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991.
Radioactive copper (II) (diacetyl-bis N4-methylthiosemicarbazone) (Cu-ATSM) isotopes were originally developed for the imaging of hypoxia in tumors. Because the decay of a 64Cu atom is emitting not only positrons but also Auger electrons, this radionuclide has great potential as a theranostic agent. However, the success of 64Cu-ATSM internal radiation therapy would depend on the contribution of Auger electrons to tumor cell killing. Therefore, we designed a cell culture system to define the contributions to cell death from Auger electrons to support or refute our hypothesis that the majority of cell death from 64Cu-ATSM is a result of high-LET Auger electrons and not positrons or other low-LET radiation. Chinese hamster ovary (CHO) wild type and DNA repair–deficient xrs5 cells were exposed to 64Cu-ATSM during hypoxic conditions. Surviving fractions were compared with those surviving gamma-radiation, low-LET hadron radiation, and high-LET heavy ion exposure. The ratio of the D10 values (doses required to achieve 10% cell survival) between CHO wild type and xrs5 cells suggested that 64Cu-ATSM toxicity is similar to that of high-LET Carbon ion radiation (70 keV/μm). γH2AX foci assays confirmed DNA double-strand breaks and cluster damage by high-LET Auger electrons from 64Cu decay, and complex types of chromosomal aberrations typical of high-LET radiation were observed after 64Cu-ATSM exposure. The majority of cell death was caused by high-LET radiation. This work provides strong evidence that 64Cu-ATSM damages DNA via high-LET Auger electrons, supporting further study and consideration of 64Cu-ATSM as a cancer treatment modality for hypoxic tumors.  相似文献   
992.
The purpose of this study was to better understand if a health educational presentation using culturally adapted materials was understandable and culturally appropriate, and that the content was retained, in an older Vietnamese American population. This study used cognitive interviewing. A convenient sampling was used to recruit eight participants by staff of a community-based organization from its client base. This is the first study to document that family eating style poses a challenge for estimating food intake among Vietnamese Americans. Participants who ate in a family eating style were not able to recall or estimate the number of servings of protein and vegetables. Some older Vietnamese Americans used food for healing and self-adjusted portion sizes from dietary recommendations. Cognitive interviewing is a useful method to improve comprehension, retention, and cultural appropriateness of health educational materials. Further nutrition research concerning intake measurement in ethnic groups that practice a family eating style is warranted.  相似文献   
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Objective

To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.

Patients and Methods

Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity.

Results

At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA.

Conclusion

Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling.  相似文献   
996.

Objective

To evaluate outcomes following a state-wide implementation of post arthroplasty review (PAR) clinics for patients following total hip and knee arthroplasty, led by advanced musculoskeletal physiotherapists in collaboration with orthopaedic specialists.

Design and setting

A prospective observational study analysed data collected by 10 implementation sites (five metropolitan and five regional/rural centres) between September 2014 and June 2015.

Main outcome measures

The Victorian Innovation and Reform Impact Assessment Framework was used to assess efficiency, effectiveness (access to care, safety and quality, workforce capacity, utilisation of skill sets, patient and workforce satisfaction) and sustainability (stakeholder engagement, succession planning and availability of ongoing funding).

Results

2362 planned occasions of service (OOS) were provided for 2057 patients. Reduced patient wait times from referral to appointment were recorded and no adverse events occurred. Average cost savings across 10 sites was AUD$38 per OOS (Baseline $63, PAR clinic $35), representing a reduced pathway cost of 44%. Average annual predicted total value of increased orthopaedic specialist capacity was $11,950 per PAR clinic (range $6149 to $23,400). The Australian Orthopaedic Association review guidelines were met (8/10 sites, 80%) and patient-reported outcome measures were introduced as routine clinical care. High workforce and patient satisfaction were expressed. Eighteen physiotherapists were trained creating a sustainable workforce. Eight sites secured ongoing funding.

Conclusions

The PAR clinics delivered a safe, cost-efficient model of care that improved patient access and quality of care compared to traditional specialist-led workforce models.  相似文献   
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Background

Nurses’ modifiable lifestyles have important health-related consequences.

Purpose

To examine the literature on U.S. hospital nurses’ activity, diet, and health outcomes of cardiovascular disease (CVD) risks and health-related quality of life (HRQOL).

Method

A systematic review using of the literature from June 2006 to June 2016 resulted in 13 studies on U.S. hospital nurses’ diet, physical activity and CVD and HRQOL outcomes. Methodological rigor was assessed using Cummings et al., adapted quality rating tool.

Discussion

Nurses are at risk for poor health outcomes due to inadequate physical activity (60%–74%) and eating a poor quality diet (53%–61%). Fewer than 5% of U.S. nurses engage in five healthy lifestyle behaviors (diet, activity, no tobacco, alcohol, and weight). Adequate physical activity contributes to better HRQOL and a healthy diet reduces CVD risks (hypertension, diabetes mellitus, obesity, stroke).

Conclusions

Nurses’ inactivity and poor diet increases risks for CVD and diminished HRQOL.  相似文献   
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