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Background: Patients with non-cancer disease are less likely to receive specialized palliative care than cancer patients. To be able to provide the best specialized palliative care, it is important to understand palliative care needs of non-cancer patients and whether the type and level of needs differ from those of cancer patients. Large studies including both cancer and non-cancer patients, using validated needs-assessment-tools, are needed to understand differences in palliative care needs at admittance to specialized palliative care., Aims: To compare palliative care needs at the start of palliative care for cancer and non-cancer disease., Design: Six-year nationwide register-based study., Setting/participants: This study included patients from all Danish specialized palliative care services (hospice care, hospital-based palliative care, home-based palliative care, or consultation) who completed a need-assessment-questionnaire. Ordinal logistic regression was performed to study the association between diagnosis and needs., Results: Cancer patients had a higher probability of receiving specialized palliative care. Of the 44,315 palliative care admissions included in this study, 93.3% were on cancer patients. Independent of diagnosis patients experienced on average six needs and high levels of fatigue and impaired physical functioning. Non-cancer patients had significantly higher odds of insomnia, fatigue and impaired emotional functioning, physical functioning, and quality of life whereas cancer patients had higher odds of pain (except for patients with neurological disease)., Conclusions: The higher levels of several symptoms/problems among non-cancer patients compared to cancer patients suggests that referral to specialized palliative care should be improved for non-cancer patients perhaps by improving identification of palliative needs., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Multilevel risk factors may increase the risk of experiencing intimate partner violence among women. The overall goal of this study was to provide a comprehensive view of factors that may be associated with three forms of intimate partner violence. The primary aim was to explore associations between understudied factors and women's experiences of physical and sexual violence and stalking by an intimate partner. Secondary analysis of existing health registry data was conducted. Our evidence-driven strategy was based on a multipronged analytical approach informed by existing literature and the social-ecological model. We created an evidence-based hierarchical list comprised of three tiers. Three separate multiple logistic regression analyses were performed. Several shared risk factors were retained across all three forms including low levels of formal education, past experiences of non- partner sexual violence, residential instability, presence of children, experiences of a traumatic event and panic attacks, status of receiving US government benefits, and barriers to healthcare access. Results contribute to future research on intimate partner violence prevention by providing preliminary evidence of emerging factors associated with experiencing three forms of intimate partner violence., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Knowledge about the process and the results of the implementation of clinical guidelines to improve palliative care is limited. A national project aimed at improving the quality of life of advanced cancer patients admitted to specialized palliative care services in Denmark by implementing clinical guidelines for the treatment of pain, dyspnea, constipation, and depression., Aim: To investigate the degree of clinical guideline implementation by evaluating the proportion of patients treated according to guidelines among those who qualified (i.e. reported severe symptom level) before and after the 44 palliative care services implemented the guidelines, and how often different types of interventions were provided., Design: This is a national register-based study., Setting/participants: Data from the improvement project were stored in and later obtained from the Danish Palliative Care Database. Adult patients with advanced cancer admitted to palliative care between September 2017 and June 2019 who answered the EORTC QLQ-C15-PAL questionnaire were included., Results: In total 11,330 patients answered the EORTC QLQ-C15-PAL. The proportions of services that implemented the four guidelines ranged 73%-93%. Among services that had implemented guidelines, the proportion of patients receiving interventions was roughly constant over time reaching between 54% and 86% (lowest for depression). Pain and constipation were frequently treated pharmacologically (66%-72%), whereas dyspnea and depression were frequently treated non-pharmacologically (61% each)., Conclusions: Implementing clinical guidelines was more successful for physical symptoms than for depression. The project generated national data on interventions provided when guidelines were followed, which may be used to understand differences in care and outcomes.

Background: Polyamines are involved in several cellular processes and inhibiting their synthesis affects chikungunya virus (CHIKV) replication and translation, and, therefore, reduces the quantity of infectious viral particles produced. In this study, we evaluated the inhibition of CHIKV replication by N-ω-chloroacetyl-L-ornithine (NCAO), a competitive inhibitor of ornithine decarboxylase, an enzyme which is key in the biosynthesis of polyamines (PAs)., Methods: The cytotoxicity of NCAO was evaluated by MTT in cell culture. The inhibitory effect of CHIKV replication by NCAO was evaluated in Vero and C6/36 cells. The intracellular polyamines were quantified by HPLC in CHIKV-infected cells. We evaluated the yield of CHIKV in titres via the addition of PAs in Vero, C6/36 cells and human fibroblast BJ treated with NCAO., Results: We found that NCAO inhibits the replication of CHIKV in Vero and C6/36 cells in a dose-dependent manner, causing a decrease in the PFU/mL of at least 4 logarithms ( p < 0.01) in both cell lines. Viral yields were restored by the addition of exogenous polyamines, mainly putrescine. The HPLC analyses showed that NCAO decreases the content of intracellular PAs, even though it is predominantly spermidines and spermines which are present in infected cells. Inhibition of CHIKV replication was observed in human fibroblast BJ treated with 100 μM NCAO 24 h before and 48 h after the infection at a MOI 1., Conclusions: NCAO inhibits CHIKV replication by depleting the intracellular polyamines in Vero, C6/36 cells and human fibroblast BJ, suggesting that this compound is a possible antiviral agent for CHIKV.

Non-small-cell lung cancer (NSCLC) is a heterogeneous disease, and therapeutic management has advanced to identify various critical oncogenic mutations that promote lung cancer tumorigenesis. Subsequent studies have developed targeted therapies against these oncogenes in the hope of personalized treatment based on the tumor's molecular genomics. This review presents a comprehensive review of the biology, new therapeutic interventions, and resistance patterns of two well-defined subgroups, tumors with KRAS and MET alterations. We also discuss the status of molecular testing practices for these two key oncogenic drivers, considering the progressive introduction of next-generation sequencing (NGS) and RNA sequencing in regular clinical practice.

Background: Previous studies suggest that the symptomatology threshold (i.e. the level and types of symptoms) for a referral to specialized palliative care might differ for doctors in different parts of the healthcare system; however, it has not yet been investigated., Aim: To investigate if the number and level of symptoms/problems differed for patients referred from the primary and secondary healthcare sectors (i.e. general practitioner versus hospital physician)., Setting/participants: Adult cancer patients registered in the Danish Palliative Care Database who reported their symptoms/problems at admittance to specialized palliative care between 2010 and 2017 were included. Ordinal logistic regression analyses were performed with each symptom/problem as outcome to study the association between referral sector and symptoms/problems, controlled for the effect of gender, age, cancer diagnosis and the specialized palliative care service referred to., Results: The study included 31,139 patients. The average age was 69 years and 49% were women. Clinically neglectable associations were found between referral sector and pain, appetite loss, fatigue, number of symptoms/problems, number of severe symptoms/problems (odds ratios between 1.05 and 1.20, all p  < 0.05) and physical functioning (odds ratio = 0.81 (inpatient care) and 1.32 (outpatient), both p  < 0.05). The remaining six outcomes were not significantly associated with referral sector., Conclusion: Differences across healthcare sectors in, for example, competences and patient population did not seem to result in different symptomatology thresholds for referring patients to palliative care since only small, and probably not clinically relevant, differences in symptomatology was found across referral sectors.

Background: Large, nationally representative studies of the association between quality of life and survival time in cancer patients in specialized palliative care are missing., Aim: The aim of this study was to investigate whether symptoms/problems at admission to specialized palliative care were associated with survival and if the symptoms/problems may improve prediction of death within 1 week and 1 month, respectively., Setting/participants: All cancer patients who had filled in the EORTC QLQ-C15-PAL at admission to specialized palliative care in Denmark in 2010-2017 were included through the Danish Palliative Care Database. Cox regression was used to identify clinical variables (gender, age, type of contact (inpatient vs outpatient), and cancer site) and symptoms/problems significantly associated with survival. To test whether symptoms/problems improved survival predictions, the overall accuracy (area under the receiver operating characteristic curve) for different prediction models was compared. The validity of the prediction models was tested with data on 5,508 patients admitted to palliative care in 2018., Results: The study included 30,969 patients with an average age of 68.9 years; 50% were women. Gender, age, type of contact, cancer site, and most symptoms/problems were significantly associated with survival time. The predictive value of symptoms/problems was trivial except for physical function, which clearly improved the overall accuracy for 1-week and 1-month predictions of death when added to models including only clinical variables., Conclusion: Most symptoms/problems were significantly associated with survival and mainly physical function improved predictions of death. Interestingly, the predictive value of physical function was the same as all clinical variables combined (in hospice) or even higher (in palliative care teams).

Precision oncology is the field that places emphasis on the diagnosis and treatment of tumors that harbor specific genomic alterations susceptible to inhibition or modulation. Although most alterations are only present in a minority of patients, a substantial effect on survival can be observed in this subgroup. Mass genome sequencing has led to the identification of a specific driver in the translocations of the tropomyosin receptor kinase family (NTRK) in a subset of rare tumors both in children and in adults, and to the development and investigation of Larotrectinib. This medication was granted approval by the US Food and Drug Administration for NTRK-positive tumors, regardless of histology or age group, as such, larotrectinib was the first in its kind to be approved under the premise that molecular pattern is more important than histology in terms of therapeutic approach. It yielded significant results in disease control with good tolerability across a wide range of diseases including rare pediatric tumors, salivary gland tumors, gliomas, soft-tissue sarcomas, and thyroid carcinomas. In addition, and by taking different approaches in clinical trial design and conducting allocation based on biomarkers, the effects of target therapies can be isolated and quantified. Moreover, and considering developing nations and resource-limited settings, precision oncology could offer a tool to reduce cancer-related disability and hospital costs. In addition, developing nations also present patients with rare tumors that lack a chance of treatment, outside of clinical trials. This, in turn, offers the possibility for international collaboration, and contributes to employment, education, and health service provisions. The reviews of this paper are available via the supplemental material section.

This article provides a review of spatial analysis methods for use in health promotion and education research and practice. Spatial analysis seeks to describe or make inference about variables with respect to the places they occur. This includes geographic differences, proximity issues, and access to resources. This is important for understanding how health outcomes differ from place to place; and in terms of understanding some of the environmental underpinnings of health outcomes data by placing it in context of geographic location. This article seeks to promote spatial analysis as a viable tool for health promotion and education research and practice. Four more commonly used spatial analysis techniques are described in-text. An illustrative example of motor vehicle collisions in a large metropolitan city is presented using these techniques. The techniques discussed are as follows: descriptive mapping, global spatial autocorrelation, cluster detection, and identification and spatial regression analysis. This article provides useful information for health promotion and education researchers and practitioners seeking to examine research questions from a spatial perspective., (© 2015 Society for Public Health Education.)

Hyptis colombiana is an aromatic shrub native to the Colombian and Venezuelan Andes. Aerial parts were collected in Mérida State at about 3100 m above sea level in February 2005, and May and October 2006. The essential oil was found to contain germacrene D and β-caryophyllene as main constituents (about 50%). The February 2005 and October 2006 oils were found to have antibacterial activity against Staphylococcus aureus, but not the May 2006 oil, probably due to the lack of some minor constituent.

The essential oil from the leaves ofRuilopezia bracteosa was obtained by hydrodistillation, and analyzed by GC-MS. Eighteen components, which made up 99.6% of the oil were identified, the most abundant being β-myrcene (34.2%), α-pinene (24.3%), 7-epi-α-selinene (9.1%), β-pinene (8.5%) and 6,9-guaiadiene (4.4%). Antibacterial activity was tested against Gram-positive and Gram-negative bacteria using broth microdilution and disk agar diffusion methods. MIC values found presented significant differences between both methods, which may be due to diffusion factors.

The essential oils obtained by hydrodistillation of the aerial parts of Valerianaparviflora (Trevir) BM Vadillo, an endemic species of the Venezuelan Andes, collected from the same location in two different seasons (dry and rainy) of the year, were analyzed by GC/MS. The essential oil obtained during the dry season showed linalool (11.9%), eugenol (8.9%), p-menth-l-en-9-al (8.7%) and α-terpineol (7.7%) as main components, while the oil obtained from the rainy season collection showed o-xylol (16.2%), 3-methyl isovaleric acid (10.6%) and geranial (9.5%) as major compounds. Some of the differences in the composition of these oils might be due to the climatic conditions at the time of harvesting.

Hydrodistillation of Vismia macrophylla Kunth (Hypericaceae) leaves (L) and fruits (F) yielded 1.3%, v/w, and 5.6%, v/w, of essential oil, respectively. GC and GC-MS analyses showed the presence of twenty-four (96.4%, L) and thirty-one (96.6%, F) components, respectively. Major compounds identified in the leaf oil were γ-bisabolene (44.4%) and β-bisabolol (14.9%), while those in the fruit oil were germacrene-D (12.1%), 6-cadinene (10.7%) and γ-bisabolene (22.3 %). Oil obtained from the fruits of V. macrophylla showed antibacterial activity against Gram-positive (S. aureus ATCC 25923 and E. faecalis ATCC 29212) as well as Gram-negative bacteria (E. coli ATCC 25922), with MIC values ranging from 150 μL/mL to 740 μL/mL. Oil obtained from leaves were active only on the Gram-positive bacteria S. aureus (100 μL/mL) and E. faecalis (500 μL/mL), but also showed antiyeast activity against Candida albicans CDC-B385 and C. krusei ATCC 6258 (600 μL/mL, each).

The essential oil from aerial parts of Conyza bonariensis (L) Cronquist collected in Mérida was obtained by hydrodistillation and analysed by GC/MS. The major components were trans-beta-farnesene (37.8%), trans-ocimene (20.7%) and beta-sesquiphellandrene (9.8%). Cytotoxicity assay was also performed with the essential oil against HeLa (cervix carcinoma), A-459 (lung carcinoma) and MCF-7 (breast adenocarcinoma) human cell lines and against normal Vero cells (African green monkey kidney) with IC50 values ranging from 1.4 to 45.8 microg/mL. Additionally, the essential oil presented a significant bactericidal effect against Bacillus cereus, while a moderate activity was observed against Staphylococcus epidermidis and Candida albicans.

Process evaluations are an often overlooked yet essential component of health promotion interventions. This study reports the results of a comprehensive process evaluation for the "Comics for Health" program, a childhood obesity prevention intervention implemented at 12 after-school programs. Qualitative and quantitative process data were collected using surveys, field notes, and open-item questionnaires, which assessed program fidelity, dose delivered, dose received, reach, recruitment, and context. Triangulation of methods was also employed to better understand how the program was implemented and received by the facilitator, staff members, and children in the program. Results indicated that program implementation had an almost perfect rate of fidelity with most lessons recording 100% tasks completed. Lessons were implemented in their intended order and lasted approximately 30 minutes as planned. After-school staff members reported that the program was well received by children, and this program should be replicated in the future. Attendance records showed that a majority of the children attended each lesson on the initial day of delivery (70.4%) and informal make-up lessons were implemented to compensate for the other children. Finally, several known sources of contamination were found such as past and concurrent exposure to similar health promotion interventions, which could potentially influence study outcomes. These findings will be used to help explain the results of this intervention and make recommendations for future intervention efforts.

The leaves and inflorescences of five species of Tagetes, family Asteraceae, were collected from different locations in Mérida state, Venezuela, and their essential oils analyzed by GC and GC/MS. Several differences were observed in the composition of these oils, mainly regarding the major components, which for T. caracasana were trans-ocimenone (64.3%) and cis-tagetone (13.7%), and for T. erecta, piperitone (35.9%) and terpinolene (22.2%). High amounts of trans-anethole (87.5%) and estragole (10.7%) were observed in T. filifolia, while T. subulata essential oil contained terpinolene (26.0%), piperitenone (13.1%) and limonene (10.8%). For T. patula, two different oil samples were analyzed, leaves (TPL) and inflorescences (TPI). The TPL oil showed terpinolene (20.9%) and piperitenone (14.0%) as main components, while the TPI sample was composed mainly of beta-caryophyllene (23.7%), terpinolene (15.6%) and cis-beta-ocimene (15.5%).

The essential oil of the leaves of Espeletia nana Cuatrec., obtained by hydrodistillation, was analyzed by GC-MS, which allowed the identification of 24 components, which made up 99.9% of the oil. The most abundant compounds were a-pinene (38.1%), beta-pinene (17.2%), myrcene (15.0%), spathulenol (4.2%), bicyclogermacrene (4.0%), a-zingiberene (4.0%), and gamma-himachalene (3.7%). Antibacterial activity was tested against Gram-positive and Gram-negative bacteria using the agar disk diffusion method. Activity was observed only against Gram-positive bacteria. MIC values were determined for Staphylococcus aureus ATCC 25923 (200 microg/mL) and Enterococcusfaecalis ATCC 29212 (600 microg/mL).

The aim of the present work is to investigate the link between two endocrine disruptor compounds (EDCs), which are chemicals that interfere with the hormone system in human and wildlife, and the human immune response through a study of their effects on the THP-1 human cell line which was used as a model for macrophages. We used two EDCs, diisononylphthalate (DiP) and 4-n-nonylphenol (NP) alone or in combination in order to evaluate the effects of these compounds on several parameters of the immune response - cytokine secretion, phagocytosis and the putative implication of the estrogen receptors - by studying the level of MAPK activation. NP and DiP strongly reduced phagocytosis and modify cytokine secretions. Indeed, differentiated THP-1 cell exposures (i) to 5 and 10 microM of combination of NP and DiP induced an IL-8 level in the medium respectively of 28.9 and 45 percent higher than the level obtained for the control (untreated cells), (ii) to combination of NP and DiP at 10 microM induced an increase of IL-1β level in comparison to the control level, (iii) to combination of NP and DiP induced an increase of TNF-α level whatever the concentration of EDCs tested (between 0 and 10 microM). Lastly, differentiated THP-1 cell exposure to NP, DiP alone or in combination (2 microM for each condition) induced a decrease of ERK1/2 phosphorylation in comparison to ERK1/2 phosphorylation level of the control. Moreover, differentiated THP-1 cell treatments by ICI-182780 (an estrogen receptor antagonist) supressed the EDC effects on ERK1/2 phosphorylation level which indicates an estrogen receptor-dependent pathway. These results suggest that EDCs have the ability to alter the human immune function, maybe by interfering with endocrine balance.

The essential oils from fresh aerial parts of Monticalia greenmaniana (Hieron) C. Jeffrey (Asteraceae) collected in March, were analyzed by GC/MS. Oil yields (w/v) of 0.1% (flowers), 0.07%, (stems) and 0.1% (leaves) were obtained by hydrodistillation. Thirteen, sixteen and eighteen components, respectively, were identified by comparison of their mass spectra with those in the Wiley GC-MS Library data base. The major components of the flower and stem oils were 1-nonane (38.8% flowers; 33.5% stems), alpha-pinene (29.0% flowers; 14.8% stems) and germacrene D (15.6% flowers; 18.6% stems). However, in the leaf oil, germacrene D was observed at 50.7%, followed by beta-cedrene at 8.4%. The leaf essential oil showed a broad spectrum of antibacterial activity against the important human pathogenic Gram-positive and Gram-negative bacteria Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 19433), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853) and Klebsiella pneumoniae (ATCC 25955) with MIC values ranging from 75 to 6000 ppm.

The essential oil obtained from the leaves of Lantana camara var. moritziana (Otto & Dietr.) López-Palacios collected at Rubio, Táchira State, Venezuela, was obtained by hydrodistillation in a Clevenger trap (0.1% yield). The oil was analyzed by gas chromatography-mass spectrometry (GC/MS) on HP GC-MS System, model 5973, identifying 33 compounds (97.1%) of which the major components were germacrene D (31.0%), followed by beta-caryophyllene (14.8%), a-phellandrene (6.7%), limonene (5.7%) and 1,8-cineole (5.2%). Evaluation of the antibacterial activity by agar diffusion method with discs against international reference bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Salmonella Typhi, Pseudomonas aeruginosa) showed growing inhibition of E. faecalis and S. aureus at MIC of 350 mg/mL and 400 mg/mL, respectively.

The essential oil from the fruits of Vismia baccifera Triana & Planch. (Gutttiferae), collected in June 2009, was analyzed by GC/MS. A yield of 0.6% oil was obtained by hydrodistillation. Twenty-seven components were identified by comparison of their mass spectra with those in the Wiley GC-MS Library data base. The major components were trans-cadin-l1,4-diene (36.6%), cis-cadin-1,4-diene (18.8%) and beta-caryophyllene (11.9%). The essential oil showed a broad spectrum of antibacterial activity against the important human pathogenic Gram-positive and Gram-negative bacteria Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 29212), Escherichia coli (ATCC 25992), Pseudomonas aeruginosa (ATCC 27853) and Klebsiella pneumoniae (ATCC 23357) with MIC values ranging from 9 to 37 microg/mL.

The essential oil from Vismia macrophylla Kunth (Guttiferae) leaves, extracted by hydrodistillation, was analyzed by GC/MS. The oil obtained (yield 0.11%) contained twenty-eight compounds, which were identified from their retention indices and by comparison of their mass spectra with those in the Wiley GC-MS Library data base. The major components were beta-caryophyllene (20.1%), germacrene D (11.6%) and beta-elemene (7.0%).

Networking is a proven strategy to enhance professional recognition and skills while promoting career development. Through a variety of techniques and for a multitude of reasons, health educators can enrich their professional endeavors by interacting and engaging in formal and informal networking with others. Through networking, health education professionals can offer each other assistance and support while establishing long-lasting mutually beneficial relationships. This article provides an overview of the basics of networking, reasons that networking is important, persons who can benefit from networking, and strategies on how to network and how to develop, maintain, and nurture a network.

The relationships among acculturation, health protective sexual communication, and HIV/AIDS risk behaviors of Hispanic women are examined. Respondents represented 14 Latin American countries, a mean age of 29.5 years, and relatively low education and income levels. A significant correlation was found between higher non-Hispanic acculturation level and higher sexual communication with new partners. Higher non-Hispanic acculturation levels were also correlated with higher number of sexual partners in the prior 12 months. The higher the score for health protective sexual communication, the higher the reported frequency of condom use with new sexual partners in the past 12 months. Given the low number of sexual partners, HIV/AIDS risk for this group of women appears to be related to not knowing whether their partners had other sexual partners and to low frequency of condom use. Implications for health education are discussed.

The status of the Golgi complex in normal vs osteoarthrotic (OA) cartilage has not yet been studied. A monoclonal antibody, MAb 58-K-9, allowed scoring of Golgi labeling intensity. In addition, ultrastructural assessment enabled us to focus on the distribution and relation between the endoplasmic reticulum (ER) and Golgi membranes. The study was performed in both normal and partially menisectomized OA-induced rat cartilage 20 and 45 days after surgery. Comparing Golgi immunolabeling intensities (mean +/- SEM) revealed a highly significant difference between normal (9.98 +/- 1.25), 20-day (2.49 +/- 0.34), and 45-day (0.82 +/- 0.22) cartilage. Moreover, chondrocytes from normal cartilage displayed 71.18% of labeling intensity in contrast to OA cartilage, in which chondrocyte labeling intensities were 24.95% (20 days) and 8.11% (45 days). OA chondrocytes appeared to display an overall reduction in Golgi labeling intensity, suggesting disruption of this organelle as the OA damage progressed. Interestingly, many 20-day OA-induced chondrocytes exhibited bubble-like Golgi immunolabeling compartmentalizing the cytoplasm, concomitant with putative apoptotic nuclear changes. At the same time, OA chondrocytes with a typical ultrastructural apoptotic pattern revealed a prominent ER gathered together with Golgi vesicles and saccules, also appearing to compartmentalize chondrocyte cytoplasm. We speculate about the role of Golgi modifications and apoptosis in OA pathogenesis.