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31.
Robert J. Buchanan PhD ; Jane Bolin RN JD PhD ; Suojin Wang PhD ; Li Zhu PhD ; MyungSuk Kim MS 《The Journal of rural health》2004,20(2):131-135
CONTEXT: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. PURPOSE: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural areas. METHODS: A total of 551,208 admission assessments in the Minimum Data Set were analyzed for all residents admitted to a nursing facility in 2001. Using the Rural Urban Commuting Areas (RUCA) methodology and ZIP code of primary residence before admission, these residents were classified into 4 urban/rural areas. FINDINGS: Residents from rural areas were significantly more likely to have executed a durable power of attorney for health care or for financial decisions than residents admitted from the other areas, with the largest differences observed between residents admitted from urban and rural areas. Almost 6 residents in 10 from urban areas had no advance directives in place at admission compared with only 4 residents in 10 admitted from rural areas. CONCLUSIONS: Health providers and social workers in both rural and urban areas should advise patients about the value of advance directives. 相似文献
32.
Zhang JD Cao YB Xu Z Sun HH An MM Yan L Chen HS Gao PH Wang Y Jia XM Jiang YY 《第二军医大学学报》2006,27(6):664-664
Antifungal activity of natural products is being studied widely. Saponins are known to be antifungal and antibacterial. We have isolated eight steroid saponins from Tribulus terrestris L. , namely TTS-8, TTS-9, TTS-10, TTS-11, TTS-12, TTS-13, TTS-14 and TTS-15. TTS-12 and TTS-15 were identified as tigogenin-3-O-β-D-xylopyranosyl(1→ 2)-[-β-D-xylopyranosyl( 1 → 3 ) 3-β- D-glucopyranosyl ( 1 → 4 )- 1- α-L-rhamnopyranosyl ( 1 → 2 ) 3-β-D-galactopyranoside and tigogenin-3-O-β-D-glucopyranpyranosyl(1→2)-[-β-D-xylopyranosyl(1→ 3)3-β-D-glucopyranosyl(1→4)-β-D-galactopyranoside, respectively. The in vitro antifungal activities of the eight saponins against six fluconazole-resistant yeasts, Candida albicans, Candida glabrata, Candida para psilosis , Candida tropicalis , Candida krusei , and Cryptococcus neo f ormans were studied using microbroth dilution assay. The results showed that TTS-12 and TTS-15 were very effective against several pathogenic candidal species and C. neoformans in vitro. It is noteworthy that TTS-12 and TTS-15 were very active against fluconazole-resistant C. albicans (MIC80 = 4.4, 9.4 mg/ml), C. neoformans (MIC80 =10.7, 18.7 mg/ml) and inherently resistant C. krusei (MIC80 =8.8, 18.4 mg/ml). So in vivo activity of TTS-12 in a vaginal infection model with fluconazole-resistant C. albicans was studied in particular. Our studies revealed TTS-12 also showed in vivo activities against fluconazole-resistant yeasts. In conclusion, steroid saponins TTS-12 and TTS-15 from Tribulus terrestris L. have significant in vitro antifungal activity against fluconazole-resistant fungi, especially TTS-12 also showed in vivo activity against fluconazole-resistant C. albicans. 相似文献
33.
Buprenorphine is considered one of the most effective treatments for opioid use disorder and significantly reduces risk of overdose death. However, concerns about its diversion and misuse have often taken center stage in public discourse and in the design of practices and policies regarding its use. This has been to the detriment of many vulnerable patient populations, especially those involved in the criminal justice system. Policies that restrict access to buprenorphine in criminal justice and other settings due to concerns of diversion do not accurately reflect the relative risks and safety profile associated with it, creating unnecessary barriers that drive an illicit market of this much-needed medication. Although proper regulation of all controlled medications should be a priority, in most instances the benefits of buprenorphine highly outweigh its risks. In the midst of a national crisis, efforts should be focused on expanding, and not restricting, access to this lifesaving treatment. 相似文献
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CJ Stewart ECL Marrs S Magorrian A Nelson C Lanyon JD Perry ND Embleton SP Cummings JE Berrington 《Acta paediatrica (Oslo, Norway : 1992)》2012,101(11):1121-1127
Aim: To describe gut colonization in preterm infants using standard culture and 16S gene rRNA profiling, exploring differences in healthy infants and those who developed NEC/late onset sepsis (LOS). Methods: Ninety‐nine stools from 38 infants of median 27‐week gestation were cultured; 44 stools from 27 infants had their microbial profiles determined by 16S. Ordination analyses explored effects of patient variables on gut communities. Results: Standard microbiological culture identified a mean of two organisms (range 0–7), DGGE 12 (range 3–18) per patient. Enterococcus faecalis and coagulase negative staphylococci (CONS) were most common by culture (40% and 39% of specimens). Meconium was not sterile. No fungi were cultured. Bacterial community structures in infants with NEC and LOS differed from healthy infants. Infants who developed NEC carried more CONS (45% vs 30%) and less Enterococcus faecalis (31% vs 57%). 16S identified Enterobacter and Staphylococcus presence associated with NEC/LOS, respectively. Conclusions: Important differences were found in the gut microbiota of preterm infants who develop NEC/LOS. The relationship of these changes to current practices in neonatal intensive care requires further exploration. 相似文献
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39.
A diaper bank and home visiting partnership: Initial exploration of research and policy questions 下载免费PDF全文
40.
Global profiling of Shewanella oneidensis MR-1: expression of hypothetical genes and improved functional annotations 总被引:1,自引:0,他引:1 下载免费PDF全文
Kolker E Picone AF Galperin MY Romine MF Higdon R Makarova KS Kolker N Anderson GA Qiu X Auberry KJ Babnigg G Beliaev AS Edlefsen P Elias DA Gorby YA Holzman T Klappenbach JA Konstantinidis KT Land ML Lipton MS McCue LA Monroe M Pasa-Tolic L Pinchuk G Purvine S Serres MH Tsapin S Zakrajsek BA Zhu W Zhou J Larimer FW Lawrence CE Riley M Collart FR Yates JR Smith RD Giometti CS Nealson KH Fredrickson JK Tiedje JM 《Proceedings of the National Academy of Sciences of the United States of America》2005,102(6):2099-2104