Stroke Management

1993 ◽  
Vol 6 (6) ◽  
pp. 297-303
Author(s):  
Susan C. Fagan
Keyword(s):  
Cerebral Ischemia ◽  
Antiplatelet Agent ◽  
The United States ◽  
Minor Stroke ◽  
Future Research ◽  
Stroke Management ◽  
Pharmacological Agents ◽  
Glutamate Antagonists ◽  
First Line Therapy ◽  
Patients At Risk

With as many as 500,000 new strokes per year in the United States, the need for safe and effective therapy of these patients is evident. The area in which the greatest impact has been made is in the development of prophylactic treatments for patients at risk of stroke. Aspirin, long the mainstay of stroke management, has repeatedly been shown to reduce the risk of cerebral ischemia in patients who have had a transient ischemic attack (TIA) or minor stroke and is first-line therapy for these patients. Either 325 mg or 975 mg of aspirin may be used. Ticlopidine (250 mg twice daily) is a new antiplatelet agent that is recommended for the prophylaxis of stroke in patients who cannot tolerate or who are resistant to aspirin therapy. The surgical procedure, carotid endarterectomy, has been shown to reduce the stroke rate in symptomatic patients, with between 70% to 99% stenosis of a carotid artery. The use of warfarin has been shown to be extremely useful in patients with atrial fibrillation for prevention of recurrent embolic events. The use of pharmacological agents in the acute treatment of the ischemic stroke patient has not yet been proven successful. It is hoped that with the trend towards hyperacute (less than 6 hours) intervention, investigators may be successful in finding an agent to decrease the ultimate neurological deficit due to stroke. Some of the more promising agents are thrombolytics, glutamate antagonists, and aminosteroids. Future research in cerebral ischemia will undoubtedly improve the prognosis of stroke patients.

Real-world treatment patterns and outcomes in ER+/PR+/HER2+ metastatic breast cancer (MBC) patients: A National Cancer Database analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1033-1033 ◽  
Author(s):  
Abby Statler ◽  
Zeina A. Nahleh ◽  
Brian Hobbs ◽  
Wei (Auston) Wei ◽  
Annie Gupta ◽  
...  
Keyword(s):  
Real World ◽  
Survival Data ◽  
Metastatic Breast ◽  
The United States ◽  
Treatment Patterns ◽  
Rank Test ◽  
Future Research ◽  
National Cancer Database ◽  
First Line ◽  
First Line Therapy

1033 Background: Treatment patterns and clinical outcomes are unclear for MBC patients diagnosed with estrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+) human epidermal growth factor 2 positive (HER2+) disease (i.e. triple positive). This study aimed to: 1) examine the utilization of first-line therapy among ER+/PR+/HER2+ MBC patients and 2) compare overall survival (OS) between the identified regimens. Methods: We analyzed triple positive MBC patients included in the National Cancer Database who were treated with endocrine therapy (ET) or chemotherapy (chemo) between 2010 and 2015. Kaplan-Meier method was used to estimate distributions of OS, which were compared among patient cohorts using the log-rank test. Results: A total of 6,234 patients were included in the analysis; of these, 3770 (60%) received ET and 2464 (40%) received chemo. Of those with complete survival data, there was no difference in median OS between patients treated with chemo vs. ET; however, those who received anti-HER2 therapy had significantly better OS than those who did not (median OS 49.4 vs. 41.0 months, p < 0.0001). Median OS stratified by ET or chemo with and without anti-HER2 further supported these findings, revealing the addition of anit-HER2 therapy to chemotherapy and ET resulted in superior median OS (Table). Conclusions: This is the first study to evaluate treatment utilization and OS among real-world triple positive MBC patients treated with ET or chemo. Our results suggest the majority of patients in the United States are treated with first-line ET; furthermore, the reported OS outcomes support the consideration of ET plus anti-HER2 therapy as a first-line treatment option for ER+/PR+/HER2+ MBC. Prospective trials evaluating de-escalation of systemic therapy in this subgroup of patients and future research to identify biomarkers to determine which patients can avoid chemotherapy are warranted. [Table: see text]

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

A Silenced Population

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Kim Gryglewicz ◽  
Melanie Bozzay ◽  
Brittany Arthur-Jordon ◽  
Gabriela D. Romero ◽  
Melissa Witmeier ◽  
...  
Keyword(s):  
At Risk ◽  
Depressive Symptomatology ◽  
The United States ◽  
Future Research ◽  
At Risk Youth ◽  
Peer Relationship ◽  
Student Records ◽  
Cross Sectional ◽  
Increased Risk ◽  
Method Student

Abstract. Background: Given challenges that exceed the normal developmental requirements of adolescence, deaf and hard-of-hearing (DHH) youth are believed to be at elevated risk for engaging in suicide-related behavior (SRB). Unfortunately, little is known about the mechanisms that put these youth potentially at risk. Aims: To determine whether peer relationship difficulties are related to increased risk of SRB in DHH youth. Method: Student records (n = 74) were retrieved from an accredited educational center for deaf and blind students in the United States. Results: Peer relationship difficulties were found to be significantly associated with engagement in SRB but not when accounting for depressive symptomatology. Limitations: The restricted sample limits generalizability. Conclusions regarding risk causation cannot be made due to the cross-sectional nature of the study. Conclusion: These results suggest the need for future research that examines the mechanisms of the relationship between peer relationship difficulties, depression, and suicide risk in DHH youth and potential preventive interventions to ameliorate the risks for these at-risk youth.

Ideal body position for epinephrine autoinjector administration

2020 ◽  
Author(s):  
Qing Wang ◽  
Luke Pittman ◽  
Andrew Healey ◽  
James Chang ◽  
T. Ted Song
Keyword(s):  
Body Position ◽  
Vastus Lateralis ◽  
The United States ◽  
Thigh Muscle ◽  
First Line ◽  
Medical Treatment Facility ◽  
First Line Therapy ◽  
Epinephrine Autoinjector ◽  
Ideal Body ◽  
The Ideal

Background: Epinephrine is the first-line therapy for patients with anaphylaxis, and intramuscular (IM) delivery is shownto be superior to subcutaneous (SC) delivery. There currently is no consensus on the ideal body position for epinephrine autoinjector (EAI) administration.Objective: We designed this study to investigate whether SC tissue depth (SCTD) is affected by body position (e.g., standing, sitting, supine), which can potentially impact delivery of EAI into the IM space.Methods: Volunteer adults (ages >/= 18 years) from a military medical treatment facility in the United States were recruitedto participate in this study. SCTD of the vastus lateralis was measured via ultrasound at standing, sitting, and supine bodypositions. Subjects’ age, sex, and body mass index (BMI) were collected. Statistical analysis was performed to compare averageSCTD between body positions, sex, and BMI.Results: An analysis of variance of 51 participants (33 men and 18 women) did not reveal statistically significant differencein SCTD among standing, sitting, and supine body positions. It did show a significantly greater SCTD in women than in men (2.72 +/- 1.36 cm versus 1.10 +/- 0.38 cm; p < 0.001). There was no significant association observed between BMI and SCTD in this study.Conclusion: Body position did not seem to significantly change the distance between skin and thigh muscle in adults. Thiswould suggest that there might not be an ideal body position for EAI administration. Therefore, in case of anaphylaxis, promptadministration of epinephrine is recommended at any position.

Fragments of the American Dream: Immigration, Race, and Medical Care in the Segregated South, 1929

Public Voices ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 1
Author(s):  
John R Phillips
Keyword(s):  
United States ◽  
American Dream ◽  
Black Population ◽  
The United States ◽  
Single Woman ◽  
Future Research ◽  
Legal Doctrine ◽  
Quarter Century ◽  
History Of ◽  
Sunflower County

The cover photograph for this issue of Public Voices was taken sometime in the summer of 1929 (probably June) somewhere in Sunflower County, Mississippi. Very probably the photo was taken in Indianola but, perhaps, it was Ruleville. It is one of three such photos, one of which does have the annotation on the reverse “Ruleville Midwives Club 1929.” The young woman wearing a tie in this and in one of the other photos was Ann Reid Brown, R.N., then a single woman having only arrived in the United States from Scotland a few years before, in 1923. Full disclosure: This commentary on the photo combines professional research interests in public administration and public policy with personal interests—family interests—for that young nurse later married and became the author’s mother. From the scholarly perspective, such photographs have been seen as “instrumental in establishing midwives’ credentials and cultural identity at a key transitional moment in the history of the midwife and of public health” (Keith, Brennan, & Reynolds 2012). There is also deep irony if we see these photographs as being a fragment of the American dream, of a recent immigrant’s hope for and success at achieving that dream; but that fragment of the vision is understood quite differently when we see that she began a hopeful career working with a Black population forcibly segregated by law under the incongruously named “separate but equal” legal doctrine. That doctrine, derived from the United States Supreme Court’s 1896 decision, Plessy v. Ferguson, would remain the foundation for legally enforced segregation throughout the South for another quarter century. The options open to the young, white, immigrant nurse were almost entirely closed off for the population with which she then worked. The remaining parts of this overview are meant to provide the following: (1) some biographical information on the nurse; (2) a description, in so far as we know it, of why she was in Mississippi; and (3) some indication of areas for future research on this and related topics.

Questions

2018 ◽  
Author(s):  
James L. Gibson ◽  
Michael J. Nelson
Keyword(s):  
United States ◽  
African Americans ◽  
Supreme Court ◽  
Legal System ◽  
Public Support ◽  
The United States ◽  
Future Research ◽  
White Americans ◽  
Two Factors ◽  
The U.S

We have investigated the differences in support for the U.S. Supreme Court among black, Hispanic, and white Americans, catalogued the variation in African Americans’ group attachments and experiences with legal authorities, and examined how those latter two factors shape individuals’ support for the U.S. Supreme Court, that Court’s decisions, and for their local legal system. We take this opportunity to weave our findings together, taking stock of what we have learned from our analyses and what seem like fruitful paths for future research. In the process, we revisit Positivity Theory. We present a modified version of the theory that we hope will guide future inquiry on public support for courts, both in the United States and abroad.

Introduction

2017 ◽  
Author(s):  
Travis D. Stimeling
Keyword(s):  
United States ◽  
The United States ◽  
Country Music ◽  
Future Research ◽  
Music Culture ◽  
Rich Variety ◽  
Ethnographic Studies ◽  
Folklore Studies ◽  
History Of ◽  
The Rich

This chapter offers a historiographic survey of country music scholarship from the publication of Bill C. Malone’s “A History of Commercial Country Music in the United States, 1920–1964” (1965) to the leading publications of the today. Very little of substance has been written on country music recorded since the 1970s, especially when compared to the wealth of available literature on early country recording artists. Ethnographic studies of country music and country music culture are rare, and including ethnographic methods in country music studies offers new insights into the rich variety of ways in which people make, consume, and engage with country music as a genre. The chapter traces the influence of folklore studies, sociology, cultural studies, and musicology on the development of country music studies and proposes some directions for future research in the field.

The Energy Politics of the United States

2020 ◽  
pp. 371-405
Author(s):  
Juliann Emmons Allison ◽  
Srinivas Parinandi
Keyword(s):  
Energy Policy ◽  
The United States ◽  
Political Polarization ◽  
Future Research ◽  
Future Research Agenda ◽  
Production And Consumption ◽  
Energy Politics ◽  
Climate Action ◽  
Subnational Governance

This chapter examines the development and politics of US energy policy, with an emphasis on three themes: the distribution of authority to regulate energy between national (or federal) and subnational governments, the relationship between energy and environmental policy and regulation, and the role of climate action in energy politics. It reviews patterns of energy production and consumption; provides an overview of national energy politics; and reviews literatures on federalism and energy politics and policy, the increasing integration of energy and environmental policies, and the politics of energy and climate action. The chapter concludes with a discussion of a future research agenda that underscores the significance of political polarization, subnational governance, and technological innovation for understanding US energy policy.

The Interplay of Developing Morality and Gender Attitudes

2020 ◽  
pp. 724-745
Author(s):  
Rebecca S. Bigler ◽  
Lynn S. Liben
Keyword(s):  
Psychological Theory ◽  
The United States ◽  
Gender Nonconformity ◽  
Gender Attitudes ◽  
Future Research ◽  
Policy And Practice ◽  
Ethical Policy ◽  
History Of ◽  
And Gender ◽  
And Behavior

Morality and gender are intersecting realms of human thought and behavior. Reasoning and action at their intersection (e.g., views of women’s rights legislation) carry important consequences for societies, communities, and individual lives. In this chapter, the authors argue that children’s developing views of morality and gender reciprocally shape one another in important and underexplored ways. The chapter begins with a brief history of psychological theory and research at the intersection of morality and gender and suggests reasons for the historical failure to view gender attitudes through moral lenses. The authors then describe reasons for expecting morality to play an important role in shaping children’s developing gender attitudes and, reciprocally, for gender attitudes to play an important role in shaping children’s developing moral values. The authors next illustrate the importance and relevance of these ideas by discussing two topics at the center of contentious debate in the United States concerning ethical policy and practice: treatment of gender nonconformity and gender-segregated schooling. The chapter concludes with suggestions for future research.

Disparities in Health Between Black and White Americans: Current Knowledge and Directions for Future Research

2018 ◽  
pp. 456-478
Author(s):  
Thomas E. Fuller-Rowell ◽  
David S. Curtis ◽  
Adrienne M. Duke
Keyword(s):  
Health Disparities ◽  
Current Knowledge ◽  
Public Investment ◽  
The United States ◽  
Future Research ◽  
Sociocultural Factors ◽  
White Americans ◽  
Biological Mechanisms ◽  
Black And White ◽  
Racial Ethnic

Conceptual frameworks for racial/ethnic health disparities are abundant, but many have received insufficient empirical attention. As a result, there are substantial gaps in scientific knowledge and a range of untested hypotheses. Particularly lacking is specificity in behavioral and biological mechanisms for such disparities and their underlying social determinants. Alongside lack of political will and public investment, insufficient clarity in mechanisms has stymied efforts to address racial health disparities. Capitalizing on emergent findings from the Midlife in the United States (MIDUS) study and other longitudinal studies of aging, this chapter evaluates research on health disparities between black and white US adults. Attention is given to candidate behavioral and biological mechanisms as precursors to group differences in morbidity and mortality and to environmental and sociocultural factors that may underlie these mechanisms. Future research topics are discussed, emphasizing those that offer promise with respect to illuminating practical solutions to racial/ethnic health disparities.

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