Can Follow Up Phone Calls Decrease Complications of Chemotherapy Toxicities In Adults?

Approximately 22% of all cancer patients in the United States receive chemotherapy. Older adults account for 60 % of new cancer diagnoses in the United States. The aging process is associated with comorbidities that potentially can increase toxicities associated with chemotherapy. These include coronary artery disease, hypertension, and diabetes. Monitoring for toxicities during treatment and intervening when needed allows patients to move forward in their treatment plan. Interruptions in the treatment plan have the potential to adversely affect treatment goals. The purpose of this study is to determine if patients receiving phone calls on predetermined days had fewer days of treatment delay related to toxicities before proceeding to cycle 2 of chemotherapy and a decrease number of emergency department visits/hospitalizations related to toxicities. The study also followed those patients that received education from the nurse practitioner to determine if they had fewer days of treatment delay related to toxicities compared to those patients that did not have treatment delays. Sixty one participants were in the treatment group and 60 were in the control group. A statistical significance of .043 was found with patients receiving phone calls after starting treatment. There was no statistical significance in telephone calls affecting emergency department visits. There was no statistical significance in education by the nurse practitioner. Sample population was a limited in number but broad in diagnoses. Future research could benefit from following this topic in a larger metropolitan area where there are sufficient numbers of patients to follow with similar diagnosis

Wage Dispersion and Decentralization of Wage Bargaining

This paper studies how decentralization of wage bargaining from sector to firm-level influences wage levels and wage dispersion. We use detailed panel data covering a period of decentralization in the Danish labor market. The decentralization process provides variation in the individual worker's wage-setting system that facilitates identification of the effects of decentralization. We find a wage premium associated with firm-level bargaining relative to sector-level bargaining, and that the return to skills is higher under the more decentralized wage-setting systems. Using quantile regression, we also find that wages are more dispersed under firm-level bargaining compared to more centralized wage-setting systems.wage bargaining, decentralization, wage dispersion

Wage Dispersion and Decentralization of Wage Bargaining

This paper studies how decentralization of wage bargaining from sector to firm level influences wage levels and wage dispersion. We use a detailed panel data set covering a period of decentralization in the Danish labor market. The decentralization process provides exogenous variation in the individual worker's wage-setting system that facilitates identification of the effects of decentralization. Consistent with predictions we find that wages are more dispersed under firm-level bargaining compared to more centralized wage-setting systems. However, the differences across wage-setting systems are reduced substantially when controlling for unobserved individual level heterogeneity.Wage bargaining; decentralization; panel data quantile regression

Practice Matters: Hypertension

Hypertension remains a significant public health concern in the United States, affecting over 110 million adults, nearly half of the adult population. As a major contributor to cardiovascular diseases, including heart disease and stroke, hypertension accounts for a large number of deaths annually. Many individuals with hypertension remain undiagnosed and undertreated, leading to increased healthcare costs. Recognizing the importance of addressing this widespread issue, the healthcare community, including Faith Community Nurses (FCNs), has played an essential role in the prevention and management of hypertension. While pharmacological interventions are common, lifestyle changes have demonstrated their effectiveness in reducing blood pressure and enhancing the impact of medications. Emphasizing lifestyle modifications has become a cornerstone in recent hypertension guidelines aiming to optimize treatment outcomes and achieve target blood pressure values. These guidelines recognize the need for personalized care, considering factors like age, cognitive impairment, comorbidities, and orthostatic hypotension. Numerous guidelines have been written to direct the care of hypertensive patients, such as those by the American College of Cardiology/American Heart Association and the European Society of Cardiology/European Society of Hypertension. While they share common principles, they differ in blood pressure classifications and initiation thresholds for antihypertensive medications. Faith Community Nurses, as respected health professionals, play an integral role in hypertension prevention and management through community support and lifestyle guidance. Collaborating with healthcare institutions and local health departments, FCNs can actively participate in initiatives to promote healthier lifestyles to manage hypertension effectively

Posturographic pattern of patients with chronic subjective dizziness before and after vestibular rehabilitation.

Chronic subjective dizziness (CSD) is frequently encountered in neurotology clinics. This diagnosis is mainly clinical, but computerized dynamic posturography (CDP) could be a helpful instrumental tool in the identification of these patients and validation of the treatment. This study was aimed to look for a specific posturographic pattern among patients diagnosed with CSD, and to eventually visualize improvement after vestibular rehabilitation. Single center, retrospective review from 2009 to 2014. We included patients diagnosed with CSD who underwent CDP in their neurotologic assessment. For those patients who benefited from vestibular rehabilitation, we compared their pre- and post-rehabilitation posturographies. We included 114 patients, of whom 74% had known anxiety disorders and 33% a history of past vestibular disorder. 62% of the assessment posturographies were abnormal. The most affected sub-items were limit of stability, composite score of sensory organization tests and condition 5 in respectively 34%, 23% and 20% of the cases. In univariate analysis, only pathologic videonystagmography and history of unilateral vestibular dysfunction were significantly related to abnormal posturography. In the 42 patients who had vestibular rehabilitation and a post rehabilitation posturography, the proportion of abnormal posturography significantly dropped from 79% to 33% (p < 0.001). When it was assessed, 79% of the patients reported a subjective improvement. Patients with CSD have a high rate of abnormal posturography, but without a specific pattern. Vestibular rehabilitation is an effective tool in the therapeutic armamentarium

Bioengineered Nisin A Derivatives with Enhanced Activity against Both Gram Positive and Gram Negative Pathogens

peer-reviewedNisin is a bacteriocin widely utilized in more than 50 countries as a safe and natural antibacterial food preservative. It is the most extensively studied bacteriocin, having undergone decades of bioengineering with a view to improving function and physicochemical properties. The discovery of novel nisin variants with enhanced activity against clinical and foodborne pathogens has recently been described. We screened a randomized bank of nisin A producers and identified a variant with a serine to glycine change at position 29 (S29G), with enhanced efficacy against S. aureus SA113. Using a site-saturation mutagenesis approach we generated three more derivatives (S29A, S29D and S29E) with enhanced activity against a range of Gram positive drug resistant clinical, veterinary and food pathogens. In addition, a number of the nisin S29 derivatives displayed superior antimicrobial activity to nisin A when assessed against a range of Gram negative food-associated pathogens, including E. coli, Salmonella enterica serovar Typhimurium and Cronobacter sakazakii. This is the first report of derivatives of nisin, or indeed any lantibiotic, with enhanced antimicrobial activity against both Gram positive and Gram negative bacteria.This work was supported by the Irish Government under the National Development Plan, through Science Foundation Ireland Investigator awards (10/IN.1/B3027) and (06/IN.1/B98) (http://www.sfi.ie)