Group therapeutic singing improves clinical motor scores in persons with Parkinson's disease.

Background: Previous reports suggest that group therapeutic singing (GTS) may have a positive effect on motor symptoms in persons with Parkinson's disease (PD). Objective: To determine the effect of a single session of GTS on clinical motor symptoms. Methods: Clinical motor symptom assessment was completed immediately before and after 1 hour of GTS in 18 participants. Results: A significant decrease in average scores for gait and posture and tremor, but not speech and facial expression or bradykinesia was revealed. Conclusion: These results support the notion that GTS is a beneficial adjuvant therapy for persons with PD that warrants further research.

Undergraduate health professions students' perceptions of athletic training students before and after an interprofessional case study program.

Students pursuing careers in health professions may initially approach their training with preconceived ideas and perceptions of those who practice different health-related careers. Little research has been conducted on athletic training students and professional stereotypes or athletic training students and interprofessional education in general. Because interprofessional education may provide some positive effects on stereotypes, the goal of this study was to measure undergraduate health professions student stereotypes of athletic training students before and after an interprofessional case study program. Undergraduate nursing and public health interprofessional case study program participants assessed various relational and intrapersonal capabilities for their own professions and the athletic training profession, pre-post-program. For nursing student participants with athletic training students on their team, perceptions of their own profession and the athletic training profession significantly (p <.05) increased as compared to those with no athletic training student on their team. For public health student participants, although scores increased, no significant differences were found. Interprofessional collaborative experiences may decrease negative stereotypes of other professions, including athletic training.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors.

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

Associations of leptin and adiponectin with incident type 2 diabetes and interactions among African Americans: the Jackson heart study.

BACKGROUND: Growing evidence suggests that leptin is critical for glycemic control. Impaired leptin signaling may also contribute to low adiponectin expression in obese individuals. We assessed the association of leptin and adiponectin with incident type 2 diabetes (T2D), their interactions with sex and obesity status, and mediation by insulin resistance. METHODS: We included study participants from the Jackson Heart Study, a prospective cohort of adult African Americans in Jackson, Mississippi, that were free of T2D at the baseline Exam 1. Incident T2D was defined as new cases at Exam 2 or Exam 3. We created separate Cox regression models (hazard ratios per log-transformed ng/mL of leptin and adiponectin) with and without insulin resistance, HOMA-IR. Mediation by insulin resistance was analyzed. Several interactions were assessed, including by sex, HbA1c, and obesity. RESULTS: Among our 3363 participants (mean age 53 years, 63% women), 584 developed incident T2D. Leptin was directly associated with incident T2D when modeled without HOMA-IR (HR = 1.29, 95% CI = 1.05-1.58). This direct association between leptin and T2D was significant among men (HR = 1.33, 95% CI = 1.05-1.69), but nonsignificant among women (HR = 1.24, 95% CI = 0.94-1.64); statistical interaction with sex was nonsignificant (p = 0.65). The associations in all participants and in men were nullified by HOMA-IR (HR = 0.99, 95% CI = 0.80-1.22; HR = 1.00, 95% CI = 0.78-1.28, respectively), indicating mediation through insulin resistance (proportion mediated: 1.04), and were not observed in abdominally obese participants. Adiponectin was inversely associated with T2D even after adjustment for HOMA-IR in women (HR = 0.68, 95% CI = 0.55-0.84), but not in men (HR = 0.80, 95% CI = 0.62-1.04). The inverse association was present only among abdominally obese participants, and persisted after adjustment for HOMA-IR. CONCLUSIONS: Among African Americans in the Jackson Heart Study the association of leptin with incident type 2 diabetes was mediated by insulin resistance. This association was present only among abdominally non-obese participants. Differences by sex appeared: men showed a significant association mediated by insulin resistance. Among abdominally obese participants, adiponectin was inversely associated with incident T2D even after adjustment for HOMA-IR. Our results should inform future clinical trials that aim to reduce the burden of type 2 diabetes through the modification of serum levels of leptin and adiponectin.

Public Health and School Nurses' Perceptions of Barriers to HPV Vaccination in Missouri.

Human Papilloma Virus (HPV) is associated with various forms of cancer and is preventable with vaccination. Nurses are in a unique position to directly influence a person's decision to receive the HPV vaccine. A statewide sample of both school and public health nurses was used to assess knowledge and attitudes related to the HPV vaccine as well as nurse's behaviors and behavioral intentions toward educating parents and recommending the vaccine. Positive attitudes and adequate knowledge levels were found, however, the majority of school nurses did not provide information and resources to parents. Targeted health promotion programs for school nurses are recommended.

Diagnosis and pharmacological treatment of chronic actinic dermatitis in the elderly: an update.

Chronic actinic dermatitis (CAD) describes a condition resulting from abnormal photosensitivity; the dermatitis is clinically similar to contact allergic dermatitis. Sun-exposed skin is more commonly affected but the condition can extend to and encompass unexposed skin. CAD is relatively rare but becomes more prevalent in the elderly population. Phototesting, patch testing and laboratory results should be used to help guide diagnosis. In the elderly, it is important to distinguish CAD from drug-induced photosensitivity. Management of the condition requires sunlight avoidance and use of sunscreens, topical emollients and topical corticosteroids. Oral corticosteroids and immunosuppressive therapy such as azathioprine may be indicated but should be used with caution in the elderly.