Revisiting Estrogen: Efficacy and Safety for Postmenopausal Bone Health

The rapid decline in endogenous estrogen production that occurs during menopause is associated with significant bone loss and increased risk for fragility fracture. While hormone therapy (HT) is an effective means to re-establish endogenous estrogen levels and reduce the risk of future fracture, its use can be accompanied by undesirable side effects such as stroke and breast cancer. In this paper, we revisit the issue of whether HT can be both safe and effective for the prevention of postmenopausal bone loss by examining standard and alternative doses and formulations of HT. The aim of this paper is to continue the dialogue regarding the benefits and controversies of HT with the goal of encouraging the dissemination of-up-to date evidence that may influence how HT is viewed and prescribed

Selective capture and ingestion of particles by suspension-feeding bivalve molluscs: a review

Suspension-feeding bivalve molluscs are foundation species in coastal intertidal systems. The selective feeding capabilities of these animals can have a large influence on phytoplankton communities and nutrient flow 10 the benthos. Particle selection, including the types of particles chosen for ingestion and the possible mechanisms mediating selection, has been studied extensively and reported in the literature. To dale, however, the possible mechanisms mediating these selective processes have remained elusive. Generally, the focus on a few key commercial species. and their demonstrated range of selective capabilities, has made it difficult 10 design studies that elucidate the mechanisms behind particle selection. This review focuses on key research 1ha1 has been carried out in the last 20 y toward better understanding the mechanism that underlays selective capture and ingestion of particles in this important group of animals. Recently, work has been completed which has advanced the field in pointing to a passive mechanism as a mediator of selection. with the interactions between the physicochemical properties of particles and the mucus covering the pallial organs most likely mediating food choice. Although no strong evidence for an immediate, active mechanism which underlies particle selection was found, avenues for future research are suggested in this review. The possible mechanisms that control capture, including qualitative precapture selection. are also summarized and discussed in depth. Methodological considerations for rigorous experiments to advance the field are also discussed, including suggestions of general guidelines for experimental designs. which will allow better comparison of findings across studies

Beliefs About Dysmenorrhea and Their Relationship to Self‐Management

Dysmenorrhea is highly prevalent and is the leading cause of work and school absences among women of reproductive age. However, self‐management of dysmenorrhea is not well understood in the US, and little evidence is available on factors that influence dysmenorrhea self‐management. Guided by the Common Sense Model, we examined women's representations of dysmenorrhea (beliefs about causes, symptoms, consequences, timeline, controllability, coherence, and emotional responses), described their dysmenorrhea self‐management behaviors, and investigated the relationship between representations and self‐management behaviors. We conducted a cross‐sectional, web‐based survey of 762 adult women who had dysmenorrhea symptoms in the last six months. Participants had varied beliefs about the causes of their dysmenorrhea symptoms, which were perceived as a normal part of life. Dysmenorrhea symptoms were reported as moderately severe, with consequences that moderately affected daily life. Women believed they understood their symptoms moderately well and perceived them as moderately controllable but them to continue through menopause. Most women did not seek professional care but rather used a variety of pharmacologic and complementary health approaches. Care‐seeking and use of self‐management strategies were associated with common sense beliefs about dysmenorrhea cause, consequences, timeline, and controllability. The findings may inform development and testing of self‐management interventions that address dysmenorrhea representations and facilitate evidence‐based management

Disconnect between emergency contacts and surrogate decision-makers in the absence of advance directives

The role played by emergency contacts can be extensive particularly for chronically seriously ill patients. If the patient's condition suddenly deteriorates, the emergency contact may be asked to make decisions that should instead fall to a designated surrogate decision-maker

Assessment Effects in Educational and Psychosocial Intervention Trials: An Important but Often-Overlooked Problem: ASSESSMENT EFFECTS IN INTERVENTION TRIALS

Baseline assessments and repeated measures are an essential part of educational and psychosocial intervention trials, but merely measuring an outcome of interest can modify that outcome, either by the measurement process alone or by interacting with the intervention to strengthen or weaken the intervention effects. Assessment effects can result in biased estimates of intervention effects and may not be controlled by the usual two-group randomized controlled trial design. In this paper, we review the concept of assessment effects and other related phenomena, briefly describe study designs that estimate assessment effects separately from intervention effects and discuss their strengths and limitations, review evidence regarding the strength of assessment effects in intervention trials targeting behavior change, and discuss implications for intervention research

The extent of informed decision-making about starting dialysis: does patients’ age matter?

A growing number of elderly patients with end-stage renal disease start dialysis. We examined elderly (≥ 65 years) patients’ views about their decision-making experience after starting dialysis in comparison with patients aged 50-64 years, and patients ≤ 49 years

Determining Consistency of Surrogate Decisions and End-of-Life Care Received with Patient Goals-of-Care Preferences

Background: Care consistent with preferences is the goal of advance care planning (ACP). However, comparing written preferences to actual end-of-life care may not capture consistency of care with preferences

Higher PLIN5 but not PLIN3 content in isolated skeletal muscle mitochondria following acute in vivo contraction in rat hindlimb

Contraction-mediated lipolysis increases the association of lipid droplets and mitochondria, indicating an important role in the passage of fatty acids from lipid droplets to mitochondria in skeletal muscle. PLIN3 and PLIN5 are of particular interest to the lipid droplet–mitochondria interaction because PLIN3 is able to move about within cells and PLIN5 associates with skeletal muscle mitochondria. This study primarily investigated: 1) if PLIN3 is detected in skeletal muscle mitochondrial fraction; and 2) if mitochondrial protein content of PLIN3 and/or PLIN5 changes following stimulated contraction. A secondary aim was to determine if PLIN3 and PLIN5 associate and whether this changes following contraction. Male Long Evans rats (n = 21;age, 52 days; weight = 317 6 g) underwent 30 min of hindlimb stimulation (10 msec impulses, 100 Hz/3 sec at 10–20 V; train duration 100 msec). Contraction induced a ~50% reduction in intramuscular lipid content measured by oil red-O staining of red gastrocnemius muscle. Mitochondria were isolated from red gastrocnemius muscle by differential centrifugation and proteins were detected by western blotting. Mitochondrial PLIN5 content was ~1.6-fold higher following 30 min of contraction and PLIN3 content was detected in the mitochondrial fraction, and unchanged following contraction. An association between PLIN3 and PLIN5 was observed and remained unaltered following contraction. PLIN5 may play a role in mitochondria during lipolysis, which is consistent with a role in facilitating/regulating mitochondrial fatty acid oxidation. PLIN3 and PLIN5 may be working together on the lipid droplet and mitochondria during contraction-induced lipolysis

Managing Opportunities and Challenges of Co-Authorship

Research with the largest impact on practice and science is often conducted by teams with diverse substantive, clinical, and methodological expertise. Team and interdisciplinary research has created authorship groups with varied expertise and expectations. Co-authorship among team members presents many opportunities and challenges. Intentional planning, clear expectations, sensitivity to differing disciplinary perspectives, attention to power differentials, effective communication, timelines, attention to published guidelines, and documentation of progress will contribute to successful co-authorship. Both novice and seasoned authors will find the strategies identified by the Western Journal of Nursing Research Editorial Board useful for building positive co-authorship experiences