents than the urban drivers (p = 0.166). Rural drivers were more likely to drive in poor weather conditions, such as snow, ice, fog, and rain (p = 0.032). Eyeglasses were worn by 10% of the rural cohort compared to 37.8% of the urban cohort (p = 0.0044). More urban drivers reported they did not want to make changes to their current driving habits (71% vs 40%; p = 0.004). Urban drivers drove a longer distance to reach their destinations. Drivers from both environments avoided unfamiliar roads and did not use cell phones or global positioning system (GPS) devices while driving. CONCLUSIONS: By understanding the habits of older drivers, healthcare providers can tailor safe driving messages to support safe driving and enhance patient safety. Physicians could benefit from knowing that older rural drivers wore their glasses less frequently, trended towards having more accidents, and were more prone to drive during inclement weather. Urban Kansas drivers drove further to get to their destinations than their rural Kansas counterparts. Understanding these driving habits and tailoring their prevention messages accordingly may help health care providers in Kansas improve older patient’s safe driving behaviors

Non lethal concentrations of pesticide impair ovarian function in the freshwater perch,Anabas testudineus

Anabas testudineus were treated with non lethal levels of metacid-50 (0.106 ppb) and carbaryl (1.66 ppm) for 90 days covering the pre-spawning and spawning phases of the annual reproductive cycle. The main purpose of the present work was to identify the effects of metacid-50 and carbaryl on the gonado somatic index (GSI) and ovarian and plasma estrogen level. There was no alteration in GSI until 15 days, initiating the inhibition on day 20 which further intensified from 20 to 90 days of exposure. Plasma and ovarian estrogen level significantly increased up to 15 days of exposure followed by a decline till the end of the experiment. It is noteworthy that the effect of pesticides on GSI is reflected in the ovarian estrogen level. This highlights the fact that at short-term exposures the nonlethal levels of pesticides have no inhibitory effect while at long-term exposure, the pesticides have potent inhibitory effect on the reproduction of fish

Pattern of Arsenic Exposure to Children: New born to toddler Stages

Elevated levels of arsenic are found in several countries which exceed the World Health Organization (WHO) drinking water guideline (10µg/L), affecting 100 million people globally. Its prevalence varies in different countries among which Andean Argentina and South-East Asia are most severely affected. Bangladesh is considered a major As-contaminated zone and more than 10µg/L of As is present in the tube wells installed during the last decade. As-contaminated water poses serious threat to the population in general, and children in particular. School-age children exposed to As are found to be deficient in cognitive functions in several countries. Although As contamination is a global phenomenon reports on children’s exposure to As, through breast milk pathway is limited. Findings of the few global studies show low level of As in breast milk even in populations exposed to high levels. Several reports indicate the potential counterbalancing the impact of exposures of chemicals through breast milk which outweigh the hazards of feeding contaminated breast milk. On the other hand, the presence of toxic elements in powdered and liquid infant milk is a cause of concern considering the probable health problems in infants. It is surmised from available data that although the lactating mothers resided in highly As-contaminated zones the concentration of the toxic metal is low in the breast milk and breast feeding infants are protected from the toxic effects of As. Therefore breast feeding is still the best way to protect the infants in As-contaminated zones as per WHO recommendations

The Uniqueness of Achatina fulica in its Evolutionary Success

The increasing load of environmental pollutants poses a serious threat over the globe. In this vulnerable situation, it is essential to have alternative sources of medicines, may be from invertebrates. Among invertebrates, although molluscs are known for their consumption as food and ethno‐medicinal use, the importance of these animals is still overlooked. Presently attention has been geared toward molluscs including Achatina fulica which are now considered as one of the most evolutionary successful animals. During the last few decades, researchers are trying to decipher their complex immune system to harvest valuable molecules to treat human diseases. In the present review, the existence of important immunological factors in Achatina is discussed addressing the coagulation system, innate immune molecules, bioactive proteins and lastly the enigmatic C‐reactive proteins

Optimizing Strategies to Improve Interprofessional Practice for Veterans, Part 1

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author’s publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Introduction Interprofessional patient care is a well-recognized path that health care systems are striving toward. The Veteran’s Affairs (VA) system initiated interprofessional practice (IPP) models with their Geriatric Evaluation and Management (GEM) programs. GEM programs incorporate a range of specialties, including but not limited to, medicine, nursing, social work, physical therapy and pharmacy, to collaboratively evaluate veterans. Despite being a valuable resource, they are now faced with significant cut-backs, including closures. The primary goal of this project was to assess how the GEM model could be optimized at the Pittsburgh, Pennsylvania VA to allow for the sustainability of this important IPP assessment. Part 1 of the study evaluated the IPP process using program, patient, and family surveys. Part 2 examined how well the geriatrician matched patients to specialists in the GEM model. This paper describes Part 1 of our study. Methods Three strategies were used: 1) a national GEM program survey; 2) a veteran/family satisfaction survey; and 3) an absentee assessment. Results Twenty-six of 92 programs responded to the GEM IPP survey. Six strategies were shared to optimize IPP models throughout the country. Of the 34 satisfaction surveys, 80% stated the GEM clinic was beneficial, 79% stated their concerns were addressed, and 100% would recommend GEM to their friends. Of the 24 absentee assessments, the top three reasons for missing the appointments were transportation, medical illnesses, and not knowing/remembering about the appointment. Absentee rate diminished from 41% to 19% after instituting a reminder phone call policy. Discussion Maintaining the sustainability of IPP programs is crucial for the health of our veterans. This project uncovered tools to improve the GEM IPP model for our veterans that can be incorporated nationally. Despite the lengthy nature of IPP models, patients and families appreciated the thoroughness, requested transportation and food, and responded well to reminder phone calls. A keen eye on these issues and concomitant medical complexity needs to be observed when planning IPP models to ensure sustainability

The “Irony” of Ferroptosis: A Review on Neurological Challenges

Ferroptosis in recent days has gained high impact due to its implication in inducing several neurological challenges. Impairment of iron homeostasis (mainly surplus iron deposition) is the key reason for the induction of the ferroptotic cell death. This type of programmed cell death in the neurons can trigger neuropathological abnormalities. Ferroptosis has been given clinical importance, where biomedical researchers are working on the pathological detection of ferroptosis and finding clinical ways to arrest it. In this review, we have elucidated the impact of ferroptotic cell death on the pathophysiology of several neurological challenges

Carlinoside reduces hepatic bilirubin accumulation by stimulating bilirubin-UGT activity through Nrf2 gene expression

Accu mulati on of biliru bin, prima rily because of its insol ubilit y, has bee n found to be associa ted with liver disea ses includ ing jaundice . Free bilir ubin is insol uble; its glucuro nidation by bilirubin -UGT enz yme (UGT1 A1) makes it soluble and elimina tes it throu gh urine and fae ces. Taki ng CCl 4 induced ra t liver dysfun ction m odel, we demonst rated that supp ression of UGT1A 1 activity in ra t liv er increa sed ser um biliru bin level wh ich could be reve rsed by carl inoside (Cln), a flavone glyc oside. Alth ough Cln is a flavone compou nd, it escaped self-glucu ronid ation in the intestin e and readily absorbe d. Kineti c stud y of mic rosoma l UGT1A 1 from HepG 2 cells sugg ested that Cln enhan ced enz yme activity by increa sing V max with out alterin g K m. This altered V max was foun d to be due to UGT1A 1 ove rexpre ssion by Cln wh ich wa s obser ved in both HepG 2 and rat prima ry hepa tocytes . Sin ce Nrf2 is the transc ription factor of UG T1A1, we exam ined whethe r Cln effe ct on UG T1A1 overexp ression is media ted th rough Nrf2. In Nrf2 knock -out cells, Cln cou ld not eleva te UG T1A1 activity indica ting Nrf2 to be its target. Cln signific antly increas ed Nrf2 ge ne expr ession in HepG2 cells wh ich was subse quently locali zed in nuclear region . Resu lts from Ch IP assa y show ed that Cln mar kedly augm ented Nrf2 bindi ng to UGT1A 1 prom oter that con sequentl y enhan ced report er act ivity. Our findings therefor e show that Cln upreg ulated Nr f2 gene expr ession, incr eased its nu clear tran slocation and stimula ted UGT1A 1 prom oter act ivity. Tota l outc ome of these even ts brought about a signific ant increase of biliru bin glucur onida tion. Cln ther efore could be a wor thy choice to int ervene hype rbilir ubinemi a due to liv er dysfunc tion

Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

<p>Abstract</p> <p>Background</p> <p>Completion of colorectal cancer (CRC) screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT) among a low-income, minority primary care population in an urban setting.</p> <p>Methods</p> <p>We recruited a convenience sample of adults over age 40 (n = 282) from a federally qualified community health center (70% African American). Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening.</p> <p>Results</p> <p>Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p < 0.01). The trend was for older participants to express more trust (p = 0.09) and less perceived discrimination (p < 0.01). Neither trust nor discrimination was associated with race or education. Trust was higher among participants over 50 who were up-to-date on FOBT screening vs. those who were not (31 vs. 29 (median), p < 0.05 by T-test). Among those over 50, up-to-date FOBT screening was nearly associated with high trust (p < 0.06; 95% CI 0.99, 1.28) and low perceived discrimination (p < 0.01; 95% CI 0.76, 0.96). Nevertheless, in multivariate-modeling, age and income explained FOBT completion better than race, trust and discrimination.</p> <p>Conclusion</p> <p>Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.</p