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Priya Palta G. Page R. L. Piferi J. M. Gill M. J. Hayat A. B. Connolly S. L. Szanton 《Journal of urban health》2012,89(2):308-316
Hypertension affects a large proportion of urban African-American older adults. While there have been great strides in drug
development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction
(MBSR) has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American
older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based
program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based
program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years
old and residents of a low-income senior residence. All participants were African-American, and one was male. Twenty participants
were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood
pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention.
A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood
pressure measurements, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes
were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention
and the outcome variable, blood pressure. Attendance remained >80% in all 8 weeks of both the intervention and the control
groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group
exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this
value was statistically significant (p = 0.020). The average diastolic blood pressure decreased in the intervention group post-intervention, but increased in the
social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared
to the social support group post-intervention, and this value was statistically significant (p = 0.003). Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be
an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study
population are warranted. 相似文献
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Duggal P Haque R Roy S Mondal D Sack RB Farr BM Beaty TH Petri WA 《The Journal of infectious diseases》2004,189(3):520-526
BACKGROUND: The association of antibody responses with both innate and acquired immunity to amebiasis indicate that CD4+ T cells play a role in protection against Entamoeba histolytica infection. To test this hypothesis, we compared the genotype frequencies of human leukocyte antigen (HLA) class II alleles in a cohort of Bangladeshi children intensively monitored for E. histolytica infection for a 3-year period. METHODS: Using logistic regression, we calculated the odds of disease by genotype and by haplotype. RESULTS: The DQB1*0601 heterozygous and homozygous genotypes were found in 55% of E. histolytica-negative children but in only 34% of E. histolytica-positive children (overall odds ratio, 2.39; 95% confidence interval [CI], 1.26-4.54). Children who were heterozygous for the DQB1*0601/DRB1*1501 haplotype were 10.1 times (95% CI, 2.02-50.6) more likely to be both E. histolytica negative and serum anti-lectin immunoglobulin G negative at baseline. Other DQB1 and DRB1 alleles (DQB1*0202, DQB1*0301, and DRB1*0701) were not associated with any of the clinical outcomes related to amebiasis. CONCLUSION: A potential protective association was observed with the HLA class II allele DQB1*0601 and the heterozygous haplotype DQB1*0601/DRB1*1501. This association may explain why amebiasis does not occur in some children who are exposed to the parasite and implicates HLA class II-restricted immune responses in protection against E. histolytica infection. 相似文献
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Lindsey M. Philpot Priya Ramar Muhamad Y. Elrashidi Tiffany A. Sinclair Jon O. Ebbert 《Mayo Clinic proceedings. Mayo Clinic》2018,93(10):1431-1439
Objective
To evaluate the impact of opioid controlled substance agreements (CSAs) enrollment on health care utilization.Patients and Methods
We retrospectively evaluated health care utilization changes among 772 patients receiving long-term opioid therapy for chronic noncancer pain enrolled in a CSA between July 1, 2015, and December 31, 2015. We ascertained patient characteristics and utilization 12 months before and after CSA enrollment. Decreased utilization was defined as a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits. Multivariate modeling assessed demographic characteristics associated with utilization changes.Results
The 772 patients enrolled in an opioid CSA during the study period had a mean ± SD age of 63.5±14.9 years and were predominantly female, white, and married. The CSA enrollment was associated with decreased outpatient primary care visits (odds ratio [OR], 0.16; 95% CI, 0.14-0.19) and increased diagnostic radiology services (OR, 1.22; 95% CI, 1.02-1.47). After CSA enrollment, patients with greater comorbidity (Charlson Comorbidity Index score >3) were more likely to have reduced hospitalizations (adjusted OR, 2.8; 95% CI, 1.3-6.0; P=.008), reduced outpatient primary care visits (adjusted OR, 2.0; 95% CI, 1.2-3.2; P=.005), and reduced specialty care visits (adjusted OR, 2.0; 95% CI, 1.2-3.3; P=.006).Conclusion
For patients receiving long-term opioid therapy for chronic noncancer pain, CSA enrollment is associated with reductions in primary care visits and increased radiologic service utilization. Patients with greater comorbidity were more likely to have reductions in hospitalizations, outpatient primary care visits, and outpatient specialty clinic visits after CSA enrollment. The observational nature of the study does not allow the conclusion that CSA implementation is the primary reason for these observed changes. 相似文献47.
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Nithya?Priya?Soundara RajanEmail authorView authors OrcID profile Ramalingam?Ponnusamy Shivasuriya?Murugesan Suruthi?Gopal Thilagavathy?Ranganathan 《Proceedings of the National Academy of Sciences, India. Section B.》2018,88(3):1025-1032
The aim of the present study was to develop a probioticated cucumber juice by optimizing the concentration of prebiotic (inulin), stevia (Stevia rebudiana) and inoculum (Lactobacillus plantarum) by varying one factor at a time. Cucumber juice with 2% prebiotic had a pH 3.76, acidity 0.239%, total sugars 198.2 μg/mL, reducing sugars 102.3 μg/mL and microbial viability of 1.36 × 108 colony forming units (CFU)/mL, respectively. The juice with 3% stevia had a pH 3.59, acidity 0.388%, total sugars 214 μg/mL, reducing sugars 156.7 μg/mL and microbial viability of 6.7 × 107 CFU/mL, respectively. The juice with 3% inoculum size had a pH 3.82, acidity 0.39%, total sugars 128.3 μg/mL, reducing sugars 198.6 μg/mL and microbial viability of 3.5 × 108 CFU/mL, respectively. Maximum growth of the probiotic (L. plantarum) in the cucumber juice was obtained at the end of 48 h of fermentation for 2% prebiotic, 3% stevia and 3% inoculum size without much changes in nutritional and organoleptic properties. The probiotic strain namely L. plantarum proved its ability and suitability to ferment cucumber juice. The growth of the probiotic in the cucumber juice was found maximum with 2% prebiotic, 3% stevia and 3% inoculum size at the end of 48 h of fermentation with minimal changes in nutritional value and organoleptic characteristics with a good shelf life at 4 °C in polyethylene terephthalate bottles. 相似文献
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On March 28, 2014, The United States Pharmacopeia and The National Formulary (USP-NF) published USP General Chapter <800> Hazardous Drugs–Handling in Healthcare Settings, as open for public comment in the USP Pharmacopeial Forum (PF) 40(3). Pharmacy directors must be proactive in understanding the impact that USP <800> will have on their processes for preparing sterile products. USP General Chapter <797> pertains to the compounding of both hazardous and nonhazardous drugs. USP <800> serves as a new standard to guide the handling of hazardous drugs in order to protect patients, health care personnel, and the environment. USP <800> describes hazardous drug handling related to the receipt, storage, compounding, dispensing, administration, and disposal of both sterile and nonsterile products and preparations. Regardless of all of the requirements listed in USP <800>, there is no substitute for disciplined, consistent work practices regarding proper sterile technique. This point should be emphasized with all compounding personnel. Even if one is compounding in the most compliant USP <800> cleanroom, improper technique can negate all the benefits of the physical structures. Pharmacy leaders at every level will play a key role in assisting an organization to achieve timely compliance with USP <800> standards. Until the standard becomes official, it is important for pharmacists to become familiarized with the latest draft to identify potential barriers to compliance and to strategize a plan to overcome barriers. Although complying with USP <800> may seem to be a daunting task, it can be manageable if approached in a systematic organized way. 相似文献