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The Impact of Managed Care on the Practice of Occupational Therapy by Hand Therapists

Current Occupational Therapy (OT) literature on managed care is limited to opinion or anecdotal experience. Questionnaires were mailed to 214 OTs practicing as hand therapists nationwide to test the null hypothesis that there was no difference in reimbursement or barriers to practice for OT services between patients enrolled in managed care organizations and those enrolled in fee-for-service insurance plans. Statistically significant results were obtained indicating greater barriers to reimbursement for OT under managed care. The primary effect has been the increased administrative demands it places on both therapists and patients. [Article copies available for a fee from The Haworth Document Delivery Service: 1–800–342–9678. E-mail address: getinfo@haworth.com]     

N-acetylcysteine attenuates renal alterations induced by senescence in the rat

The aim of this study was to evaluate the effects of N-acetylcysteine (NAC) on renal function, as well as on sodium and water transporters, in the kidneys of aged rats. Normal, 8-month-old male Wistar rats were treated (n = 6) or not (n = 6) with NAC (600 mg/L in drinking water) and followed for 16 months. At the end of the follow-up period, we determined inulin clearance, serum thiobarbituric acid reactive substances (TBARS), serum cholesterol, and urinary phosphate excretion. In addition, we performed immunohistochemical staining for p53 and for ED-1-positive cells (macrophages/monocytes), together with Western blotting of kidney tissue for NKCC2, aquaporin 2 (AQP2), urea transporter A1 (UT-A1) and Klotho protein. At baseline, the two groups were similar in terms of creatinine clearance, proteinuria, cholesterol, and TBARS. At the end of the follow-up period, NAC-treated rats presented greater inulin clearance and reduced proteinuria, as well as lower serum cholesterol, serum TBARS, and urinary phosphate excretion, in comparison with untreated rats. In addition, NAC-treated rats showed upregulated expression of NKCC2, AQP2, and UT-A1; elevated Klotho protein expression, low p53 expression, and few ED-1 positive cells. In conclusion, we attribute these beneficial effects of NAC (the significant improvements in inulin clearance and in the expression of NKCC2, AQP2, and UT-A1) to its ability to decrease oxidative stress, inhibit p53 expression, minimize kidney inflammation, and stimulate Klotho expression.     

The Influence of Aging on Angiotensinogen Production By Rat Vascular Smooth Muscle Cells in Vitro

Aortic smooth muscle cells from 3,12 and 24 mo old rats were grown in cell culture. All of the cultures produced angiotensinogen, but cultures from 24 mo old rats produced significantly more (p<0.01). These results suggest that angiotensinogen is synthesized in arterial smooth muscle. Furthermore, when the activity of the plasma renin system decreases with advancing age, increased activity of a local angiotensin system may contribute to the regulation of vascular tone.     

Catalpol improves cholinergic function and reduces inflammatory cytokines in the senescent mice induced by d-galactose

The neuroprotective effects of catalpol, an iridoid glycoside isolated from the fresh rehmannia roots, on the cholinergic system and inflammatory cytokines in the senescent mice brain induced by d-galactose were assessed. The results showed that acetylcholinesterase (AChE) activity increased in senescent mice brain and choline acetyltransferase (ChAT) positive neurons, detected by immunohistochemical staining, decreased remarkably in the basal forebrain of senescent mice. Simultaneously, muscarinic acetylcholine receptor M1 (mAChR1) expression declined in senescent mice brain by western blotting method. We also found that the contents of tumor necrosis factor (TNF-α), interleukin-1β (IL-1β) and advanced glycation endproducts (AGEs) increased in senescent mice brain by ELISA method. However, administration of catalpol for 2-weeks significantly reversed the biochemical markers mentioned above. These results suggest that catalpol can exert protective effects on senescent mice brain induced by d-galactose and this effect may be due to its protective effects on cholinergic and immune impairment in mice brain. Thus catalpol is worth testing for further preclinical study aimed for senescence or neurodegenerative diseases such as Alzheimer’s disease.     

某院47名护士长高危药物外渗相关态度技能认知调查分析

目的了解护士长对高危药物外渗态度技能知识掌握情况,为加强高危药物的风险管理提供依据,促进护理持续质量改进.方法采用自制高危药物外渗相关态度技能知识调查问卷对暨南大学附属第一医院47名护士长进行调查评定,调查内容包括高危药物外渗相关态度、技能和知识3个维度,采用SPSS 16.0统计软件进行系统描述分析.结果关于高危药物外渗态度、技能、知识的平均正确率分别为99%、75%、23%;加权后总体平均正确率为70%.不同年龄、学历、职称、工作年限的护士长问卷总体平均正确率差异均无统计学意义(P>0.05).结论护士长在高危药物外渗态度方面掌握较好,在技能和知识方面存在欠缺.作为风险管理者和质量控制者,护士长应同时重视处理高危药物外渗技能和知识方面的提高.     

本科实习护生患者安全态度及影响因素的调查分析

目的 调查本科实习护生的患者安全态度现状,并分析影响因素,为开展患者安全教育提供参考.方法 采用中文版安全态度问卷(C-SAQ)对重庆市某医学院校的225名本科实习护生进行问卷调查,采用SPSS 20.0软件进行数据分析.结果 实习护生患者安全态度总均分为(3.75±0.54)分,安全态度6个维度的平均分由高到低依次为...     

Changes in muscarinic acetylcholine receptors in guinea-pig lung: Effects of aging,inhalation of an allergen,administration of drugs,and vagotomy

This study was undertaken to investigate the effects of aging; inhalation of Konjak-Maiko, a typical Japanese allergen; administration of various drugs; and unilateral cervical vagotomy on muscarinic acetylcholine receptors (MAchR) in guinea-pig lung. We assessed the characteristics of MAchR by determining the affinity and the density of MAchR using [³H]quinuclidinyl benzilate, a potent muscarinic antagonist. A significant decrease in the density of MAchR was observed at 6 months of age and this decrease became more prominent until 2 years of age. No significant change in the affinity of MAchR was noted through the experimental period. Inhalation of Konjak-Maiko (60 min/day, for 10 days) did not affect either the affinity or the density of the receptors. Administration of ipratropium bromide (0.1 mg/kg/day, for 10 days) or prednisolone acetate (2 mg/kg/day, for 7 days) did not affect the characteristics of the receptors. In contrast to these drugs, diisopropyl fluorophosphate, an irreversible acetylcholinesterase inhibitor, produced a 26% reduction in the density without affecting the affinity of the receptors. The right cervical vagotomy increased the density of MAchR in the right lung by 17% without affecting the affinity of MAchR. These results suggest that the density of MAchR in lung may be controlled by changes in the activity of the receptors.