Adult perceptions of mental health access barriers facing youth in rural Washington State: A group concept mapping study.

Purpose: To explore adult community members' perspectives concerning barriers to mental health care that confront rural-dwelling youth.

Methods: Group concept mapping, a participatory community-engaged research method, was used. Adult community members brainstormed and sorted statements describing barriers rural youth encounter in accessing mental health services.

A stepwise external cardioversion protocol for atrial fibrillation to maximize acute success rate.

Aims: Cardioversion is a very commonly performed procedure for persistent atrial fibrillation (AF). However, there is no well-defined protocol to address failed external electrical direct current cardioversion. The aim of the study is to test the efficacy of a pre-defined stepwise cardioversion protocol for patients with persistent AF of ≤12 months.

Residential Satisfaction of Rural Older Adults Aging in Place.

This study explored residential (housing and town) satisfaction of rural older adults aging in place, relating to demographic and housing characteristics. We conducted a structured, face-to-face survey with 149 rural older adults. Regression results revealed that housing satisfaction for rural older adults were significantly related to demographic and housing characteristics, including personal health status, healthy home status, and structure size.

Efficacy of unsupervised exercise in adults with obstructive lung disease: a systematic review and meta-analysis.

Introduction: The benefits of unsupervised exercise programmes in obstructive lung disease are unclear. The aim of this systematic review was to synthesise evidence regarding the efficacy of unsupervised exercise versus non-exercise-based usual care in patients with obstructive lung disease.

Methods: Electronic databases (MEDLINE, CINAHL, Embase, Allied and Complementary Medicine Database, Web of Science, Cochrane Central Register of Controlled Trials and Physiotherapy Evidence Database) and trial registers (ClinicalTrials.

Randomized trial comparing the effectiveness of internal (through implantable cardioverter defibrillator) versus external cardioversion of atrial fibrillation.

Purpose: When patients with implantable cardioverter defibrillators (ICD) develop symptomatic atrial fibrillation (AF), external direct current cardioversion (EDCCV), as well as internal cardioversion using their ICD, are the options available. It is currently unknown which of these two methods are more effective. We compared the effectiveness of EDCCV versus internal cardioversion to terminate AF in patients with a single-coil ICD.

Single incision technique for implantation of subcutaneous implantable cardioverter defibrillators.

Background: Subcutaneous implantable cardioverter defibrillators (S-ICDs) have gained increasing popularity because of certain advantages over transvenous ICDs. However, while conventional ICDs require a single surgical incision to implant, S-ICDS need two or three incisions, making them less appealing.

Objective: This study sought out to investigate the feasibility of using a single-incision technique to implant S-ICDs.

Comparison of Complications of Catheter Ablation for Ventricular Arrhythmias in Adults With Versus Without Structural Heart Disease.

Catheter ablation (CA) is an effective treatment for ventricular arrhythmias (VA), with a potential for complications. The presence of structural heart disease (SHD) is associated with a higher complication rate although there is no data comparing CA of VA between patients with SHD and those without. We aimed to compare trends, morbidity, and mortality associated with real world practice of CA for VA (ventricular tachycardia and premature ventricular contraction) based on the presence of SHD.

Sex differences in complications of catheter ablation for atrial fibrillation: results on 85,977 patients.

Purpose: Catheter ablation (CA) is an effective treatment for atrial fibrillation (AF). The differences in complication rates and outcomes between women and men remain poorly studied. We aimed to study the sex differences in morbidity and mortality associated with CA in AF.

Junctional ectopic rhythm after AVNRT ablation: An underrecognized complication.

Background: Ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). The occurrence of junctional ectopic rhythm (JER), including junctional ectopic tachycardia, following AVNRT ablation has been described as an extremely rare phenomenon, but may be underestimated. We aimed to determine the incidence of JER following AVNRT ablation within our institution, as well as that reported in the literature via an extensive review.

Like Peas and Carrots: Combining Wellness Policy Implementation With Classroom Education for Obesity Prevention in the Childcare Setting.

Objectives: We evaluated an intervention combining policy training and technical assistance for childcare teachers with a nutrition education curriculum to improve (1) the knowledge and self-efficacy of childcare teachers in implementing obesity prevention policies and practices, (2) the quantity and quality of nutrition and physical activity education, and (3) the childcare wellness environment.

Methods: Thirteen teachers and 8 administrators (2 of whom were also teachers) from 8 childcare programs in Clarke County, Georgia, participated in the Healthy Child Care Georgia intervention during June-October 2015. The intervention included (1) training and technical assistance on obesity prevention policies, systems, and practices and (2) direct education by teachers using the Eat Healthy, Be Active curriculum.

Oral factor Xa inhibitors for the treatment of left ventricular thrombus: a case series.

Left ventricular thrombus (LVT) formation usually necessitates short term anticoagulation for thrombus resolution and to prevent embolic events. Historically, vitamin K antagonist therapy has been the treatment of choice. However, with the advent of direct acting anticoagulants, their role in the management of LVT is not clear.

Use of adenosine to shorten the post ablation waiting period for cavotricuspid isthmus-dependent atrial flutter.

Background: Dormant conduction unmasked by adenosine predicts clinical recurrences of cavotricuspid isthmus (CTI) dependent atrial flutter following catheter ablation. Conventional practice involves a waiting period of 20 to 30 minutes after achievement of a bidirectional line of block (BDB) to monitor for recovery of conduction.

Objective: Assess whether abolition of dormant conduction with adenosine immediately after CTI ablation and BDB can predict the lack of CTI conduction recovery during the following 30 minutes.

Acute Effects of Implantable Cardioverter-Defibrillator Shocks on Biomarkers of Myocardial Injury, Apoptosis, Heart Failure, and Systemic Inflammation.

Background: Implantable cardioverter-defibrillator (ICD) shocks are potentially associated with myocardial injury, altered hemodynamics, apoptosis, and inflammatory signaling. Their precise cellular impact can be explored after defibrillation testing (DFT) via biomarkers. We evaluated changes in biomarkers after ICD shocks during DFT.

Solubility and stability of melatonin in propylene glycol and 2-hydroxypropyl-beta-cyclodextrin vehicles.

The physicochemical properties of melatonin (MT) in propylene glycol (PG) and 2-hydroxypropyl-beta-cyclodextrin (2-HPbetaCD) vehicles were characterized. MT was endothermally decomposed as determined by differential scanning calorimetry (DSC). Melting point and heat of fusion obtained were 116.

Batch variation and pharmacokinetics of oral sustained release melatonin-loaded sugar spheres in human subjects.

The three different batches of an oral sustained release melatonin (MT) delivery system were prepared by aqueous-based fluid-bed coating of the sugar spheres for the evaluation ofin vitro release characteristics and plasma concentration profiles in human subjects. The MT contents in 20% coated sugar spheres of three batches (B1, B2 and B3) were 3.3+/-0.

Management of abdominal compartment syndrome in a very low birth weight neonate using Penrose drains and subsequent management of abdominal-wall defects.

Percutaneous drainage of the peritoneal cavity has been recently evaluated for the treatment of perforated viscous in the very low birth weight (VLBW) neonate and percutaneous decompression for abdominal compartment syndrome (ACS) has been studied in older patient populations. This is the first reported case of using this technique to treat ACS in a VLBW neonate.

Microwave modeling and validation in food thawing applications.

Developing temperature fields in frozen cheese sauce undergoing microwave heating were simulated and measured. Two scenarios were investigated: a centric and offset placement on the rotating turntable. Numerical modeling was performed using a dedicated electromagnetic Finite Difference Time Domain (FDTD) module that was two-way coupled to the PHYSICA multiphysics package.

Incidence of delirium and associated mortality in hematopoietic stem cell transplantation patients.

Delirium has been associated with a high risk of mortality in medical patients. Despite the high incidence of delirium in patients who undergo hemapoietic stem cell transplantation (HSCT), delirium as a risk factor for death has not been examined in this population. Thirty adult patients undergoing HSCT who were admitted to the University of Iowa Blood and Marrow Transplantation Program inpatient unit were assessed prospectively from 1 to 2 weeks before transplantation, throughout their inpatient stay, and at 100 days after transplantation.

Receptor activation regulates cortical, but not vesicular localization of NDP kinase.

We used immunofluorescence techniques to determine the localization of nucleoside diphosphate (NDP) kinase in NIH-3T3 fibroblasts. We found that cytoplasmic NDP kinase can be separated into two populations according to subcellular localization and response to extracellular stimuli. Specifically, within minutes of stimulation of resting fibroblasts with serum, growth factors or bombesin, a portion of NDP kinase becomes associated with membrane ruffles and lamellipodia.

Percutaneous absorption and model membrane variations of melatonin in aqueous-based propylene glycol and 2-hydroxypropyl-beta-cyclodextrin vehicles.

Percutaneous absorption and model membrane variations of melatonin (MT) in aqueous-based propylene glycol and 2-hydroxypropyl-beta-cyclodextrin vehicles were investigated. The excised hairless mouse skin (HMS) and two synthetic ethylene vinyl acetate (EVA) and microporous polyethylene (MPE) were selected as a model membrane. The solubility of MT was determined by phase equilibrium study.

Transmucosal, oral controlled-release, and transdermal drug administration in human subjects: a crossover study with melatonin.

The effect of oral controlled-release (CR), oral transmucosal (buccal; TMD) and transdermal (TDD) drug delivery systems on plasma concentrations of melatonin (MT) and its principal metabolite in human subjects using a crossover, single dose design was evaluated. Twelve adult male volunteers participated in the study and received all three dosage forms on three separate occasions. All patch dosage forms were removed after 10 h of wear.

Preliminary evaluation of transdermal delivery of melatonin in human subjects.

A transdermal delivery device (TDD)1 was applied to four human subjects to investigate whether melatonin (MT) could penetrate through human skin. The TDD (total surface area of 3.80 cm2) was applied to the forearm of each subject.

Stability of levodopa in 5% dextrose injection at pH 5 or 6.

The stability of solutions of levodopa 1 mg/mL in 5% dextrose injection adjusted to pH 5 or 6 and stored at one of three temperatures was determined. Solutions were adjusted to pH 5 or 6 with sodium acetate injection or sodium phosphate injection, respectively. Three samples of solution adjusted to pH 5 were stored at each of three temperatures (4, 25, and 45 degrees C), and three samples of solution adjusted to pH 6 were stored at 25 degrees C.

Influence of cimetidine on the disposition of ibuprofen in the rat.

Ibuprofen is a non-steroidal anti-inflammatory agent which is extensively metabolized in both man and the rat. Cimetidine is a well known H2 antagonist which is known to inhibit microsomal enzyme drug metabolism. The influence of cimetidine on the disposition of ibuprofen was studied in Sprague-Dawley rats.

Eleven years of experience with capitation reimbursement for pharmacy services.

Pharmacy services encompass more than dispensing medications. However, traditional pharmacy reimbursement methods are based heavily on the dispensing of medications--i.e.