Evaluation of an Interdisciplinary Curriculum Teaching Team-Based Palliative Care Integration in Oncology.

For students of the health care professions to succeed in today's health care environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work, and chaplaincy students.

Cariprazine exerts antimanic properties and interferes with dopamine D2 receptor β-arrestin interactions.

Activation of dopamine D2 receptors (D2R) modulates G protein/cAMP-dependent signaling and also engages Akt-GSK-3 signaling through D2R/β-arrestin 2 scaffolding of Akt and PP2A. This G protein-independent pathway may be important in mediating the antimanic effects of mood stabilizers and antipsychotics. The mood stabilizer lithium influences behavior and Akt/GSK-3 signaling in mice and many antipsychotics have been shown to more potently antagonize the activity of the β-arrestin-2 pathway relative to the G protein-dependent pathway.

Adherence and assured administration of medications in bipolar patients.

Adherence to treatment is a major determinant of outcome in bipolar disorder. Poor insight, attitudes towards treatment, and poor understanding of medications and the illness can all lead to reduced adherence. Nonadherence and partial adherence both also appear to play a significant role in relapse and recurrence.

Molecular basis of two novel and related high-prevalence antigens in the Kell blood group system, KUCI and KANT, and their serologic and spatial association with K11 and KETI.

Background: The numerous antigens in the Kell blood group system result from missense nucleotide changes in KEL. Antibodies to antigens in this system can be clinically important. We describe six probands whose plasma contained antibodies to high-prevalence Kell antigens and discuss their relationship.

Phase 2 trial of paclitaxel polyglumex with capecitabine for metastatic breast cancer.

Background: Capecitabine and paclitaxel are established effective treatments, alone and combined with other cytotoxic and targeted agents, for metastatic breast cancer (MBC). Paclitaxel polyglumex (a macromolecular conjugate of paclitaxel bound to poly-L-glutamic acid) has potential advantages over conventional paclitaxel, including little alopecia, short infusion time with no premedication, enhanced tumor permeability/retention effect, and improved tolerability. We therefore examined tolerability and efficacy of paclitaxel polyglumex with capecitabine in patients with MBC.

A three-step critical pathway for community-acquired pneumonia reduces duration of hospital stay and intravenous antibiotic use by 2 days.

Implications for practice and research: Although early switch therapy and hospital discharge are well-recognised processes, current practices show that these practices are not well established worldwide. Pathways are useful tools to remind treating physicians about criteria for early switch and discharge. A behavioural change may be necessary in order to decrease the gap between national recommendations and current management of hospitalised patients with community-acquired pneumonia.

Irradiation of donor mononuclear cells for treatment of chemorefractory metastatic solid cancers: a community-based immune transplant pilot study.

Purpose: Chemotherapy has demonstrated ability to generate tumor antigens secondary to induction of apoptosis, against which human leukocyte antigen-compatible, irradiated, related donor mononuclear cells may be administered with immune stimulation to activate antigen presenting and cytotoxic T cells, while minimizing risk of graft-versus-host disease (GVHD). The present study endeavours to describe feasibility and efficacy of this treatment, specifically in the community setting.

Materials And Methods: Eligible patients had rapidly progressive, chemorefractory metastatic solid tumors.

Computed tomographic angiography identification of intramural segments in anomalous coronary arteries with interarterial course.

Certain coronary anomalies are associated with high risk features. We sought to determine the diagnostic accuracy of coronary computed tomographic angiography (CTA) in determining high-risk features, particularly intramural segments. Anomalous coronary arteries can be associated with adverse clinical events.

New opportunities for the management and therapy of hepatitis C in correctional settings.

Hepatitis C in prison populations is now a major public health problem, and large numbers of correctional facilities have no comprehensive management program, often because of formidable projected costs and tightening budget constraints. The North Dakota Department of Corrections and Rehabilitation has operated a management and therapy program since 2002 using consensus interferon and ribavirin with 45% cost savings. The program has provided excellent sustained viral responses: 54.

Pharmacogenetic testing of CYP2D6 in patients with aripiprazole-related extrapyramidal symptoms: a case-control study.

Aripiprazole is primarily metabolized by the polymorphic CYP2D6. We genotyped four children (aged 6-15 years) who had developed extrapyramidal symptoms within 1 week of aripiprazole initiation or dose titration, and four matched children without extrapyramidal symptoms. All of the four children who developed extrapyramidal symptoms with aripiprazole had a dysfunctional CYP2D6 enzyme, based on genotype, and were categorized as either intermediate metabolizers (n = 2) or poor metabolizers (n = 2).

Antidepressant-associated chronic irritable dysphoria (ACID) in STEP-BD patients.

Background: It has been proposed that antidepressants can induce a chronic, dysphoric, irritable state in bipolar patients (called ACID for antidepressant-associated chronic irritable dysphoria). This phenomenon has only been described in case series format, and has not been prospectively validated.

Methods: Prospective data from the first 1500 patients (62.

Comorbid anxiety in bipolar disorder alters treatment and prognosis.

Mood disorders in general, and bipolar disorder in particular, are unique among the psychiatric conditions in that they are associated with extraordinarily high rates of comorbidity with a multitude of psychiatric and medical conditions. Among all the potential comorbidities, co-occurring anxiety disorders stand out due to their very high prevalence. Outcome in bipolar illness is worse in the presence of a comorbid anxiety disorder.

"More on respect for embryos and potentiality: does respect for embryos entail respect for in vitro embryos?".

It is commonly assumed that persons who hold abortions to be generally impermissible must, for the same reasons, be opposed to embryonic stem cell research [ESR]. Yet a settled position against abortion does not necessarily direct one to reject that research. The difference in potentiality between the embryos used in ESR and embryos discussed in the abortion debate can make ESR acceptable even if one holds that abortion is impermissible.

Comparison of incidence of invasive Streptococcus pneumoniae disease among children before and after introduction of conjugated pneumococcal vaccine.

Objectives: The objective was to determine whether there has been a significant decrease in the incidence of invasive Streptococcus pneumoniae disease in the Louisville, KY, area since heptavalent pneumococcal conjugate vaccine was introduced in the winter of 1999-2000. A secondary objective was to collect demographic data regarding invasive S. pneumoniae disease in the Louisville, KY, area during the 1997-2002 period.

State-related thalamic changes during antipsychotic treatment in schizophrenia: preliminary observations.

Thalamic volumes and psychotic symptoms were assessed during psychotic exacerbation and during antipsychotic drug treatment. Reduction of psychotic symptoms (SAPS) during four weeks of treatment was highly correlated with volumetric expansion as measured by magnetic resonance imaging in both left and right thalamus [r(s)=0.75 and r(s)=0.

Facilitating children's grief.

A program of education and support is essential for children and their parent or adult caregivers when the children have experienced the death of a significant person. Children need guidance on how to deal with their profound feelings of grief. The purpose of this article is to give school nurses the ability to help children face the strange new world that follows the death experience.

Using art to express a personal philosophy of nursing.

The authors describe an innovative teaching strategy using art to express personal philosophy of nursing. This teaching strategy gives students and faculty an opportunity to be creative and to express their personal feelings about the nature of nursing.