Why Them: The Informal Caregiver\u27s Transition to a Cancer Diagnosis

Background: Hematologic malignancies (HM) are life-threatening cancers associated with high mortality, numerous symptoms, and lengthy hospitalizations. Informal caregivers (family or friend; IC) of adults with various diseases experience negative quality of life and poor psychological well-being. However, there is scant research exploring the IC experience. Objective: To learn how ICs adapt to patients’ diagnosis of HM and their caregiver role. Methods: The current study used a qualitative descriptive design to analyze the semi-structured interview responses from ICs (N=28) within six weeks of the patients’ HM diagnosis. A content analysis was conducted to generate common themes. Findings: Several themes emerged related to the IC’s psychological adjustment to their loved one’s illness (HM). Markers of positive adaptation included accepting help, preparedness for caregiver roles, and feelings of empowerment. Markers of poor adaptation included perceived powerlessness, rumination over discomforting thoughts, and struggle with illness transition. Reports of positivity and hope were accompanied by endorsements of easing stress about the patient’s survival and aiding the IC coping. Findings suggest that IC’s are uncomfortable with uncertainty for their future and the logistical challenges associated with the diagnosis. Implications: Results foster understanding of the psychological complexities of caregiver burden as ICs adapt to the diagnosis and their new supportive role as a caregiver for their loved one with HM. This highlights the need to assess and support ICs during this time. For example, palliative care principles can be leveraged to promote healthy acceptance of the diagnosis, preparation for caregiving, burden prevention, and targeted coping strategies.https://scholarscompass.vcu.edu/gradposters/1128/thumbnail.jp

Gender Attitudes and Fertility Aspirations among Young Men in Five High Fertility East African Countries

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97275/1/j.1728-4465.2013.00341.x.pd

Englacial Architecture of Lambert Glacier, East Antarctica

The analysis of englacial layers using radio-echo sounding data enables the characterisation and reconstruction of current and past ice-sheet flow. Despite the Lambert Glacier catchment being one of the largest in Antarctica, discharging ~16 % of East Antarctica&rsquo;s ice, its englacial architecture has been little analysed. Here, we present a comprehensive analysis of Lambert Glacier&rsquo;s englacial architecture using radio-echo sounding data collected by the Antarctica's Gamburtsev Province Project (AGAP) North survey. We used an &ldquo;internal-layering continuity index&rdquo; (ILCI) to characterise the internal architecture of the ice and identify four macro-scale ILCI zones with distinct glaciological contexts. Whilst the catchment is dominated by continuous englacial layering, disrupted or discontinuous layering is highlighted by the ILCI at both the onset of enhanced ice flow (defined here as &gt;15 ma&minus;1) and along the shear margin, revealing the transition from internal-deformation-controlled to basal-sliding-dominated ice flow. These zones are characterised by buckled and folded englacial layers which align with the current ice-flow regime, and which we interpret as evidence that the flow direction of the Lambert Glacier trunk has changed little, if at all, during the Holocene. However, disturbed englacial layers along a deep subglacial channel that does not correspond to modern ice-flow routing suggest that ice-flow change has occurred in a former tributary which fed Lambert Glacier from grid north. As large outlet systems such as Lambert Glacier are likely to play a vital role in the future drainage of the East Antarctic Ice Sheet, constraining their englacial architecture to reconstruct their past ice flow and assess basal conditions is important.</p

Respiratory virus infection up-regulates TRPV1, TRPA1 and ASICS3 receptors on airway cells.

Receptors implicated in cough hypersensitivity are transient receptor potential vanilloid 1 (TRPV1), transient receptor potential cation channel, Subfamily A, Member 1 (TRPA1) and acid sensing ion channel receptor 3 (ASIC3). Respiratory viruses, such as respiratory syncytial virus (RSV) and measles virus (MV) may interact directly and/or indirectly with these receptors on sensory nerves and epithelial cells in the airways. We used in vitro models of sensory neurones (SHSY5Y or differentiated IMR-32 cells) and human bronchial epithelium (BEAS-2B cells) as well as primary human bronchial epithelial cells (PBEC) to study the effect of MV and RSV infection on receptor expression. Receptor mRNA and protein levels were examined by qPCR and flow cytometry, respectively, following infection or treatment with UV inactivated virus, virus-induced soluble factors or pelleted virus. Concentrations of a range of cytokines in resultant BEAS-2B and PBEC supernatants were determined by ELISA. Up-regulation of TRPV1, TRPA1 and ASICS3 expression occurred by 12 hours post-infection in each cell type. This was independent of replicating virus, within the same cell, as virus-induced soluble factors alone were sufficient to increase channel expression. IL-8 and IL-6 increased in infected cell supernatants. Antibodies against these factors inhibited TRP receptor up-regulation. Capsazepine treatment inhibited virus induced up-regulation of TRPV1 indicating that these receptors are targets for treating virus-induced cough

Clinical pharmacokinetics of antipsychotics in pediatric populations:a scoping review focusing on dosing regimen

Introduction:Achieving optimal clinical responses and minimizing side effects through precision dosing of antipsychotics in children and adolescents with psychiatric disorders remains a challenge. Identifying patient characteristics (covariates) that affect pharmacokinetics can inform more effective dosing strategies and ultimately improve patient outcomes. This review aims to provide greater insight into the impact of covariates on the clinical pharmacokinetics of antipsychotics in pediatric populations. Areas covered: A comprehensive literature search was conducted, and the main findings regarding the effects of the covariates on the pharmacokinetics of antipsychotics in children and adolescents are presented. Expert opinion: Our study highlights significant covariates, including age, sex, weight, CYP2D6 phenotype, co-medication, and smoking habits, which affect the pharmacokinetics of antipsychotics. However, the findings were generally limited by the small sample sizes of naturalistic, open-label, observational studies, and the homogeneous subgroups. Dosing based on weight and preemptive genotyping could prove beneficial for optimizing the dosing regimen in pediatric populations. Future research is needed to refine dosing recommendations and establish therapeutic reference ranges critical for precision dosing and Therapeutic Drug Monitoring (TDM). The integration of individual patient characteristics with TDM can further optimize the efficacy and safety of antipsychotics for each patient.</p

Failure of Working Memory Training to Enhance Cognition or Intelligence

Fluid intelligence is important for successful functioning in the modern world, but much evidence suggests that fluid intelligence is largely immutable after childhood. Recently, however, researchers have reported gains in fluid intelligence after multiple sessions of adaptive working memory training in adults. The current study attempted to replicate and expand those results by administering a broad assessment of cognitive abilities and personality traits to young adults who underwent 20 sessions of an adaptive dual n-back working memory training program and comparing their post-training performance on those tests to a matched set of young adults who underwent 20 sessions of an adaptive attentional tracking program. Pre- and post-training measurements of fluid intelligence, standardized intelligence tests, speed of processing, reading skills, and other tests of working memory were assessed. Both training groups exhibited substantial and specific improvements on the trained tasks that persisted for at least 6 months post-training, but no transfer of improvement was observed to any of the non-trained measurements when compared to a third untrained group serving as a passive control. These findings fail to support the idea that adaptive working memory training in healthy young adults enhances working memory capacity in non-trained tasks, fluid intelligence, or other measures of cognitive abilities.</p

Prospectus, October 26, 1973

STAFF PROFILES; Trustees Welcome Stugo President Kendricks To Board; Chills Highlight Haunted House; Only Two Of Seven Amendments Pass, Original Report Incorrect; Prospectus In Perspective: Impeachment Now; The Short Circuit; Cruisin\u27 \u2773; Senator Hulsizer Asks For Student Involvement; Letters From Our Readers; To the Faculty of Parkland College; Bowling Bulletin Board; Death By Hunger; TARGET Explained At Open House; Behind The Books; Scott I Deal With The Issues ; Human Development Seminar Slated; The History Of The Controversial Film - Salt Of The Earth ; S.W.A.M.P. Not A Fad; News Bulletin; Allman Bros. Come Through On Brothers and Sisters; Johnson We Take The Student Where He Is, and Build On That ; Campus Continues To Be Completed; Pre-Registration Additional Info; Mutt and Mortie; Leaders To Meet At Allerton This Saturday, Sunday; Debaters Shows Strength At Bradley Tourney; Health Center Free Clinic; Day Senators Outline Platforms; Slave Auction, Dance Today; President Releases Tapes; Marshall Wins PCFW Scholarship; A\u27s Repeat As World Champs, Dump N.Y. Mets In Seven Games; Wrist-Wrestling, Frisbie Contests To Be Held Soon; Monday\u27s Coach; Harriers Lose Flores Burnette, Will Run In Region IV Finals On Saturday, October 26; Fast Freddy\u27s Football Forecast; Fast Freddy Pays In Cash, Too; Female Winner Of Fast Freddy; Classified Ads; Champaign To Pick Up Leaves; Masters\u27 \u27Spoon River\u27 Comes To Parkland; A Column By And For Women; What The Signs Say; W. Virginia U. Hires Attorney; Who Will Listen?; Final Exam Schedule - Fall Quarter; Callboard; Sharing Group Recommends Eighthttps://spark.parkland.edu/prospectus_1973/1003/thumbnail.jp

Non-culprit MACE-rate in LRP:The influence of optimal medical therapy using DAPT and statins

Background/Purpose: The Lipid Rich Plaque (LRP) study demonstrated the association between coronary plaque lipid content and outcomes. In this LRP substudy, we assessed the impact of optimal medical therapy (OMT) on the occurrence of non-culprit major adverse cardiac events (NC-MACE). Advanced intracoronary imaging modalities are able to identify patients with vulnerable coronary lesion morphology associated with future events. Methods/Materials: A total of 1270 patients who underwent cardiac catheterization for suspected coronary artery disease (CAD) with evaluable maxLCBI4mm in non-culprit vessels and known medical therapy after discharge were followed for 2 years. OMT was defined as the use of a statin and dual antiplatelet therapy (DAPT). Results: Among the 1270 patients included in this substudy, 1110 (87.7%) had PCI for an index event, and 1014 (80%) patients received OMT. Estimated cumulative incidence functions of NC-MACE did not differ significantly between patients treated with or without OMT (log-rank p-value = 0.876). In patients labeled high risk (maxLCBI4mm > 400), cumulative incidence function also did not differ between patients treated with vs without OMT (log-rank p-value = 0.19). Conclusions: In the current LRP analysis, we could not identify a beneficial effect of OMT in the reduction of NC-MACE rate, even in patients with high-risk plaques during 24-month follow-up

Rib head protrusion into the central canal in type 1 neurofibromatosis

Intraspinal rib head dislocation is an important but under-recognized consequence of dystrophic scoliosis in patients with neurofibromatosis 1 (NF1). To present clinical and imaging findings of intraspinal rib head dislocation in NF1. We retrospectively reviewed clinical presentation, imaging, operative reports and post-operative courses in four NF1 patients with intraspinal rib head dislocation and dystrophic scoliosis. We also reviewed 17 cases from the English literature. In each of our four cases of intraspinal rib head dislocation, a single rib head was dislocated on the convex apex of the curve, most often in the mid- to lower thoracic region. Cord compression occurred in half of these patients. Analysis of the literature yielded similar findings. Only three cases in the literature demonstrates the MRI appearance of this entity; most employ CT. All of our cases include both MRI and CT; we review the subtle findings on MRI. Although intraspinal rib head dislocation is readily apparent on CT, sometimes MRI is the only cross-sectional imaging performed. It is essential that radiologists become familiar with this entity, as subtle findings have significant implications for surgical management

Towards precision dosing of aripiprazole in children and adolescents with autism spectrum disorder:Linking blood levels to weight gain and effectiveness

Aims: Aripiprazole is one of the most commonly prescribed antipsychotic drugs to children and adolescents worldwide, but it is associated with serious side-effects, including weight gain. This study assessed the population pharmacokinetics of aripiprazole and its active metabolite and investigated the relationship between pharmacokinetic parameters and body mass index (BMI) in children and adolescents with autism spectrum disorder (ASD) and behavioural problems. Secondary outcomes were metabolic, endocrine, extrapyramidal and cardiac side-effects and drug effectiveness. Methods: Twenty-four children and adolescents (15 males, 9 females) aged 6–18 years were included in a 24-week prospective observational trial. Drug plasma concentrations, side-effects and drug effectiveness were measured at several time points during follow-up. Relevant pharmacokinetic covariates, including CYP2D6, CYP3A4, CYP3A5 and P-glycoprotein (ABCB1) genotypes, were determined. Nonlinear mixed-effects modelling (NONMEM®) was used for a population pharmacokinetic analysis with 92 aripiprazole and 91 dehydro-aripiprazole concentrations. Subsequently, model-based trough concentrations, maximum concentrations and 24-h area under the curves (AUCs) were analysed to predict outcomes using generalized and linear mixed-effects models. Results: For both aripiprazole and dehydro-aripiprazole, one-compartment models best described the measured concentrations, with albumin and BMI as significant covariates. Of all the pharmacokinetic parameters, higher sum (aripiprazole plus dehydro-aripiprazole) trough concentrations best predicted higher BMI z-scores (P &lt;.001) and higher Hb1Ac levels (P =.03) during follow-up. No significant association was found between sum concentrations and effectiveness. Conclusions: Our results indicate a threshold with regard to safety, which suggests that therapeutic drug monitoring of aripiprazole could potentially increase safety in children and adolescents with ASD and behavioural problems.</p