Reducing 30-Day Heart Failure Readmission Among Elderly Population in Long-term Care

Background: Heart failure is the leading cause of hospitalization in the United States and accounts for more than one million hospitalizations every year. Readmission within 30 days of discharge is an indicator used for measuring the quality of care for heart failure patients. Methods: The goal of this quality improvement project was to reduce the 30-day readmission rate of heart failure patients 60 years and older in a long-term care setting in Texas by using an evidence-based transitional readiness discharge checklist for heart failure. Interventions included staff education on the key components and on the checklist. A pre- and post-test was given to measure staff learning, and the 30-day readmission rate of patients was tracked in the long-term care facility. Results: The project followed 18 patients with heart failure and other comorbidities admitted between October 2018 and March 2019. None of the 18 patients were readmitted to the hospital within 30 days for heart failure exacerbation, although two were readmitted for other reasons. Following staff education, the readmission rate decreased from a previous high rate of readmission to the hospital from this facility of 45% to 13%. Ten licensed staff reported increased knowledge of HF with pre-test mean scores of 82.78 and post-test mean scores increased to 98.57. Conclusion: Staff education on discharge readiness checklist of heart failure older adult patients may increase the knowledge of the staff resulting in better care of heart failure patients on discharge from acute care facilities and reductions in the 30-day readmission rate as seen in the heart failure patients at this Texas long term care facility

Host associations and pollution responses of ciliate epibionts of macroinvertebrates in the six rivers in the Western Cape Province of South Africa

Includes bibliographical references.This study is the first documentation of ciliate epibiont-host associations in the Western Cape Province of South Africa. Benthic macroinvertebrates were sampled from six rivers in the Western Cape Province (Wolwekloof, Wit, Rooielskloof, Molenaars, Elandspad and Eerste) to determine epibiotic prevalence and to explore relationships between prevalence and host abundance. Ciliate morphology and 18S rDNA and ITS region sequence data were used to identify the different taxa present, and attachment preferences of epibiont colonies for host body part were determined. The response of ciliate epibionts to water pollution along a pollution gradient in the Eerste River was examined to assess their potential as bioindicators of water pollution

Morphological, phytochemical and molecular characterization of five common Jatropha species in the Niger Delta Region of Nigeria

The economic and medicinal important genus Jatropha contains many distinctly different species. To elucidate the genetic relationship of five common occurring Jatropha species namely J. multifida, J. podagrica, J.tanjorernsis, J. curcas, and J. gossypifolia, thirty-nine morphological, six phytochemical features and one arbitrary marker was used to screen and explore their similarity. Morphological data was obtained from the measurement of vegetative and reproductive parts while the presence of five phytochemicals was determined using differentphytochemical tests. The DNA of all five Jatropha species were amplified and sequenced using Ribolose 1, 5- biphosphate carboxylase molecular marker. The DNA sequences were then aligned using the Basic Local Alignment Search Tool for nucleotide 2.8.0 version of the National Center for Biotechnology Information database and phylogenetic trees were constructed using Paleontological Statistical software and Molecular Evolutionary Genetics Analysis version 7.0.26 software. From the results of the classical and phylogenetic cluster analysis, the five Jatropha species was separated into two major clusters. The highly distinctive J. gossypifolia was the only species that clustered separately from the other Jatropha species. Although, J. tanjorensis has been reported to be a hybrid from J. curcas and J. gossypifolia, the species did not segregate and cluster with these species, but segregated with J. multifida, and J.podagrica, indicating that this species is more closely related to J. multifida, and J. podagrica than J. curcas and J.gossypifolia. The result therefore provide information that would be useful in the plant improvement programs for the genus Jatropha

Studies on chemotaxonomic properties of tomato (Solanum lycopersicum Linn.)

This research investigated the chemotaxonomic properties of Solanum lycopersicum Linn belonging to Solanaceae. The annual herbaceous free branching cultivated crop grows up to 60 cm or more in height. It has simple uniseriate trichomes densely dispersed all over the plant with adaxial and abaxial foliar trichome indices of 27.19% and 19.44% respectively. The compound leaves measure up to 6±3 cm long and 4 ± 2cm wide with serrated margin. The inflorescence has a cyme of 3 to 5 flowers or more. The petals are yellowish, up to 2±1 cm long and 1.5±0.7 cm wide with greenish sepals up to 1.5±0.7 cm long and 0.7±0.3 cm wide. Flowers are axile, hexa-pentamerous up to 1 cm in diameter with bilocular 2 celled ovary. The berry fruit is greenish when unripe and reddish when ripe, up to 5 cm in diameter with seed measuring up to 0.3 cm in diameter. The epidermal studies revealed anisocytic stomata with adaxial and abaxial stomatal indices of 19.30% and 19.64% respectively. The anatomy of mid-ribs and petioles showed bicollateral vasculation. The node is unilacunar. The stem anatomical section is made of 5 to 6 vascular bundles, with petioles associated with 2 rib traces at primary growth phase while at secondary growth phase, the mid-rib and petiole revealed vascular arcs and the stem, rings of open vascular system. Alkaloids, saponins, tannins, phlobatannins, flavonoids and combined anthraquinones were present while free anthraquinones and cardiac glycosides were absent.Keywords: Morphological, Anatomical, Cytological, Phytochemical, Studie

Isolation and Identification of Fungi Associated with Habanero Pepper (Capsicum chinense jacq) Using Basic Molecular Techniques

Habanero pepper (Capsicum chinense Jacq.) is an economically important vegetable. It is used as spices for foods and for medicinal purposes in many parts of the country. Despite the importance of the crop, it has been observed that during storage, the fruits of the Habanero pepper (HP) shelf-life is reduced by several post-harvest diseases caused by fungal pathogens. A study was conducted to identify the common fungal pathogens causing post-harvest rot of Habanero fruits at the daily market in Omoko Aluu Town, Rivers State. The DNA of the most common fungal isolate HP-02 was molecularly characterized using Internal Transcribed Spacer 1 (ITS-1) molecular marker. The HP-02 isolate DNA sequence was aligned using the Basic Local Alignment Search Tool for nucleotide (BLASTN) 2.8.0 version of the National Center for Biotechnology Information (NCBI) database. The results indicated that the HP-02 isolate sequence was 79% identical to Mucor irregularis and also Rhizomucor viriabilis isolate SAPB3. These findings showed that Mucor irregularis, which was formerly known as Rhizomucor variabilis is one of the emerging causal fungal pathogens of post-harvest Habanero pepper

An Educational Module on High Blood Pressure Management and Control

An educational module, based on evidence-based practice (EBP) guidelines by the 8th Joint National Committee (JNC 8) and the American College of Cardiology (ACC), was created and implemented to determine if its implementation would impact the knowledge of clinic staff regarding current EBP guidelines about self-management of hypertension (HTN). The module has the potential to contribute to the resolution of patient noncompliance on HTN treatment and management by increasing nursing staff proficiency in knowledge transfer to patients on effective self-management of their health condition. The creation of the module was guided by the concept of need or asset assessment and the theory of planned behavior. The module was composed of 2 short lecture presentations on HTN, current EBP guidelines on lifestyle modifications, and proper blood pressure measurement. The module also included pre- and postlecture surveys to evaluate knowledge and practices of staff, and reiterated the current guidelines and approaches presented in the lectures. Survey data were analyzed using McNemar’s test for paired and binary data. Results showed the agreement of all the staff in recognizing the utility of the module in standardizing their knowledge of current EBP guidelines on lifestyle modifications and blood pressure measurement procedures. The results also showed the enhancement of staff proficiency which might lead to efficient education of patients on effective HTN treatment and management protocol. This pathway has the potential to bring about social change by decreasing the incidence of patient noncompliance and improving patient health

Adaptive Capacity of two Varieties of Groundnut (Arachis hypogaea L.) in Crude Oil Polluted Soil

Arachis hypogaea L. (Groundnut) production in Niger Delta, Nigeria is limited as the crop has not been well adapted to this region. This research was carried out to determine the adaptive capability of groundnut in crude oil polluted soil. Seeds of two varieties (Java and Bold Type) were planted in soil polluted with 0.8% and 0% of crude oil. Growth parameters were measured every 10 days up to 50 days after planting. Nodules were isolated from the roots 50 days after planting and cultured in YEMA solid medium and further subcultured in PDA medium to obtain pure cultures. Result showed that they adapted to the crude oil polluted soil with Java variety having the optimum agronomic performance, root architecture and rhizobium population. Nodules formed from day 10 to day 50 after planting shows that the highest number of nodules formation occurred on day 50 for the Java variety in polluted soil (32 nodules) while the bold variety had the lowest (5 nodules). Four fungal organisms identified in the pure-cultures were penicillium chrysogenum, Aspergillus niger, Mucor circinelloides, Botrydiplodia theobromae.  This research suggested that the ability of groundnut to grow in crude oil polluted soil could be due to their root architecture and ability to fix nitrogen in the soil. Further adaptation studies should be carried out covering other part of Niger Delta region. Keywords: Groundnut, Nodule, Adaptive Capacity DOI: 10.7176/JBAH/13-4-06 Publication date:March 31st 202

Identification and characterization of bacteria isolated from patients with cancer at Enugu State Teaching Hospital Parklane, Enugu, Nigeria

Cancer affects millions of people worldwide and contributes to the highest percentage of global deaths compared to other ailments. Most cancer sites are vulnerable to infection by a vast number of opportunistic pathogens. Data from several surveillance reports have revealed several opportunistic pathogens responsible for infections in cancer patients. The present study investigated the spectrum of bacteria isolated from acute cancer patients. Samples were recovered from urine, vaginal swab, and breast swab. Identification and characterization of the isolates were performed using standard microbiological methods. A total of 130 bacteria comprising 78(60%) gram-positive and 52(40%) gram-negative were recovered. A statistically significant difference (P<0.05) was observed between the two groups. The most prevalent organism was Staphylococcus spp. (42.3%) followed by Escherichia coli (36.2%), Lactobacillus spp. (8.5%), Micrococcus spp. (6.2%), Streptococcus spp. (3.1%), Klebsiella spp. (1.5%), Proteus spp. (1.5%) and Pseudomonas spp. (0.8%). Our findings showed the predominance of gram-positive bacteria in infections among cancer patients. However, Enterobacteriaceae (E. coli) was the most frequently isolated among the gram-negative. This study indicates that cancer patients may be infected by several opportunistic pathogens, highlighting an ongoing trend toward gram-positive organisms causing infection in cancer patients. Therefore, it underscores the importance of constant monitoring at regional levels as surveillance efforts are important to provide the clinicians with the appropriate information in choosing treatment regimens and implement a proper policy for infection control guidelines. &nbsp

Targeted Deletion of Fibrinogen Like Protein 1 Reveals a Novel Role in Energy Substrate Utilization

Fibrinogen like protein 1(Fgl1) is a secreted protein with mitogenic activity on primary hepatocytes. Fgl1 is expressed in the liver and its expression is enhanced following acute liver injury. In animals with acute liver failure, administration of recombinant Fgl1 results in decreased mortality supporting the notion that Fgl1 stimulates hepatocyte proliferation and/or protects hepatocytes from injury. However, because Fgl1 is secreted and detected in the plasma, it is possible that the role of Fgl1 extends far beyond its effect on hepatocytes. In this study, we show that Fgl1 is additionally expressed in brown adipose tissue. We find that signals elaborated following liver injury also enhance the expression of Fgl1 in brown adipose tissue suggesting that there is a cross talk between the injured liver and adipose tissues. To identify extra hepatic effects, we generated Fgl1 deficient mice. These mice exhibit a phenotype suggestive of a global metabolic defect: Fgl1 null mice are heavier than wild type mates, have abnormal plasma lipid profiles, fasting hyperglycemia with enhanced gluconeogenesis and exhibit differences in white and brown adipose tissue morphology when compared to wild types. Because Fgl1 shares structural similarity to Angiopoietin like factors 2, 3, 4 and 6 which regulate lipid metabolism and energy utilization, we postulate that Fgl1 is a member of an emerging group of proteins with key roles in metabolism and liver regeneration

The intracellular segment of the sodium channel β1 subunit is required for its efficient association with the channel α subunit

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65797/1/j.1471-4159.2001.00192.x.pd