Background
African American (AA) caregivers of patients with Alzheimer’s disease (AD) and related disorders can play a critical role in maintaining patient health. The Maya Angelou Center for Health ...Equity at Wake Forest University School of Medicine Caregiver College (MC2) aims to (1) improve informal caregivers’ knowledge of AD and related disorders, (2) enhance the quality of life for AD patients and caregiver’s by providing awareness of and access to resources that can help reduce caregiver burden, (3) provide strategies to effectively manage patient symptoms associated with AD, and (4) fill gaps in culturally relevant health education and awareness on AD, brain health, and dementia caregiving skills for AAs.
Method
The 40‐hour inaugural session of MC2 was conducted in‐person in October 2022. Educational sessions were facilitated by experts in various fields including AD, social work, nursing, aging, nutrition, and pharmacy. Topics covered over the course of the educational week included: Alzheimer’s Disease Overview, Health Disparities in AAs, Risk Factors for AD, End of Life Planning, and Caregiver Health. The 21‐item Dementia Knowledge Assessment Tool (DKAT), version 2 (Toye, et al. 2013) was used to track changes in AD knowledge and awareness. A DKAT pre‐test was administered before the educational sessions began on Day 1, and a post‐test assessment was administered at the end of the last educational session on Day 5.
Result
Attendees (N = 21) are African American (100%), primarily female (90.48%), with an average age of 66.8 years (range 42‐82 years, 1 missing value). DKAT assessments from the week‐long educational training, showed an 8% increase in knowledge about AD in this sample of dementia caregivers based on a 5.7 percentage point increase on the DKAT from an average of 71.4% correct pre‐training to an average of 77.1% correct post‐training.
Conclusion
Findings suggest that community‐based educational training is a useful strategy for improving AD knowledge and resource awareness for AA informal caregivers. Results will be used to expand this training to include community members who will be engaged through presentations by attendees of the MC2.
A panel of monoclonal antibodies (MAbs) has been identified which may be useful in detecting SCLC tumour cells and which does not cross-react significantly with normal marrow elements. Compared with ...conventional techniques this MAb panel markedly increases detection of micrometastases in the bone marrow especially in limited disease and post-chemotherapy in responding patients. There is a close correlation between immunological positivity and the ability to grow SCLC-like cells for variable periods in serum-free culture. In 4 cases SCLC-like cells have been characterized by electron microscopy or by the establishment of SCLC cell lines in continuous culture. The prognostic importance of pre-treatment detection of marrow involvement is unknown. The implications of post-chemotherapy detection of micrometastases are also uncertain but there may be an association with early systemic relapse which may occur regardless of intervention, including high dose intensification with autologous marrow rescue with primary site and CNS prophylactic irradiation.
Timeout from auditory reinforcement was employed to reduce rates of target responses of two mentally retarded children (9 and 11 years old). Results supported the response deceleration characteristic ...of timeout from auditory reinforcement and indicated its effectiveness as a response reduction technique. (Author)
Twenty broiler chickens were fed 80 g/T salinomycin, an antibiotic produced by Streptomyces albus, and 20 birds were fed a control, unmedicated feed. The birds were experimentally infected with ...Salmonella typhimurium. The study evaluated the effects of salinomycin on Salmonella incidence, shedding, and antimicrobial resistance. Salinomycin had no effect on body weights, length of time salmonellae were shed, number of salmonellae shed on postdosing day 3, salmonellae tissue recoverability, or on the total number of resistance patterns. Salinomycin caused the decline of salmonellae to be more gradual; however, both treatments were comparable at the end of the study. The majority of isolated from birds receiving salinomycin maintained the original S. typhimurium antibiogram of streptomycin, sulfadiazine, and nalidixic acid. The salinomycin salmonellae were more susceptible to tetracycline, amikacin, carbenicillin, gentamicin, and cephalothin. The multiple resistance patterns of eight and nine drugs tended to be more prevalent among salmonellae from control birds than salinomycin treated birds. The antibiotic salinomycin appears to be an acceptable feed additive in broilers at the level of 80 g/T based on these results of its effects on salmonellae shedding and antimicrobial resistance.
But with long-term bond prices at lofty levels, interest rates at their lowest since the Treasury began selling 30-year bonds in 1977, and stock prices near record highs, early evidence of renewed ...growth seemed like the last thing investors wanted to see last week. To some it conjured up visions of tight supplies of goods and services, rising prices, and a Federal Reserve only too willing to fight inflation by raising interest rates to slow an overheating economy. But if you were one of the worried ones last week, perhaps you should relax a bit. Few experts believe that any of the visions of doom are likely to come to pass anytime soon. Most say economic growth may improve, but it is unlikely to be robust by any measure. Inflation isn't an issue; there are too many restraints to prevent prices from rising sharply. That means that the Fed isn't apt to take steps to restrain the economy, that interest rates will probably remain at long-term lows and that the stock market may have room to post further gains. And even those who sold in fear can't be blamed for acting hastily. After all, they have had the familiar pattern of recession giving way to recovery followed by inflation and high interest rates drummed into them for the past three decades. Even as the economy emerged from its latest recession in fits and starts, nervous investors kept their fingers on the trigger, ready to jump ship at the slightest hint of inflation. Only after two years of recovery marked by declining inflation did caution finally give way to mild euphoria and this year's bond-market rally. That rally drove longterm interest rates to a low of 5.79% last month and, some say, set the stage for last week's sharp retreat, in which the yield on the benchmark 30-year bond rose to 6.20% on Friday.
But with long-term bond prices at lofty levels, interest rates at their lowest since the U.S. Treasury began selling 30-year bonds in 1977, and stock prices near record highs, early evidence of ...renewed growth seemed like the last thing investors wanted to see last week. To some it conjured visions of tight supplies of goods and services, rising prices, and a Federal Reserve only too willing to fight inflation by raising interest rates to slow the overheating economy. But if you were one of the worried ones in the U.S. last week, perhaps you should relax a bit. Few experts believe that any of the prevailing visions of doom are likely to come to pass anytime soon. Most say economic growth may improve, but it is unlikely to be robust by any measure. Inflation isn't an issue; there are too many restraints to prevent prices from rising sharply. That means the Fed is unlikely to take steps to restrain the economy, that interest rates will probably remain at long-term lows and that the stock market may have room to post further gains. And even those who sold in fear can't be blamed for acting hastily. After all, they have had the familiar pattern of recession giving way to recovery followed by inflation and high interest rates drummed into them for the past three decades. Even as the economy emerged from its latest recession in fits and starts, nervous investors kept their fingers on the trigger, ready to jump ship at the slightest hint of inflation. Only after two years of recovery marked by declining inflation did caution finally give way to mild euphoria and this year's bond-market rally. That rally drove longterm interest rates to a low of 5.79% last month and, some say, set the stage for last week's sharp retreat.
•As of May 27, 2020 there are over 1,678,843 confirmed cases of COVID-19 claiming more than 100,000 lives in the Unites States. Currently there is no known effective therapy or vaccine.•According to ...a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.•Findings of this observational study provide crucial data on experience with hydroxychloroquine therapy, providing necessary interim guidance for COVID-19 therapeutic practice.
The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies.
The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19.
Multi-center retrospective observational study.
The Henry Ford Health System (HFHS) in Southeast Michigan: large six hospital integrated health system; the largest of hospitals is an 802-bed quaternary academic teaching hospital in urban Detroit, Michigan.
Consecutive patients hospitalized with a COVID-related admission in the health system from March 10, 2020 to May 2, 2020 were included. Only the first admission was included for patients with multiple admissions. All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48h unless expired within 24h.
Receipt of hydroxychloroquine alone, hydroxychloroquine in combination with azithromycin, azithromycin alone, or neither.
The primary outcome was in-hospital mortality.
Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4–10 days), median age was 64 years (IQR:53–76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3–53). Overall in-hospital mortality was 18.1% (95% CI:16.6%–19.7%); by treatment: hydroxychloroquine+azithromycin, 157/783 (20.1% 95% CI: 17.3%–23.0%), hydroxychloroquine alone, 162/1202 (13.5% 95% CI: 11.6%–15.5%), azithromycin alone, 33/147 (22.4% 95% CI: 16.0%–30.1%), and neither drug, 108/409 (26.4% 95% CI: 22.2%–31.0%). Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 95% CI:1.9–3.3), white race (HR:1.7 95% CI:1.4–2.1), CKD (HR:1.7 95%CI:1.4–2.1), reduced O2 saturation level on admission (HR:1.5 95%CI:1.1–2.1), and ventilator use during admission (HR: 2.2 95%CI:1.4–3.3). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine+azithromycin 71% compared to neither treatment (p<0.001).
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.
PDF
