Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction.

Aims: We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy. Methods and Results: Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression analysis to identify independent predictors of post-AMI beta-blocker initiation. We computed the proportion of days covered (PCD) as a measure of medication adherence at 6 and 12 months post-discharge. Following discharge, 16,383 (67%) cohort members initiated beta-blocker therapy. Independent predictors of beta-blocker initiation included age and receipt of invasive procedures during hospitalization, such as coronary artery bypass graft surgery (odds ratio [OR], 2.37; 95% confidence interval [CI], 2.00-2.81), percutaneous transluminal coronary angioplasty (OR, 1.42; 95% CI, 1.31-1.54), and cardiac catheterization (OR, 1.21; 95% CI, 1.11-1.32). Among initiators, adherence to beta-blocker treatment at 6 and 12 months was low and decreased in each study year. Conclusion: Overall, use of and adherence to post-AMI beta-blocker therapy was suboptimal in RER between 2004 and 2007. Older patients and those with indicators of frailty were less likely to initiate therapy. The proportion of patients adherent at 6 and 12 months decreased over time

Fostering the Development of Emotional Intelligence among Health Science Students: Empowering Students to Impact Institutional Culture

Objectives: Identify challenges of navigating institutional culture for students interacting in a variety of clinical settings Discuss the importance of integrating concepts of emotional intelligence throughout curricular plans of study Consider contemporary research findings in the health science literature regarding emotional intelligence among students.https://jdc.jefferson.edu/nursingposters/1000/thumbnail.jp

Reputation Agent: Prompting Fair Reviews in Gig Markets

Our study presents a new tool, Reputation Agent, to promote fairer reviews from requesters (employers or customers) on gig markets. Unfair reviews, created when requesters consider factors outside of a worker's control, are known to plague gig workers and can result in lost job opportunities and even termination from the marketplace. Our tool leverages machine learning to implement an intelligent interface that: (1) uses deep learning to automatically detect when an individual has included unfair factors into her review (factors outside the worker's control per the policies of the market); and (2) prompts the individual to reconsider her review if she has incorporated unfair factors. To study the effectiveness of Reputation Agent, we conducted a controlled experiment over different gig markets. Our experiment illustrates that across markets, Reputation Agent, in contrast with traditional approaches, motivates requesters to review gig workers' performance more fairly. We discuss how tools that bring more transparency to employers about the policies of a gig market can help build empathy thus resulting in reasoned discussions around potential injustices towards workers generated by these interfaces. Our vision is that with tools that promote truth and transparency we can bring fairer treatment to gig workers.Comment: 12 pages, 5 figures, The Web Conference 2020, ACM WWW 202

Tissue-specific calibration of extracellular matrix material properties by transforming growth factor-beta and Runx2 in bone is required for hearing

Publisher version: http://www.nature.com/embor/journal/v11/n10/full/embor2010135.htmlDA - 20100917 IS - 1469-3178 (Electronic) IS - 1469-221X (Linking) LA - ENG PT - JOURNAL ARTICLEDA - 20100917 IS - 1469-3178 (Electronic) IS - 1469-221X (Linking) LA - ENG PT - JOURNAL ARTICLEDA - 20100917 IS - 1469-3178 (Electronic) IS - 1469-221X (Linking) LA - ENG PT - JOURNAL ARTICLEPhysical cues, such as extracellular matrix stiffness, direct cell differentiation and support tissue-specific function. Perturbation of these cues underlies diverse pathologies, including osteoarthritis, cardiovascular disease and cancer. However, the molecular mechanisms that establish tissue-specific material properties and link them to healthy tissue function are unknown. We show that Runx2, a key lineage-specific transcription factor, regulates the material properties of bone matrix through the same transforming growth factor-beta (TGFbeta)-responsive pathway that controls osteoblast differentiation. Deregulated TGFbeta or Runx2 function compromises the distinctly hard cochlear bone matrix and causes hearing loss, as seen in human cleidocranial dysplasia. In Runx2(+/-) mice, inhibition of TGFbeta signalling rescues both the material properties of the defective matrix, and hearing. This study elucidates the unknown cause of hearing loss in cleidocranial dysplasia, and demonstrates that a molecular pathway controlling cell differentiation also defines material properties of extracellular matrix. Furthermore, our results suggest that the careful regulation of these properties is essential for healthy tissue functio

Strategies for Integrating Health Literacy into Entry-level OT Curricula: A Comprehensive Approach

Synopsis: Health literacy is a significant factor impacting the efficacy of healthcare services. Initiatives related to health literacy demonstrate that OTs have unique opportunities to promote health literacy and facilitate its integration into practice. It is therefore critical to explore ways in which health literacy content can be incorporated into entry-­‐level OT curricula. Doing so will help ensure that future practitioners are prepared to meet key standards related to health literacy, including those established by ACOTE. This session will highlight strategies and methods to incorporate health literacy into entry-­‐level OT curricula

The Role of Relationships in the Professional Formation of Physicians

BACKGROUND: Studies of the professional development of physicians highlight the important effect that the learning environment, or \ hidden curriculum,\ has in shaping student attitudes, behaviors, and values. We conducted this study to better understand the role that relationships have in mediating these effects of the hidden curriculum. [See PDF for complete abstract

The Toxicity of Extracts of Tephrosa virginiana (Fabaceae) in Oklahoma

The Hale Scout Reservation is located in the Ouachita Mountains of  southeastern Oklahoma, a region of high plant diversity in the state. A vascular plant inventory yielded 463 species of vascular plants in 288  genera and 99 families. The largest families were the Asteraceae (with 65 species) and Poaceae (56). The flora consisted of 120 annuals, 1 biennial,  and 342 perennials. Forty-two non-native species were collected, representing 8.8% of the flora. Sixteen species tracked by the Oklahoma Natural Heritage Inventory were present: Amorpha ouachitensis (S1), Aristolochia serpentaria (S1), Baptisia nuttalliana (S2), Brachyelytrum  erectum (S1), Brasenia schreberi (S1), Carex ouachitana (S1), Chionanthus virginicus (S2), Clematis crispa (S1), Didiplis diandra (S1S2), Galium arkansanum (S2), Houstonia ouachitana (S1), Juncus repens (S1), Modiola caroliniana (S2), Monotropa hypopithys (S1), Muhlenbergia bushii (S1), and Ribes cynosbati (S2) (Oklahoma Natural Heritage Inventory, 2010)

Preterm birth a long distance from home and its significant social and financial stress

The present paper reports a retrospective cohort of preterm infants admitted to our hospital who delivered outside the normal geographical catchment area of the mother's local level three neonatal nursery. Nineteen mothers had 21 preterm infants (23.1-34.9 weeks, 500-2330 g born) where 14 infants required ventilation (median 57 h, range 3-428). Eighteen survivors had a median length of stay of 41 days (range 3-91). Twelve of 19 mothers were interviewed: all described isolation, loneliness, poor social support and significant financial hardship related to getting their infants back to a local hospital or home. To avoid these problems, we recommend confining travel to within a short distance from home or local maternity unit after 22 weeks