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The purpose of this study was to explore the predictive relationships between cultural belief and stage of change and mammography adherence in low-income Midwestern African American urban women (N = 321). Secondary analysis of questionnaire data measuring religiosity, racial pride, family collectivism, future and present time orientation, and stage of mammography screening adoption was conducted. Religiosity (OR = 1.12; p = .002) and future time orientation (OR = 1.12; p = .05) predicted mammography adherence with a positive association, while present time orientation (OR = 0.91; p = .05) was significantly negatively associated. Religiosity (OR = 1.11; p = .002) and future time orientation (OR = 1.12; p = .05) were positive predictions of stage progression, whereas present time orientation (OR = 0.90; p = .03) had a significant negative relationship. By identifying cultural variables that are related to mammography adherence in African American women, mammography-promoting interventions can be more effectively tailored. [ABSTRACT FROM AUTHOR]

Purpose: This study measured the effect of demographic and clinical characteristics on health and cultural beliefs related to mammography.Design: Cross-sectional study.Setting: Interviews were conducted during 2003 and 2004 in a Midwestern urban area.Subjects: Subjects were 344 low-income African-American women 40 years and older who had not had mammography within the previous 18 months.Measures: The instrument measured personal characteristics, belief and knowledge scales, and participants' mammography experience and plans.Analysis: Multiple regression analysis assessed the effect of specific demographic and clinical characteristics on each of the scale values and on subjects' stages of readiness to change.Results: The subjects' levels of education significantly affected six of the 12 belief and knowledge scales. Higher-educated women felt less susceptible to breast cancer, had higher self-efficacy, had less fear, had lower fatalism scores, were less likely to be present-time oriented, and were more knowledgeable about breast cancer. Older women felt they were less susceptible to breast cancer, had higher fatalism scores, were more present-time oriented, and were less knowledgeable about breast cancer.Conclusions: The findings suggest that mammography promotion programs for African-Americans should consider the education levels and ages of the target women to be most effective. [ABSTRACT FROM AUTHOR]

In 2012 and 2014 the author was a consultant to law enforcement regarding crime scenes of a ritualistic nature in the American Southeast. These ritual activities were expressions of folk magic spells linked to certain West African traditions. These spells were used for magico-religious, curative, and 'justice' (i.e. revenge) practices known as hoodoo, conjure or rootwork . The ritual activities were conducted at gravesites in a public cemetery. When standard investigative police procedures failed to produce anything substantive with which to solve, prevent, or even understand the motive beyond one of 'vandalism,' or 'kids fooling around,' the author was approached to contribute forensic archaeological and anthropological insights that had thus far proved elusive. This article is an examination of how cultural anthropological understanding and a forensic archaeological "eye" to an outdoor crime scene can re-define crime scene investigative methodology and interpretation., Competing Interests: None., (© 2019 The Author(s).)

Mercury concentrations were measured in eggs, larvae, and adult spawning-phase sea lampreys (Petromyzon marinus) collected in tributaries of Lake Superior to investigate spatial and ontogenetic variation. There were significant differences in mercury concentrations between all three life stages, with levels highest in adults (mean = 3.01 µg/g), followed by eggs (mean = 0.942 µg/g), and lowest in larvae (mean = 0.455 µg/g). There were no significant differences in mercury concentrations by location for any life stage or by sex in adults. Mercury was not correlated with adult or larval lamprey length or mass. Mercury levels in adult lampreys exceeded U.S. and Canadian federal guidelines for human consumption. Mercury concentrations in all life stages exceeded criteria for the protection of piscivorous wildlife, posing a threat to local fish, birds, and mammals. High mercury levels in adult lampreys combined with their semelparous life history make them a potential source of lake-derived mercury to spawning streams.

Background: Immunotherapy has had a long history in cancer treatment and, with recent breakthroughs, new drugs are available that have shown promising results., Objectives: The current article discusses an overview of immune function, including immunoediting and the theory of immune checkpoints, as well as specific drugs that have been approved as immune checkpoint inhibitors. Additional discussion includes a review of nursing implications and administration, side effects, adverse events, and the future of immuno-oncology., Methods: This review of literature focused on locating, summarizing, and synthesizing data from published articles, the American Cancer Society, U.S. Food and Drug Administration, and literature from pharmaceutical manufacturers that focused on immunotherapy treatment options that use checkpoint inhibition. Search criteria included articles published from 2005-2015 and archived in CINAHL®, OVID®, and PubMed databases using the key words immunotherapy, immune checkpoint inhibition, PD-1, PD-L1, CTLA-4, and oncology., Findings: Cancer therapy targeting immune checkpoint inhibition has shown promising results and continues to evolve. Oncology nurses need to remain abreast of new immune-modulating therapies to understand their efficacy, as well as side effect management.

Risk assessments of persistent organic pollutants (POPs) are often based on octanol-water (KOW) partitioning dynamics and may not adequately reflect bioaccumulation in air-breathing organisms. It has been suggested that compounds with low KOW and high octanol-air partitioning (KOA) coefficients have the potential to bioaccumulate in air-breathing organisms, including marine mammals. Here we evaluate differences in concentrations of POPs for two trophically matched Arctic species, spotted seal (Phoca largha) and sheefish (Stenodus leucichthys). We compared concentrations of 108 POPs in matched tissues (liver and muscle) across three ranges of KOW. We found a significant positive correlation between POP concentration and log KOA in spotted seal tissues for low log KOW compounds (log KOW <5.5, p<0.05). This provides further evidence for empirical models and observed bioaccumulation patterns in air-breathing organisms, and highlights the potential for bioaccumulation of these compounds in Arctic marine mammals., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The major purpose of the study was to determine if a 5-minute DVD is an effective method for communicating anticipatory guidance to parents at their child's 4-month well-child visit. A total of 84 caregivers were randomly assigned to receive anticipatory guidance through standard care (written anticipatory guidance handout and free talk) or DVD (DVD format + standard care). Participants completed a brief questionnaire immediately before and after their visit. As anticipated, knowledge scores improved significantly from pre-test to post-test. There was also a significant interaction between format used for anticipatory guidance and time. Specifically, there was greater improvement in knowledge over time for parents in the DVD group as compared with the standard care group. Additionally, the mean knowledge level of those in the DVD group as compared with those in the standard care group trended toward significance. Finally, visit length was shortened by nearly 3 minutes in the DVD group, and close to 100% of all respondents, regardless of anticipatory guidance format, indicated that they were very satisfied with their visit and amount of information learned.

Mercury (Hg) bioaccumulates in the tissues of organisms and biomagnifies within food-webs. Gray wolves (Canis lupus) in Alaska primarily acquire Hg through diet; therefore, comparing the extent of Hg exposure in wolves, in conjunction with stable isotopes, from interior and coastal regions of Alaska offers important insight into their feeding ecology. Liver, kidney, and skeletal muscle samples from 162 gray wolves were analyzed for total mercury (THg) concentrations and stable isotopic signatures (δ(13)C, δ(15)N, and δ(34)S). Median hepatic THg concentrations were significantly higher in wolves with coastal access compared to wolves from interior Alaska. Stable isotope ratios, in conjunction with THg concentrations, provide strong evidence that coastal wolves are utilizing marine prey representing several trophic levels. The utilization of cross-ecosystem food resources by coastal wolves is clearly contributing to increased THg exposure, and may ultimately have negative health implications for these animals., (© 2013 Elsevier B.V. All rights reserved.)

Background: Understanding mercury (Hg) distribution in blood and the importance of hair as an excretory pathway is critical for evaluating risk from long term dietary Hg exposure. The major objective of this study was to characterize changes in total Hg concentrations in specific blood compartments and hair over time due to long term piscivory., Methods: Eight sled dogs (Canis lupus familiaris) were fed either a fish and kibble diet (n = 4), or a fish-free control diet (n = 4) for 12 weeks. Concentrations of Hg were monitored throughout the exposure period, and for 10 weeks post exposure, until Hg concentrations in all blood compartments of one of the exposed dogs dropped below detection limit. Additionally, foreleg hair was sampled during acclimation and weeks 0 and 12., Results: Hg was detected primarily in whole blood and packed cells, although it was sporadically detected at low concentrations in plasma and serum in two of the fish fed dogs. Dogs ingested an estimated average of 13.4 ± 0.58 μg Hg per kg body weight per day. Hg was detectable in whole blood and packed cells within a week of exposure. Detected concentrations continued to rise until plateauing at approximately 3-6 weeks of exposure at a mean of 9.2 ± 1.97 ng/g (ppb) in whole blood. Hg concentration decreased post exposure following 1st order elimination. The mean half-life (t1/2) in whole blood for Hg was 7 weeks. Mean Hg in hair for the fish-fed dogs at week 12 was 540 ± 111 ppb and was significantly greater (about 7-fold) than the Hg hair concentration for the control dogs. The hair to blood ratio for Hg in fish-fed dogs was 59.0 ± 7.6:1., Conclusions: This study found the sled dog model to be an effective method for investigating and characterizing blood Hg distribution (whole blood, serum, plasma, packed cells) and toxicokinetics associated with a piscivorous diet, especially for Hg-exposed fur bearing mammals (such as polar bears). Although hair excretion and hair to blood Hg ratios were not similar to human concentrations and ratios, the sled dog toxicokinetics of Hg in blood, was more similar to that of humans than traditional laboratory animals (such as the rat).

The risk of mercury (Hg) exposure to humans and wildlife from fish consumption has driven extensive mercury analysis throughout the Great Lakes Region since the 1970s. This study compiled fish-Hg data from multiple sources in the region and assessed spatiotemporal trends of Hg concentrations in two representative top predator fish species. Walleye (Sander vitreus) and largemouth bass (Micropterus salmoides) were chosen for the trend analysis because they had more Hg records (63,872) than other fish species that had been sampled from waters throughout the region. Waterbody types were inland lakes (70%), the Great Lakes, impoundments, and rivers. The compiled datasets were analyzed with a mixed effects statistical model having random effects of station, year, and fish length; and fixed effects of year, tissue type, fish length, habitat, and season. The results showed a generally declining temporal trend in fish-Hg for the region (1970-2009), with spatial trends of increasing Hg concentration from south to north and from west to east across the region. Nonlinearity was evident in the general downward trends of Ontario walleye, with a shift to an upward trend beginning in the 1990s. Only ongoing monitoring can reveal if this upward shift is an oscillation in a long-term decline, a statistical anomaly, or a sustained declining temporal trend in regional fish-Hg concentrations.

The purpose of this study was to compare the effectiveness of continuous femoral nerve block (CFNB) protocol, to extended release epidural morphine DepoDur protocol, in patients having a total knee arthroplasty (TKA) enrolled in a structured joint replacement educational program. Overall, the results of this randomized controlled study demonstrate that CFNB and DepoDur protocol pain strategies were well tolerated in TKA patients during this study with expected side effects and appropriate side effect management. Moreover, the DepoDur protocol enhanced pain management experience and satisfaction and provided superior prolonged analgesia compared with CFNB protocol. The occurrence of adverse events, cost, length of stay, and functional outcomes was comparable between groups.

Developing and sustaining a research infrastructure that meets Magnet program requirements are daunting responsibilities. Our Lady of the Lake Regional Medical Center in Louisiana created the program director of nursing research position to coordinate the research council and ongoing projects. This article discusses the process of developing and improving a nursing research program.

Objectives: To determine nutrient and contaminant concentrations, document concentration changes related to common preparation methods and provide a basic risk-benefit analysis for select subsistence foods consumed by residents of Kotzebue, Alaska., Study Design: Eleven organic nutrients and 156 persistent organic pollutants (POPs) were measured in foods derived from spotted seals and sheefish., Methods: Nutrients in foodstuffs were compared to Daily Recommended Intake criteria. POPs were compared to Tolerable Daily Intake Limits (TDIL)., Results: Cooking, as well as absence/presence of skin during sheefish processing, altered nutrient and contaminant concentrations in seals and fish. Sheefish muscle and seal blubber were particularly rich in omega-3 fatty acids and seal liver in vitamin A. Seal liver exceeded the recommended upper limit for vitamin A. POP contribution to TDIL was >25% in all tissues except blubber, in which 4 POPS were present at >25% TDIL. No POPs exceeded TDIL in a serving of any tissue studied. The most prominent concerns identified were levels of vitamin A in spotted seal liver and certain POPs in blubber, warranting consideration when determining how much and how often these foods should be consumed., Conclusions: Preparation methods altering tissues from their raw state significantly affect nutrient and contaminant concentrations, thus direct evaluation of actual food items is highly recommended to determine risk-benefits ratios of traditional diets. Traditional foods provide essential nutrients with very limited risk from contaminants. We encourage the consumption of traditional foods and urge public health agencies to develop applicable models to assess overall food safety and quality.

Objectives: To determine inorganic nutrient and contaminant concentrations in subsistence foods consumed by Alaska Natives, concentration changes related to common preparation methods and provide a basic risk-benefit analysis for these foods., Study Design: Eleven essential and six non-essential elements were measured in foods derived from spotted seals and sheefish., Methods: Essential nutrients in foodstuffs were compared to Daily Recommended Intake (DRI) criteria. Non-essential elements were compared to Tolerable Daily Intake Limits (TDIL). These comparisons serve as a risk-benefit analysis, not as consumption advice., Results: Cooking altered nutrient and contaminant concentrations. Spotted seal muscle and kidney are rich in Fe and Se; liver in Cu, Fe, Mo and Se; and sheefish muscle in Se. TDIL was exceeded in a 100 g serving of seal for THg in raw and fried liver and boiled kidney; MeHg in dried muscle and raw and fried liver; Cd in raw and boiled kidney; and As in raw and rendered blubber. Arsenic exceeded TDIL in sheefish muscle. However, toxicity potential is likely reduced by the element form (i.e., organic As, inorganic Hg) and the presence of protective nutrients such as Se., Conclusions: Preparation methods alter wildlife tissues from their raw state, significantly affecting element concentrations. Direct evaluation of actual food items is warranted to determine risk-benefit ratios of traditional diets. Traditional foods provide many essential nutrients with a very limited risk from contaminants. We encourage continued consumption of traditional foods, and urge public health agencies to develop applicable models for providing consumption advice, incorporating food processing considerations.

Background: We recently reported that the altitude of origin altered the photic and thermal sensitivity of the circadian pacemaker controlling eclosion and oviposition rhythms of high altitude Himalayan strains of Drosophila ananassae. The present study was aimed at investigating the effects of altitude of origin on the pacemaker controlling the adult locomotor activity rhythm of D. helvetica., Methods: Locomotor activity rhythms of the high altitude Himalayan (haH) strain (Hemkund-Sahib, 4,121 m above sea level) and the low altitude Himalayan (laH) strain (Birahi, 1,132 m a.s.l.) of D. helvetica were assayed by two experiments. The first experiment examined the natural entrainment pattern in light-dark (LD) cycles at the breeding site of each strain. The second experiment examined the entrainment parameters in LD 12:12 cycles and the period of free-running rhythm in constant darkness (DD) under controlled laboratory conditions., Results: When entrained by natural or artificial LD cycles, the haH strain had an unimodal activity pattern with a single peak that commenced in the forenoon and continued till evening, while the laH strain had a bimodal activity pattern in which the morning peak occurred before lights-on and was separated by about 4 h from the evening peak. Unimodality of the haH strain was retained in DD; however, bimodality of the laH strain was abolished in DD since the evening peak disappeared immediately after the trasfer from LD 12:12 to DD. The period of the free-running rhythm of the haH strain was ~26.1 h, whereas that of the laH strain was ~21.7 h., Conclusion: Parameters of entrainment and free-running rhythm of the adult locomotor activity of the haH strain of D. helvetica were strikingly different from those of the laH strain and were likely due to ecological adaptations to the prevailing environmental conditions at the altitude where the species evolved.

In this investigation, the potency distribution of a low-dose drug in a granulation was optimized through a two-part study using statistically designed experiments. The purpose of this investigation was to minimize the segregation potential by improving content uniformity across the granule particle size distribution, thereby improving content uniformity in the tablet. Initial operating parameters on the Gerteis 3-W-Polygran 250/100/3 Roller Compactor resulted in a U-shaped potency function (potency vs. granule particle size) with superpotent fines and large granules. The roller compaction optimization study was carried out in two parts. Study I used a full factorial design with roll force (RF) and average gap width (GW) as independent variables and Study II used a D-optimal response surface design with four factors: RF, GW, granulating sieve size (SS), and granulator speed (GS). The planned response variables for Study I were bypass weight % and potency of bypass. Response variables for Study II included mean granulation potency with % relative standard deviation (% RSD), granulation particle size, sieve cut potency % RSD, tablet potency with % RSD, compression force at 7 kP crushing strength, and friability of 7-kP tablets. A constraint on GW was determined in Study I by statistical analysis. Bypass and observations of ribbon splitting were minimized when GW was less than 2.6 mm. In Study II, granulation potency, granulation uniformity, and sieve cut uniformity were optimized when the SS was 0.8 mm. Higher RF during dry granulation produced better sieve cut uniformity and tablets with improved uniformity throughout the run, as measured by stratified tablet samples taken during compression and assayed for potency. The recommended optimum roller compaction and milling operating parameters that simultaneously met all constraints were RF = 9 kN, GW = 2.3 mm, SS = 0.8 mm, and GS = 50 rpm. These parameters became the operating parameter set points during a model confirmation trial. The results from the confirmation trial proved that the new roller compaction and milling conditions reduced the potential for segregation by minimizing the granulation potency variability as a function of particle size as expressed by sieve cut potency % RSD, and thus improved content uniformity of stratified tablet samples.