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The disparities that Black/African-American women experience in health care are persistent and staggering. Findings from health outcomes research continue to demonstrate poorer outcomes for African-American women compared to women of other race/ethnicity in several conditions. These racial/ethnic and gender health disparities observed are complex, heavily nuanced and multi-factorial. To understand these, there is a need to apply an 'intersectionality' lens. Intersectionality refers to the experience of persons with multiple intersecting statuses. The objective of this exploratory study was to gain insight into the healthcare experiences of low-income African-American women. In-depth one-on-one interviews were conducted with 22 women and 2 focus group discussions with community leaders and advocates. Investigators conducted a thematic analysis of the transcripts. The thematic analysis revealed four major themes, which tell the story of the intersectional invisibility experienced by low-income AA women in the healthcare system. These included (1) the perception of 'not feeling heard'; (2) patient as 'expert of her own body'; (3) disregard of patient preferences; and (4) the need for self-advocacy. Black/African-American women, and particularly those with socioeconomic disadvantage, experience intersectional invisibility resulting from provider implicit bias, stereotypical assumptions, and systemic structures that enable discriminatory practices in healthcare delivery. Healthcare provider education that more explicitly addresses these biases and stereotypes should be complemented with system-level interventions that aim to dismantle the structural racism inherent in healthcare policies and practices. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide an initial assessment of the potential biologic activity of toceranib phosphate (Palladia®, Pfizer Animal Health, Madison, NJ, USA) in select solid tumours in dogs. Cases in which toceranib was used to treat dogs with apocrine gland anal sac adenocarcinoma (AGASACA), metastatic osteosarcoma (OSA), thyroid carcinoma, head and neck carcinoma and nasal carcinoma were included. Clinical benefit (CB) was observed in 63/85 (74%) dogs including 28/32 AGASACA [8 partial response (PR), 20 stable disease (SD)], 11/23 OSAs (1 PR and 10 SD), 12/15 thyroid carcinomas (4 PR and 8 SD), 7/8 head and neck carcinomas [1 complete response (CR), 5 PR and 1 SD] and 5/7 (1 CR and 4 SD) nasal carcinomas. For dogs experiencing CB, the median dose of toceranib was 2.8 mg kg−1, 36/63 (58.7%) were dosed on a Monday/Wednesday/Friday basis and 47/63 (74.6%) were treated 4 months or longer. Although these data provide preliminary evidence that toceranib exhibits CB in dogs with certain solid tumours, future prospective studies are necessary to define its true activity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In response to findings from a statewide survey of hospital nurses, the authors designed, conducted, and evaluated a 'Back to Sleep' nursing curriculum and training program in Missouri hospitals using two distinct training formats. This article evaluates the initial and follow-up outcomes for training participants and assesses the impact of training format on participant outcomes. METHODS: Participants selected training format by hospital site. In each training format, participants responded to a pre and post test questionnaire measuring knowledge, beliefs, and current infant care behaviors as well as satisfaction with the training. Three months after completion of all statewide trainings, the authors also conducted a follow-up survey. RESULTS: Nurses who participated in the training reported statistically significant improvements in knowledge and 'Back to Sleep' adherent beliefs. Over 98% of participants (N = 515) intended to place infants in back-only sleep positions following the training. Knowledge, attitudes, and practice intentions were significantly improved across both training formats. Additionally, follow-up survey respondents statewide (N = 295) reported lasting improvements, including 63% of nurses reportedly using supine-only sleep position for infants after the first 24 h of life, compared to 28% in the original statewide survey. CONCLUSIONS: Further research is needed to determine the long-term impact of this intervention and assess its applicability beyond this initial implementation. Ultimately, the findings from the evaluation of this pilot intervention and nursing-specific 'Back to Sleep' curriculum demonstrate that it has a promising effect on risk-reduction adherence in hospital settings where parent observations of safe sleep behavior first occur. [ABSTRACT FROM AUTHOR]

A chemical and radiochemical neutron activation analysis (CNAA/RNAA) method has been developed for the determination of three calcium isotopes (48Ca,46Ca, and44Ca) in a single sample derived from urine. This method was developed in support of clinical research using a dual enriched stable isotope methodology to study bone mineralization in premature infants, juvenile rheumatoid arthritics, and cystic fibrosis. In these studies, one enriched isotope of calcium is administered orally, and one is administered intravenously. By making determinations of three isotopes (two enriched, one unenriched) within the same sample, the perturbation from natural isotopic ratios can be determined and used to calculate true absorption of calcium. In our method,48Ca is determined via the48Ca(n,γ)49Ca reaction and 3084 keV gamma-ray,46Ca via the46Ca(n,γ)47Ca reaction and 1296 keV gamma-ray, and44Ca via the44Ca(n,γ)45Ca reaction and 256 keV (max) beta-particle. A pair of chemical separation steps are employed to separate calcium from urine as calcium oxalate with a yield in the range of 80–90%, and a radiochemical step is employed prior to the measurement of45Ca to remove interfering radionuclides. [ABSTRACT FROM AUTHOR]

Serum 1,25(OH)2D concentrations were measured in serial serum samples from 19 premature infants of 29.6 +/- 1.3 weeks gestation and 1,129 +/- 159 g birthweight. 1,25(OH)2D was always normal or elevated and mean concentrations increased with age (adult, 55.2 +/- 13; infants, 1-2 weeks, 81.5 +/- 37.7 pg/mg; 3 weeks, 65 +/- 21; 6 weeks, 90.0 +/- 17.3; 9 weeks, 99.0 +/- 25.1; 12 weeks, 103.3 +/- 26.6 pg/ml). No correlation was seen with 25-OHD. Infants given 800 IU D2 supplements had lower 1,25(OH)2D levels than infants given 400 IU D2. Breast fed infants had initially higher 1,25(OH)2D levels; however, this was not sustained. These preliminary data suggest that premature infants regulate 1,25(OH)2D production similar to more mature infants and children. Whether the premature infant has a normal gastrointestinal and/or bone responsiveness to 1,25(OH)2D and whether these elevated 1,25(OH)2D concentrations are "adequately elevated" requires further study. [ABSTRACT FROM AUTHOR]