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Clinic-ambulatory blood pressure (BP) difference is influenced by patients- and device-related factors and inadequate clinic-BP measurement. We investigated whether nonadherence to antihypertensive medications may also influence this difference in a post hoc analysis of the DENERHTN trial (Renal Denervation for Hypertension). We pooled the data of 77 out of 106 evaluable patients with apparent resistant hypertension who received a standardized antihypertensive treatment and had both ambulatory BP and drug-screening results available at baseline after 1 month of standardized triple therapy and at 6 months on a median of 5 antihypertensive drugs. After drug assay samplings on study visits, patients took their antihypertensive treatment under supervision immediately after the start of the ambulatory BP recording, and supine clinic BP was measured 24 hours post-dosing; both allowed to calculate the clinic minus daytime ambulatory systolic BP (SBP) difference (clinic-SBP-day-SBP). A total of 29 (37.7%) were found nonadherent to medications at baseline and 38 (49.4%) at 6 months. At baseline, the mean clinic-SBP-day-SBP difference in the nonadherent group was 12.7 mm Hg (95% CI, 7.8-17.7 mm Hg, P<0.001). In contrast, clinic SBP was almost identical to day-SBP in the adherent group (clinic-SBP-day-SBP difference, 0.1 mm Hg; 95% CI, -3.3 to 3.5 mm Hg; P=0.947). Similar observations were made at 6 months. Using receiver operating characteristics curves, we found that a 6 mm Hg cutoff of clinic-SBP-day-SBP difference had 67% sensitivity and 69% specificity to predict nonadherence to the triple therapy at baseline. In conclusion, a large clinic-SBP-day-SBP difference may help discriminating between adherence and nonadherence to treatment in patients with resistant hypertension. Clinical Trial Registration- URL: https://www.clinicaltrials.gov. Unique identifier: NCT01570777. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adults with cystic fibrosis (CF) must continuously manage their condition, while working for a living, and want a normal life. Adherence rates to treatments/medications are less than optimal. Existing theory offers little to explain adherence rates. The purpose of this study was to develop a theory to further the understanding of how people with CF manage their condition in an adherence-driven health care system. METHODS: Constructivist Grounded Theory methodology was used to conduct 27 semistructured interviews with adults with CF, family members, and health care providers. Data collection and analysis were simultaneous, using constant comparative methods, initial and focused coding, and category identification and reduction to develop a theory. RESULTS: Doing what works to balance life and CF is the theory generated from this study. The main concern of participants was to be seen as normal. The theory depicts what participants with CF and their family members do about their concerns and involves 4 interrelated processes: working overtime, receiving support, passing as normal, and facing disease progression. CONCLUSION: Participants did not relate to the term nonadherent; rather they described working overtime to manage CF, to work, and to have a normal life. Health care provider and researcher perspectives on adherence differ from those of people with CF. Engaging adults with CF and health care providers in a dialogue in which expectations are shared may lead to individualized treatment regimens that work, because adults with CF will do what works. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nitrate accumulation in aquatic reservoirs from agricultural pollution has often been overlooked as a water quality hazard, yet a growing body of literature suggests negative effects on human and wildlife health following nitrate exposure. This research seeks to understand differences in oxygen consumption rates between different routes of laboratory nitrate exposure, whether via immersion or injection, in zebrafish ( Danio rerio ) embryos. Embryos were exposed within 1 h post fertilization (hpf) to 0, 10, and 100 mg/L NO 3 -N with sodium nitrate, or to counter ion control (CIC) treatments using sodium chloride. Embryos in the immersion treatments received an injection of 4 nL of appropriate treatment solution into the perivitelline space. At 24 hpf, Oxygen Consumption Rates (OCR) were measured and recorded in vivo using the Agilent Technologies XF e 96 Extracellular Flux Analyzer and Spheroid Microplate. Immersion exposures did not induce significant changes in OCR, yet nitrate induced significant changes when injected through the embryo chorion. Injection of 10 and 100 mg/L NO 3 -N down-regulated OCR compared to the control treatment group. Injection of the 100 mg/L CIC also significantly down-regulated OCR compared to the control treatment group. Interestingly, the 100 mg/L NO 3 -N treatment further down-regulated OCR compared to the 100 mg/L CIC treatment, suggesting the potential for additive effects between the counter ion and the ion of interest. These data support that elevated nitrate exposure can alter normal metabolic activity by changing OCR in 24 hpf embryos. These results highlight the need for regularly examining the counter ion of laboratory nitrate compounds while conducting research with developing zebrafish, and justify examining different routes of laboratory nitrate exposure, as the chorion may act as an effective barrier to nitrate penetration in zebrafish, which may lead to conservative estimates of significant effects in other species for which nitrate more readily penetrates the chorion. [ABSTRACT FROM AUTHOR]

Objective To explore faculty and student utilization of social media and its professional implications in nurse education. Methods A descriptive study. Five hundred six Bachelor of Nursing students, 112 Practical Nursing students and 74 faculty members were invited to complete a questionnaire of 28 questions relating to social media. Results Three hundred thirty-seven students and 29 faculty responded. Students spent significantly more time using social media compared to faculty and both groups used it mainly for personal use. However, almost twice as many students used social media for educational purposes than did faculty (58.5% vs 27.6%, p < 0.001). While almost 96% of students used social media to talk about academic related problems, only 28% of faculty did so ( p < 0.000). Almost 60% of faculty expressly disagreed with using social media to discuss academic related problems. YouTube and text messaging were popular platforms for educational purposes. While Facebook was also a popular educational site for students (95% used it for informal learning; 67% for formal learning), it was much less commonly used by faculty (45% used it for informal learning; 17% for formal learning). More students than faculty felt that they were aware of privacy features, and of the professional behavior expected when using social media. In addition, more students (90.7%) than faculty (71.43%) used these privacy features ( p < 0.000). However, 100% of students compared to only 13.79% of faculty reported that they had posted information that they would not want a prospective employer/member of academic staff to view ( p = 0.003). Conclusion There is a high reported usage of social media among students and faculty. Utilization of public platforms, while potentially beneficial, can have professional implications if not used appropriately with both personal and academic use. Developing best practice approaches for using social media in nurse education is essential to ensure that faculty and students are informed of e-professionalism. [ABSTRACT FROM AUTHOR]

Several studies indicate a potential link between orthostatic hypotension (OH) and incident dementia but without substantial evidence to date. Our objective is to study the association between OH and dementia in a cohort of elderly individuals. To do so, baseline lying and standing blood pressure measurements were taken from 7425 subjects in the Three-City study. These subjects were then followed-up for 12 years. Cox proportional hazard models, adjusted for potential confounders, were used to estimate the risk of incident dementia according to OH status. Sensitivity analysis was performed using the so-called illness-death model, a specific statistical method which takes into account competitive risk with death. OH frequency was found to be around 13%, and 760 cases of dementia were diagnosed during follow-up. We observed significant associations between the presence of OH at baseline and the occurrence of dementia during the follow-up, with an increased risk of at least 25% observed regardless of the OH threshold and the statistical method used. In conclusion, there is an association between OH and dementia. Considering that OH is a common condition and is easy to measure, OH measurements could help to identify subjects with higher risk of dementia. Moreover, reducing OH could be a step to prevent conversion to dementia. [ABSTRACT FROM AUTHOR]

The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control). Average and standard deviation of 24-hour, daytime, and nighttime BP and the smoothness index were calculated on recordings performed at randomization and 6 months. Responders were defined as a 6-month 24-hour systolic BP reduction ≥20 mm Hg. Analyses were performed on the per-protocol population. The significantly greater BP reduction in the denervation group was associated with a higher smoothness index (P=0.02). Variability of 24-hour, daytime, and nighttime BP did not change significantly from baseline to 6 months in both groups. The number of responders was greater in the denervation (20/44, 44.5%) than in the control group (11/53, 20.8%; P=0.01). In the discriminant analysis, baseline average nighttime systolic BP and standard deviation were significant predictors of the systolic BP response in the denervation group only, allowing adequate responder classification of 70% of the patients. Our results show that denervation lowers ambulatory BP homogeneously over 24 hours in patients with resistant hypertension and suggest that nighttime systolic BP and variability are predictors of the BP response to denervation. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le contexte sanitaire lié à la pandémie COVID-19 a entraîné le développement rapide de nombreux vaccins contre le virus SarS-Cov-2. Quatre d'entre eux sont actuellement disponibles en France et contiennent comme excipients du polyethylène glycol (PEG) ou du polysorbate 80, déjà décrits comme pourvoyeurs d'anaphylaxie. Des recommandations françaises ont été suggérées par plusieurs instances d'allergologie et proposaient une conduite à tenir face à une suspicion d'allergie à ces vaccins. Ainsi, les allergies aux excipients constituaient la seule contre-indication à la vaccination anti COVID-19. Notre objectif principal était de déterminer l'impact de ces recommandations vaccinales d'allergologie sur la prise en charge de ces patients. Notre objectif secondaire était de déterminer la prévalence des allergies vraies à ces vaccins. Nous avons mené une étude rétrospective descriptive unicentrique concernant l'ensemble des patients de plus de 18 ans adressés pour un avis allergologique avant ou après une vaccination anti COVID-19. Les patients ont été classés en différents groupes d'intérêt, à partir des recommandations françaises. La vaste majorité des patients n'ont pas nécessité de bilan allergologique pré vaccinal. En effet, seulement 25 patients ont reçu des tests cutanés préalables à la vaccination. Le reste des patients ont pu être vaccinés sans bilan allergologique. Les patients non vaccinés pour cause d'allergie aux excipients représentent moins de 1 % de l'effectif total (n = 3/320). Les recommandations françaises ont permis de vacciner la grande majorité des patients inclus dans notre étude. L'allergie au PEG, polysorbate ou leurs dérivés, seule contre-indication à la vaccination anti COVID, d'après les recommandations de février 2021, reste rare. À ce jour, plusieurs auteurs proposent des inductions de tolérance permettant la vaccination de patients allergiques aux PEG ou à leurs dérivés avec une bonne tolérance. The health context with COVID-19 pandemic has led to fast development of many vaccines against the SarS-Cov-2 virus. Four of them are currently available in France and contain polyethylene glycol (PEG) or polysorbate 80 as excipients, already described as causing anaphylaxis. French recommendations have been suggested by allergology authorities and proposed a course of action in the event of a suspected allergy to these vaccines. Thus, allergies to excipients were the only contraindication to COVID-19 vaccination. Our main objective was to determine the impact of these allergology vaccine recommendations on the management of these patients. Our secondary objective was to determine prevalence of true allergies to these vaccines. We conducted a unicentric descriptive retrospective study with all patients over 18 years of age referred for an allergological opinion before or after an injection of one of the anti-COVID-19 vaccines. Nineteen patients were classified into different interest groups, based on french recommendations. The vast majority of patients did not require a pre-vaccination allergological assessment. Indeed, only 25 patients received skin tests prior to vaccination. The rest of patients were able to be vaccinated without allergological assessment. Patients not vaccinated due to allergy to excipients represent less than 1% of the population (n = 3/320). French recommendations made it possible to vaccinate the vast majority of patients included in our study. Allergy to PEG, polysorbate or their derivatives, the only contraindication to anti-COVID vaccination, according to the recommendations of February 2021, remains rare. Today, several authors propose tolerance inductions allowing the vaccination of patients allergic to PEGs or their derivatives with good tolerance. [ABSTRACT FROM AUTHOR]

The article discusses the black theology of the theologian Marcus Garvey and how it affected the organization that he founded the Universal Negro Improvement Association and African Communities League (UNIA-ACL). Topics include an analysis of the numerous literature that has been written on Garvey and his religious movement of Garveyism including the book "Garveyism as a Religious Movement" by the author Randall Burkett and Garvey's interpretation of the Bible to raise black man's consciousness

The objective of the study was to evaluate the Integrated Comprehensive Care (ICC) program, a novel health system integration initiative that coordinates home care and hospital-based clinical services for patients undergoing major thoracic surgery relative to traditional home care delivery. Methods included a pilot retrospective cohort analysis that compared the intervention cohort (ICC), composed of all patients undergoing major thoracic surgery in the 2012-2013 fiscal year with a control cohort, who underwent surgery in the year before the initiation of ICC. Length of stay, hospital costs, readmission, and emergency room visit data were stratified by degree and approach of resection and compared using univariate logistic regression analysis. A total of 331 patients under ICC and 355 control patients were enrolled. Hospital stay was significantly shorter in patients under video-assisted thoracoscopic surgery (VATS) ICC (sublobar median 3 vs 4 days, P = 0.013; lobar median 4 vs 5 days, P = 0.051) but not for open resections. The frequency of emergency room visits within 60 days of surgery was lower for all stratification groups in the ICC cohort, except for VATS sublobar (25.7% control vs 13.9% ICC, P = 0.097). There were no significant differences in 60-day readmission frequency in any subcohort. The mean inpatient case cost was significantly lower for ICC VATS sublobar resections ($8505.39 vs $11,038.18, P = 0.007), with the other resection types trending lower for ICC but nonsignificant. In conclusion, a hospital-based, postdischarge, patient-centered program could potentially result in shorter hospital stay, fewer readmission and emergency room visits, costsavings, and no increase in adverse postdischarge outcomes after major thoracic surgery. [ABSTRACT FROM AUTHOR]

Chlorine-36 production rates obtained from different geological calibration studies (e.g. Evans et al., 1997; Phillips et al., 2001; Schimmelpfennig et al., 2011; Stone et al., 1996; Swanson and Caffee, 2001) vary significantly, principally because of the many reactions contributing to the production of this nuclide. The CRONUS-Earth Project has provided high-quality geological calibration sites, including Lake Bonneville, Peru, and Scotland, for a large-scale calibration of 36 Cl production rates. Three sites were used to calibrate the K and Ca spallation pathways for 36 Cl production yielding production rates of 56.0 ± 4.1 at 36 Cl (g Ca) −1 yr −1 and 155 ± 11 at 36 Cl (g K) −1 yr −1 respectively, using Lifton-Sato-Dunai scaling (LSDn). The low-energy production parameter, P f ( 0 ), was calibrated separately using CRONUS-Earth data from the Bonneville and Baboon Lakes sites where Cl concentrations were higher, and yielded a value of 759 ± 180 neutrons (g air) −1 yr −1 . There is significant uncertainty associated with this pathway due to the sensitivity of this reaction to environmental conditions. The uncertainties associated with the calibrated production parameters were estimated based on the variance of calculated ages from independent ages for an independent secondary dataset. [ABSTRACT FROM AUTHOR]