In Adult Patients with Obsessive Compulsive Disorder (OCD), is the Amino Acid N-Acetyl Cysteine (NAC) Effective in Reducing Severity of OCD?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “In adult patients with Obsessive Compulsive Disorder (OCD), is the amino acid N-Acetyl Cysteine (NAC) effective in reducing severity of OCD?” STUDY DESIGN: Review of three English language primary studies, published between 2015-2017. DATA SOURCES: Three randomized controlled trials (RCTs) were found using PubMed-NCBI. These studies analyzed the effectiveness in reducing the severity of OCD in adults with OCD. OUTCOME MEASURED: The main outcome measured was a reduction of OCD severity after taking N-Acetyl Cysteine. Outcomes were measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Participants answered a 67 part questionnaire about their everyday habits. From the questionnaire, the interviewer generated a list of target OCD symptoms. The target symptoms were then used in 19 interview style questions asking about the severity of each symptom. The severity of those symptoms range from 0-4, with 4 being the highest severity. Questions 1-10 were added together for a Y-BOCS final score, based on the patient’s responses. RESULTS: There was an overall reduction of symptoms from the beginning to end of each trial. However, the placebo group had a similar reduction in symptoms, which made the results statistically insignificant. In the study conducted by Costa et al. 6 of 16 patients in the NAC group versus 5 of 19 patients in the control group had a significant reduction in Y-BOCS score (P=0.40). In the results of the study by Paydray et al. 11 of 22 in the NAC group and 8 of 22 in the control group had a significant reduction in Y-BOCS score (P=0.54). In the study conducted by Sarris et al. 4 of 20 patients in the NAC group versus 4 of 15 in the control group had a significant reduction in Y-BOCS score (P=0.15). CONCLUSION: The results of the RCTs remain inconclusive as to whether NAC is an effective medication for reducing the severity of OCD in adults. NAC as an alternative treatment to current medications for OCD remains affordable and tolerable, indicating further research is needed for its efficacy

The Virtual Classroom: An Enhancement or Replacement to Traditional Education?

The processes by which learners learn and teachers teach are about as ever-changing as the seasons. Throughout time, pedagogical researchers have developed new methods for the educational process, but none have been quite as revolutionary or as controversial as e-learning. E-learning, often referred to as distance learning or online learning, provides a platform that facilitates learning through communication without requiring a face-to-face contact in the same space and time (Wahlstedt 1021). Optimistic commentators see a new world of an educational process: “Every learner can, at his or her own choice of time and place, access a world of multimedia material…immediately the learner is unlocked from the shackles of fixed and rigid schedules, from physical limitations…and is released into an information world which reacts to his or her own pace of learning (Benjamin 49; Salmon 11).” However, is this view of education universally shared? Is distance education truly a “new world” of learning, or is it only the latest “miracle” that promises solutions to problems in education and training (Huett 66)? Perhaps, the most important question: Will this process replace traditional “face-to-face” methods of learning? The answer to all of these questions is no. E-learning has, indeed, redefined education, but it has not replaced class-based learning

A Survey of the Teaching of Biology in Eighty-Five Accredited Negro High Schools in Texas

In recent years, increasing emphasis has been placed upon our responsibility toward the education of our youth to meet the ever increasing complexities of modem living. Faced with an era that has seen topographical consideration of the earth diminish as a result of modern methods of communication and transportation, educators and logicians are at once beset, not only with the problems of keeping abreast of developments in previously considered remote parts of the world, but also with those of utlizing every segment of our population and of supplying the technicians necessary to preserve the conerstone of our heritage. This is a study of (1) types of biology courses; (2) methods and materials; (3) equipment; (4) audio-visual aids; (5) training of teachers; (6) supervision, and (7) problems of biology teachers in eighty-five accredited Negro high schools. It is the writer\u27s desire to present the conditions of the Negro schools on a statewide basis, with no restriction to a particular area. This study covers schools as far as Texarkana in the east; as far north as Ft. Worth; as far south as Corpus Christi, and as far west as EI Paso

Local interaction Strategies and Capacity for Better Care in Nursing Homes: A Multiple Case Study

To describe relationship patterns and management practices in nursing homes (NHs) that facilitate or pose barriers to better outcomes for residents and staff. Methods: We conducted comparative, multiple-case studies in selected NHs (N = 4). Data were collected over six months from managers and staff (N = 406), using direct observations, interviews, and document reviews. Manifest content analysis was used to identify and explore patterns within and between cases. Results: Participants described interaction strategies that they explained could either degrade or enhance their capacity to achieve better outcomes for residents; people in all job categories used these 'local interaction strategies'. We categorized these two sets of local interaction strategies as the 'common pattern' and the 'positive pattern' and summarize the results in two models of local interaction. Conclusions: The findings suggest the hypothesis that when staff members in NHs use the set of positive local interaction strategies, they promote inter-connections, information exchange, and diversity of cognitive schema in problem solving that, in turn, create the capacity for delivering better resident care. We propose that these positive local interaction strategies are a critical driver of care quality in NHs. Our hypothesis implies that, while staffing levels and skill mix are important factors for care quality, improvement would be difficult to achieve if staff members are not engaged with each other in these ways.National Institutes of Health 2 R01NR003178-04A2Claude A. Pepper Older American's Independence Center AG-11268Paul A. Beeson Award NIA AG024787VA Health Services Research and Development EDU 08-417John A. Hartford Building Academic Geriatric Nursing Claire M. Fagin FellowshipBusiness Administratio

A Microsoft Windows-based information search and retrieval tool : INFOTOOL

Includes bibliographical references.This project implements a Microsoft Windows-based information search and retrieval tool that supports mapping a single item to multiple keywords. It supports up to 70 locations per keyword and a description field which describes the item. It is fully compliant with the Multiple Document Interface, Dynamic Data Exchange, and "Point and Click" standards.B.S. (Bachelor of Science

C\u3csub\u3e60\u3c/sub\u3e and Sc\u3csub\u3e3\u3c/sub\u3eN@C\u3csub\u3e80\u3c/sub\u3e(TMB-PPO) Derivatives as Constituents of Singlet Oxygen Generating, Thiol-ene Polymer Nanocomposites

Numerous functionalization methods have been employed to increase the solubility, and therefore, the processability of fullerenes in composite structures, and of these radical addition reactions continue to be an important methodology. C60 and Sc3N@C80 derivatives were prepared via radical addition of the photodecomposition products from the commercial photoinitiator TMB-PPO, yielding C60(TMB-PPO)5 and Sc3N@C80(TMB-PPO)3 as preferred soluble derivatives obtained in high yields. Characterization of the mixture of isomers using standard techniques suggests an overall 1PPO:6TMB ratio of addends, reflecting the increased reactivity of the carbon radical. Although, a higher percentage of PPO is observed in the Sc3N@C80(TMB-PPO)3 population, perhaps due to reverse electronic requirements of the substrate. Visually dispersed thiol-ene nanocomposites with low extractables were prepared using two monomer compositions (PETMP:TTT and TMPMP:TMPDE) with increasing fullerene derivative loading to probe network structure-property relationships. Thermal stability of the derivatives and the resulting networks decreased with increased functionality and at high fullerene loadings, respectively. TMPMP:TMPDE composite networks show well-dispersed derivatives via TEM imaging, and increasing Tg’s with fullerene loading, as expected for the incorporation of a more rigid network component. PETMP:TTT composites show phase separation in TEM, which is supported by the observed Tg’s. Singlet oxygen generation of the derivatives decreases with increased functionality; however, this is compensated for by the tremendous increase in solubility in organic solvents and miscibility with monomers. Most importantly, singlet oxygen generation from the composites increased with fullerene derivative loading, with good photostability of the networks

Transitional care of older adults in skilled nursing facilities: A systematic review

Transitional care may be an effective strategy for preparing older adults for transitions from skilled nursing facilities (SNF) to home. In this systematic review, studies of patients discharged from SNFs to home were reviewed. Study findings were assessed (1) to identify whether transitional care interventions, as compared to usual care, improved clinical outcomes such as mortality, readmission rates, quality of life or functional status; and (2) to describe intervention characteristics, resources needed for implementation, and methodologic challenges. Of 1,082 unique studies identified in a systematic search, the full texts of six studies meeting criteria for inclusion were reviewed. Although the risk for bias was high across studies, the findings suggest that there is promising but limited evidence that transitional care improves clinical outcomes for SNF patients. Evidence in the review identifies needs for further study, such as the need for randomized studies of transitional care in SNFs, and methodological challenges to studying transitional care for SNF patients

Supporting the Dynamic Careers of Licensed Practical Nurses: A Strategy to Bolster the Long-Term Care Nurse Workforce

As the U.S. population ages and the demand for long-term care increases, an insufficient number of licensed practical nurses (LPNs) is expected in the nursing workforce. Understanding the characteristics of LPN participation in the workforce is essential to address this challenge. Drawing on the theory of boundaryless careers, the authors examined longitudinal employment data from LPNs in North Carolina and described patterns in LPN licensure and career transitions. Two career patterns were identified: (a) the continuous career, in which LPNs were licensed in 75% or more of the years they were eligible to be licensed and (b) the intermittent career, in which lapses in licensure occurred. Findings indicated that LPNs who made job transitions were more likely to demonstrate continuous careers, as were Black LPNs. These findings suggest the importance of organizational support for LPN career transitions and support for diversity in the LPN workforce

Book Reviews

Book reviews of: Behind the Big House: Reconciling Slavery, Race, and Heritage in the U.S. South. By Jodi Skipper (Iowa City: University of Iowa Press, 2022. Foreword, Acknowledgements, Introduction, Epilogue, Appendix A, Appendix B, Notes, Bibliography, Index. Pp. ix, 218. 27.50 paper. ISBN: 9781609388171.) Gin, Jesus, & Jim Crow: Prohibition and the Transformation of Racial and Religious Politics in the South. By Brendan J. J. Payne. (Baton Rouge: Louisiana State University Press, 2022. Pp. 304. 45 hardcover. ISBN: 0807171486.) The Women’s Fight: The Civil War’s Battles for Home, Freedom, and Nation. By Thavolia Glymph. (Chapel Hill: University of North Carolina Press, 2020. Acknowledgments, figures, notes, bibliography, index of names, index of subjects. Pp. 379. $37.50 cloth,$27.95 paper. ISBN: 9781469653631.) Until I Am Free: Fannie Lou Hamer’s Enduring Message to America. By Keisha N. Blain. (Boston: Beacon Press, 2021, Acknowledgements, notes, index, image credits, about the author. Pp ix, 181. $12.97 cloth,$24.95 paper. ISBN-13:9780807061503 Land of Milk and Money: The Creation of the Southern Dairy Industry. By Alan I. Marcus. (Baton Rouge: Louisiana State University Press, 2021. Acknowledgements, illustrations, notes, index. Pp. ix, 317. $50 cloth. ISBN: 0807176052.) Black Bodies in the River: Searching for Freedom Summer. By Davis W. Houck. (University Press of Mississippi, 2022. Preface, notes, index. Pp. ix, 153.$99 cloth, $25.00 paper. ISBN: 9781496840790.) Mississippi Zion: The Struggle for Liberation in Attala County, 1865–1915. By Evan Howard Ashford. (Jackson: University Press of Mississippi, 2022. Acknowledgements, illustrations, notes, index. Pp. ix, 233.$99 cloth, $25 paper. ISBN: 9781496839732