Women supporting women: Supportive/educative groups for ethnically diverse,urban, impoverished women dealing with depression and anxiety

Depression and anxiety are mental health issues that disproportionately affect urban, ethnically diverse, impoverished women. Using community based participatory research and in the context of long-term partnerships between a nursing department and underserved neighborhoods that are predominately Black, Hispanic, and White respectively, supportive/educative groups were offered. The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. Seventy-two women aged 17–88?years participated. Repeated measures ANOVA indicated a significant increase in knowledge for self-care for depression and anxiety and a significant decrease in anxiety and depression symptomatology from before to after the group sessions.     

An uncommon cause of dyspnea in the emergency department

Chest pain and shortness of breath are chief complaints frequently evaluated in the emergency department. ACS, pulmonary embolism, and disorders involving the lung parenchyma are some of the disease processes commonly screened for. Occasionally, patients presenting with histories and clinical exams consistent with these common illnesses may end up having more rare pathology. We present the case of a young patient who presented with chest pain and dyspnea with ECG changes and history concerning for pulmonary embolism who was ultimately diagnosed with idiopathic primary pulmonary hypertension. The importance of a prompt diagnosis of this condition along with emergency department management of complications related to the disease is discussed in this report.     

Travel Distance and Home Dialysis Rates in the United States

♦ Introduction: Rural residence is associated with increased peritoneal dialysis (PD) utilization. The influence of travel distance on rates of home dialysis utilization has not been examined in the United States. The purpose of this study was to determine whether travel distances to the closest home and in-center hemodialysis (IHD) facilities are a barrier to home dialysis.♦ Methods: This was a retrospective cohort study of patients aged ≥ 18 years initiating dialysis between 2005 and 2011. Unadjusted PD and home hemodialysis (HHD) rates were compared by travel distances to both the closest home dialysis and closest IHD facilities. Adjusted PD and HHD utilization rates were examined using multivariable logistic regression models.♦ Results: There were 98,608 patients in the adjusted analyses. 55.5% of the dialysis facilities offered home dialysis. IHD, PD and HHD patients traveled median distances of 5.4, 3.5 and 6.6 miles respectively to their initial dialysis facilities. Unadjusted analyses showed an increase in PD rates and decrease in HHD rates with increased travel distances. Adjusted odds of PD and HHD were 1.6 and 1.2 respectively for a ten mile increase in distance to the closest home dialysis facility, while for distances to the closest IHD facility the odds ratios for both PD and HHD were 0.7 (all p < 0.01).♦ Conclusions: In metropolitan areas, PD and HHD generally increased with increased travel distance to the closest home dialysis facility and decreased with greater distance to an IHD facility. Examination of travel distances to PD and HHD facilities separately may provide further insight on specific barriers to these modalities which can serve as targets for future studies examining expansion of home dialysis utilization.     

Microsatellite markers for Longfin Dace, Agosia chrysogaster, a sentinel fish species in imperiled arid-land rivers of the Sonoran Desert

We isolated and characterized 16 microsatellite DNA loci in Longfin Dace, Agosia chrysogaster, a minnow native to Sonoran Desert streams (southwestern US and northwestern Mexico). After optimization, all primer pairs produced consistently scorable products. Genetic diversity metrics were determined for each locus using 50 individuals from two populations in the Gila River basin, New Mexico. Allelic richness ranged from 2 to 37 and observed heterozygosity ranged from 0.08 to 0.95 across loci. These microsatellites offer a powerful tool to study effects of habitat fragmentation, dewatering, and climate change on population connectivity and genetic diversity in this species. Moreover, Longfin Dace co-occurs with more geographically restricted and endangered desert fish species. Genetic information for Longfin Dace could provide an important comparative dataset to assist conservation and management of other imperiled fishes in the region.     

An examination of low distress tolerance and life stressors as factors underlying obsessions

A growing body of research has linked poor distress tolerance (DT) to obsessions, but not other OC symptom domains. However, limited research has been conducted with clinical samples. Further, there is a dearth of research regarding the moderating influence of DT on the contribution of stress to OC symptoms. In Study 1, we sought to test the specificity of the link between poor DT and greater obsessions relative to other OC symptom domains in a clinical sample. In Study 2, we conducted a longitudinal investigation with a non-clinical sample examining DT and daily stressors in the prediction of daily obsessions. For Study 1, 22 outpatients with an OCD diagnosis and 37 healthy controls completed measures of DT, depression, and OC symptoms. For Study 2, 102 undergraduates completed measures of DT at baseline and daily assessments of OC symptoms and stressors twice weekly for one-month. In Study 1, OCD diagnosis was not a significant predictor of DT, though greater obsessions, but not other OC symptoms, were uniquely associated with lower DT. In Study 2, lower baseline DT predicted greater daily obsessions among those experiencing greater daily negative life events, though this relationship was absent among those with elevated DT. The specific association between DT and obsessions was replicated in a clinical sample. Further, results suggest that low DT increases obsessions in the context of life stress.     

The posttraumatic stiff elbow: an update

Posttraumatic elbow stiffness is a disabling condition that remains challenging to treat despite improvement of our understanding of the pathogenesis of posttraumatic contractures and new treatment regimens. This review provides an update and overview of the etiology of posttraumatic elbow stiffness, its classification, evaluation, nonoperative and operative treatment, and postoperative management.