A cross-sectional study of depressive symptoms and diabetes self-care in African Americans and Hispanics/Latinos with diabetes: the role of self-efficacy

Purpose The purpose of this study is to examine the relationship between depressive symptoms and diabetes self-care in African American and Hispanic/Latino patients with type 2 diabetes and whether the association, if any, is mediated by diabetes-related self-efficacy. Methods The sample included self-report baseline data of African American and Hispanic/Latino patients with type 2 diabetes who were aged ≥18 years and enrolled in a diabetes self-management intervention study. Depressive symptoms were assessed with the 9-item Patient Health Questionnaire. The Summary of Diabetes Self-care Activities measured engagement in healthy eating, physical activity, blood glucose checking, foot care, and smoking. The Diabetes Empowerment Scale–Short Form assessed diabetes-related psychosocial self-efficacy. Indirect effects were examined with the Baron and Kenny regression technique and Sobel testing. Results Sample characteristics (n = 250) were as follows: mean age of 53 years, 68% women, 54% African American, and 74% with income <$20 000. Depressive symptoms showed a significant inverse association with the self-care domains of general diet, specific diet, physical activity, and glucose monitoring in the African American group. In Hispanics/Latinos, depression was inversely associated with specific diet. Self-efficacy served a significant mediational role in the relation between depression and foot care among African Americans. Conclusions Self-efficacy mediated the relationship between depression and foot care in the African American group but was not found to be a mediator of any self-care areas within the Hispanic/Latino group. In clinical practice, alleviation of depressive symptoms may improve self-care behavior adherence. Diabetes education may consider inclusion of components to build self-efficacy related to diabetes self-care, especially among African American patients

Deposition and Resuspension of Sediments in Near Bank Water Zones of the River Elbe

Catchment processes, such as spatially and temporally distributed rainfall, influence quantity and quality of river runoffs and thus, the transport of particulate sediments and associated contaminants in a river network. During flood events resuspension of contaminated sediments impacts the water quality and thus, it is important to determine the erosion probability of such deposits. The research is focused on the River Elbe deposits in groyne fields and their sediment dynamics. High percentage of contaminated deposits in the groyne fields originate from the tributary Mulde, which discharges high concentrations of arsenic and lead into the Elbe [Kraft, 2007]. Various hydrological scenarios were investigated for a 112 km long river reach of the Middle Elbe to predict the spatial distribution of the particulate suspended sediments and associated contaminants. The scenario results gave the estimation of erosion probability and pointed out the importance of the Mulde as the main contributor to the groyne field deposition and their potential source of contamination

Impact of community pharmacist intervention on concurrent benzodiazepine and opioid prescribing patterns

Objectives (1) To evaluate the number of opioid/benzodiazepine (BZD) prescription changes resulting from pharmacist communication to prescriber(s); (2) to determine the number of patients on concurrent opioid/BZD therapy from single versus multiple prescribers; (3) to compare the number of opioid/BZD prescription changes resulting from communication when a single versus multiple prescribers was involved in a patient’s care; and (4) to compare the number of opioid/BZD prescription changes resulting from communication via fax versus the Kansas Health Information Network (KHIN) direct messaging feature. Methods Prospective study conducted at 13 community pharmacies, including patients 18 years of age or older simultaneously filling opioid and BZD prescriptions within 90 days before October 2017. Prescribers received faxed or KHIN communication proposing evidence-based prescription changes to opioid/BZD agents. Prescription changes were evaluated weekly for 3 months after the initial intervention. Descriptive statistics assessed demographics and the number and types of prescription changes. Spearman rho correlations compared prescription changes and number of prescriptions to number of prescribers; a priori alpha was set at 0.05. Results A total of 137 prescribers and 121 patients were included. Ninety-nine prescribers were contacted via fax and 38 via KHIN. After 4 weeks, 34 recommendations were received: 20 responses (59%) indicated rejection of recommendations, 5 (15%) approved BZD taper/discontinuation, 3 (9%) deferred changes until a patient visit, 2 (6%) approved opioid taper/discontinuation, 2 (6%) prescribed naloxone, and 2 (6%) withdrew from the patient’s care. Three months after communication, 35 prescription changes were noted: 22 (63%) opioid/BZD agent tapers/discontinuation, 14 (26%) opioid/BZD dose increases, and 2 (6%) naloxone prescriptions. There was positive correlation between the number of tapered/discontinued agents and the number of prescribers involved in a patient’s care (P = 0.046). Conclusion A faxed pharmacist intervention may help to reduce opioid/BZD coprescribing, especially when multiple providers are involved in a patient’s care

A cross-sectional study of depressive symptoms and diabetes self-care in African Americans and Hispanics/Latinos with diabetes: the role of self-efficacy

Purpose The purpose of this study is to examine the relationship between depressive symptoms and diabetes self-care in African American and Hispanic/Latino patients with type 2 diabetes and whether the association, if any, is mediated by diabetes-related self-efficacy. Methods The sample included self-report baseline data of African American and Hispanic/Latino patients with type 2 diabetes who were aged ≥18 years and enrolled in a diabetes self-management intervention study. Depressive symptoms were assessed with the 9-item Patient Health Questionnaire. The Summary of Diabetes Self-care Activities measured engagement in healthy eating, physical activity, blood glucose checking, foot care, and smoking. The Diabetes Empowerment Scale–Short Form assessed diabetes-related psychosocial self-efficacy. Indirect effects were examined with the Baron and Kenny regression technique and Sobel testing. Results Sample characteristics (n = 250) were as follows: mean age of 53 years, 68% women, 54% African American, and 74% with income <$20 000. Depressive symptoms showed a significant inverse association with the self-care domains of general diet, specific diet, physical activity, and glucose monitoring in the African American group. In Hispanics/Latinos, depression was inversely associated with specific diet. Self-efficacy served a significant mediational role in the relation between depression and foot care among African Americans. Conclusions Self-efficacy mediated the relationship between depression and foot care in the African American group but was not found to be a mediator of any self-care areas within the Hispanic/Latino group. In clinical practice, alleviation of depressive symptoms may improve self-care behavior adherence. Diabetes education may consider inclusion of components to build self-efficacy related to diabetes self-care, especially among African American patients

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Metal ions in macrophage antimicrobial pathways: emerging roles for zinc and copper

The immunomodulatory and antimicrobial properties of zinc and copper have long been appreciated. In addition, these metal ions are also essential for microbial growth and survival. This presents opportunities for the host to either harness their antimicrobial properties or limit their availability as defence strategies. Recent studies have shed some light on mechanisms by which copper and zinc regulation contribute to host defence, but there remain many unanswered questions at the cellular and molecular levels. Here we review the roles of these two metal ions in providing protection against infectious diseases in vivo, and in regulating innate immune responses. In particular, we focus on studies implicating zinc and copper in macrophage antimicrobial pathways, as well as the specific host genes encoding zinc transporters (SLC30A, SLC39A family members) and CTRs (copper transporters, ATP7 family members) that may contribute to pathogen control by these cells

Bioavailable Trace Metals in Neurological Diseases

Medical treatment in Wilson’s disease includes chelators (d-penicillamine and trientine) or zinc salts that have to be maintain all the lifelong. This pharmacological treatment is categorised into two phases; the first being a de-coppering phase and the second a maintenance one. The best therapeutic approach remains controversial, as only a few non-controlled trials have compared these treatments. During the initial phase, progressive increase of chelators’ doses adjusted to exchangeable copper and urinary copper might help to avoid neurological deterioration. Liver transplantation is indicated in acute fulminant liver failure and decompensated cirrhosis; in cases of neurologic deterioration, it must be individually discussed. During the maintenance phase, the most important challenge is to obtain a good adherence to lifelong medical therapy. Neurodegenerative diseases that lead to a mislocalisation of iron can be caused by a culmination of localised overload (pro-oxidant siderosis) and localised deficiency (metabolic distress). A new therapeutic concept with conservative iron chelation rescues iron-overloaded neurons by scavenging labile iron and, by delivering this chelated metal to endogenous apo-transferrin, allows iron redistribution to avoid systemic loss of iron

Differential Expression of Novel Potential Regulators in Hematopoietic Stem Cells

The hematopoietic system is an invaluable model both for understanding basic developmental biology and for developing clinically relevant cell therapies. Using highly purified cells and rigorous microarray analysis we have compared the expression pattern of three of the most primitive hematopoietic subpopulations in adult mouse bone marrow: long-term hematopoietic stem cells (HSC), short-term HSC, and multipotent progenitors. All three populations are capable of differentiating into a spectrum of mature blood cells, but differ in their self-renewal and proliferative capacity. We identified numerous novel potential regulators of HSC self-renewal and proliferation that were differentially expressed between these closely related cell populations. Many of the differentially expressed transcripts fit into pathways and protein complexes not previously identified in HSC, providing evidence for new HSC regulatory units. Extending these observations to the protein level, we demonstrate expression of several of the corresponding proteins, which provide novel surface markers for HSC. We discuss the implications of our findings for HSC biology. In particular, our data suggest that cell–cell and cell–matrix interactions are major regulators of long-term HSC, and that HSC themselves play important roles in regulating their immediate microenvironment