An Educational Intervention to Enhance Palliative Care Training at HBCUs.

Context: Primary palliative care training is important for clinicians at Historically Black Colleges and Universities (HBCUs) given the decreased access to specialty palliative care among Black patients and patients' preferences for race concordant care.

Objectives: To describe the impact of a palliative care educational intervention at two HBCUs.

Methods: We administered a palliative care educational intervention in family and internal medicine residency programs at Morehouse School of Medicine and Howard University College of Medicine.

Subanesthetic ketamine exerts antidepressant-like effects in adult rats exposed to juvenile stress.

Juvenile stress, like that caused by childhood maltreatment, is a significant risk factor for psychiatric disorders such as depression later in life. Recently, the antidepressant effect of ketamine, a noncompetitive N-methyl-d-aspartate receptor antagonist, has been widely investigated. However, little is known regarding its efficacy against depressive-like alterations caused by juvenile stress, which is clinically relevant in human depression.

The Paradox of Higher Charges for Lower-Risk Inpatient Admissions: When Healthier Patients Cost More.

Risk stratification is essential to achieving the Triple Aim of better health, better care, and lower costs. Although risk tiers based on chronic disease diagnoses and recent healthcare utilization were predictive of healthcare utilization and charges in a managed population, their correlation with specific high-cost outcomes was unknown. More detailed analyses were performed to confirm that admissions for higher-risk patients were more expensive.

Longitudinal Changes in Risk Stratification for a Managed Population.

The LIGHT project managed the care of approximately 10,000 Medicare (primarily elderly) and Medicaid (low income) patients between 2013 and 2015. Risk tiers based on chronic disease diagnoses and recent healthcare utilization were strongly predictive of future healthcare utilization, and the authors expected that the members of an aging and well-insured population would gradually rise in risk of healthcare utilization over the course of three years. Various analytic techniques were used to characterize the members of higher risk tiers.

Repeated fluvoxamine treatment recovers juvenile stress-induced morphological changes and depressive-like behavior in rats.

Human studies have suggested that early life stress such as child abuse could enhance susceptibility to depressive disorders. Moreover, the abnormalities of the prefrontal cortex have been associated with depression. Although clinical studies have implied the negative effects of early life stress on brain development, the causality and the detailed morphogenetic changes has not been clearly elucidated.

Comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units.

Patients hearing command hallucinations to harm whose only self-management strategies are to obey these commands, can represent serious safety concerns on inpatient psychiatric units. A comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units is described that includes five components: suggestions for staff education; patient self-assessment tools; an interview guide and safety protocol; a course to teach strategies for managing distressing voices and commands to harm; suggestions to improve staff communication; and a plan to extend the program from inpatient care settings into the community by sharing materials with community case managers and caregivers when patients are discharged.

Supplementation with pumpkin seed oil improves plasma lipid profile and cardiovascular outcomes of female non-ovariectomized and ovariectomized Sprague-Dawley rats.

Pumpkin (Cucurbita species) seed oil (PSO) is a rich source of phytoestrogens and the aim of this study was to examine the effect of PSO supplementation on the total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides, high density lipoprotein cholesterol (HDL-C), systolic and diastolic blood pressure in non-ovariectomized and ovariectomized Sprague-Dawley rats. Female rats weighing 220-300 g were divided into non-ovariectomized rats for supplementation with corn oil (control CO; n = 6) or PSO (control PSO; n = 5) and ovariectomized rats for supplementation with corn oil (OVX/CO; n = 6) or PSO (OVX/PSO; n = 5) for 5 days per week for 12 weeks (corn oil 40 mg/kg or PSO 40 mg/kg given orally). Systolic and diastolic blood pressures were measured weekly.

Genetic screening protocol for familial hypercholesterolemia which includes splicing defects gives an improved mutation detection rate.

Familial hypercholesterolemia (FH) is a common single gene disorder, which predisposes to coronary artery disease. In a previous study, we have shown that in patients with definite FH around 20% had no identifiable gene defect after screening the entire exon coding area of the low density lipoprotein receptor (LDLR) and testing for the common Apolipoprotein B (ApoB) R3500Q mutation. In this study, we have extended the screen to additional families and have included the non-coding intron splice regions of the gene.

SNPs at the APOA5 gene account for the strong association with hypertriglyceridaemia at the APOA5/A4/C3/A1 locus on chromosome 11q23 in the Northern Irish population.

Serum triglyceride levels (TG) are important independent risk factors for coronary heart disease. The apolipoproteins C-III (apoCIII) and A-V (apoAV) are central to normal TG metabolism and the complete sequence analysis of these genes was carried out in severe cases (TG > 9 mmol/l) and controls (TG < 2 mmol/l). A total of 53 SNPs were identified in these genes with 17 being novel to this study.

Asymmetric dimethyl arginine levels correlate with cardiovascular risk factors in patients with erectile dysfunction.

Background: Erectile dysfunction is related to penile arterial endothelial nitric oxide production. Asymmetric dimethylarginine (ADMA) and E-selectin are often considered plasma markers of endothelial function.

Objective: This study investigated the relationship between these plasma markers and cardiovascular risk factors in patients with erectile dysfunction.

The influence of tissue depth and composition on the performance of the Lunar dual-energy X-ray absorptiometer whole-body scanning mode.

To assess the performance of the Lunar dual-energy X-ray absorptiometer (DPX) whole-body scanning mode (software version 3.1), a simple phantom was devised. This had known but variable amounts of lard to represent fat, and water to represent fat-free tissue.

Comparative performance in vitro and in vivo of Lunar DPX and Hologic QDR-1000 dual energy X-ray absorptiometers.

The measured absolute bone mineral density values of spine and femur and their precision were compared on two dual energy X-ray absorptiometers, the Lunar DPX and the Hologic QDR-1000. There were systematic differences between the two systems, the Lunar DPX always giving a higher bone density value. The ratio of the mean Lunar DPX/Hologic QDR-1000 bone density measurements obtained in vivo was 1.