Evaluation of efficacy and safety of lascufloxacin for nursing and healthcare associated pneumonia: single-arm, open-label clinical trial: A study protocol.

BACKGROUND: Lascufloxacin hydrochloride (LSFX) is a quinolone antibiotic that inhibits DNA gyrase and topoisomerase IV of bacteria, it is anticipated to minimize antibiotic resistance in bacteria. It exhibits antibacterial activity against a relatively wide range of bacterial species, including anaerobic bacteria, and its efficacy and safety against community-acquired pneumonia have been shown; however, its efficacy and safety against nursing and healthcare associated pneumonia (NHCAP) have not been verified. METHODS/DESIGN: Here, a single-arm, open-label, uncontrolled study was conducted in which LSFX was administered to patients with NHCAP at 24 facilities. The research subjects (77 cases) were orally administered 75 mg of LSFX once a day for 7 days. The primary endpoint was the clinical efficacy at the time of test of cure (TOC) (TOC; 5-10 days after the end of LSFX administration), while the secondary endpoints were the efficacy at the time of end of treatment, early clinical efficacy, microbiological efficacy at the time of TOC and end of treatment, and safety evaluation of LSFX. DISCUSSION: NHCAP is a common pneumonia in clinical settings and a notable pneumonia whose mortality is high compared to community-acquired pneumonia. The present study showed the efficacy and safety of LSFX against NHCAP, which could lead to a larger number of therapeutic options for NHCAP.

Writing Support Group for Medical School Faculty-A Simple Way to Do It.

Problem: Writing for publication is a core activity for many medical school faculty, but faculty report numerous challenges to publication. To help address these challenges, some medical schools establish writing support programs, but those programs are often resource-intensive, involving didactic courses, accountability groups, formal mentorships, and even assistance from professional writers. Not all medical schools, however, provide resources for such programs, and many faculty members, especially clinicians, lack time needed to participate. Furthermore, success of these programs is typically judged by the total number of papers published. However, many clinicians would judge success as publication of the occasional papers they decide to write, not the total number of papers they or the group publish. With these issues in mind, we established a low-resource writing program focused on individual acceptance rates rather than total publications. Intervention: Our writing program is an informal group that meets monthly. Members bring their ideas for papers and drafts of papers, and other members provide critique and suggestions for improvement. Members then revise their papers to address that critique prior to journal submission. There are no formal or assigned mentors, courses, lectures, or writing assistants. Context: The program takes place in our family medicine department, in which faculty have various roles. Some group members are clinician-educators seeking to publish occasional clinical reviews or research articles; others are PhDs seeking to publish on aspects of their work. Impact: During the six years of the program, 86% of papers reviewed by the group were accepted for publication and 94% of those were accepted by the journal to which they were first submitted. Publication success rate of individual members averaged 79%. This exceeds the 30-40% acceptance rate for scholarly journals worldwide. Group members published an average of 5.2 papers per member, with some publishing as few as 2-3 papers and others as many as 10-11. Lessons Learned: An informal, low-resource writing program in medical school departments can help faculty reach their publication goals. We found that members were satisfied by having the group help them publish whatever number of papers they decided to write. The program's simple, informal approach fostered a culture of respectful and collegial interactions, in which members learned to depend on and accept critiques from colleagues. Finally, an unexpected benefit of our program resulted from membership of both clinicians and non-clinicians. This provided feedback from individuals with different perspectives, which enhanced development of manuscripts.

Family Caregiver Experience of Resistance to Care: Occurrence Patterns, Context, and Impact on Caregiver.

Although the extant literature identifies resistance to care (RTC) as one of the most frequently reported and impactful caregiver (CG) stressors, typical studies that rely on quantitative measures of RTC do not fully explain how and why RTC negatively influences CGs' well-being. As such, it is difficult to develop specific intervention strategies to support CGs in dealing with RTC. Informed by existing literature and tenets from Stress Theory, the current study includes semi-structured interviews with 19 family CGs of community-dependent (non-institutionalized) elders, regarding their RTC experiences. Through a directed qualitative content analysis, we explored occurrence patterns, contextual factors of when and how RTC occurs, how CGs respond to RTC, and its potential impact on CGs' subjective stress. The results revealed distinguishable characteristics of four types of RTC: Frequent-Pervasive, Frequent-Delimited, Transition-Activated, and Shock-to-Unfamiliar/Unexpected. We discuss how recognition of those types of RTC can be integrated into CG support intervention strategies.

National Dementia Capable Care Training: A Model Implementation and Evaluation.

With a growing need for specialized training for direct caregivers and support staff of persons with intellectual and developmental disabilities (IDD) affected by dementia, the National Task Group on Developmental Disabilities and Dementia Practices (NTG) developed a comprehensive evidence-informed Dementia Capable Care Training (DCCT). To overcome the challenge of the training length and cost, and to extend its dissemination, the Sonoran Center developed a shorter version of the NTG-DCCT while retaining its core components, and implemented it in seven cities in the U. S. Southwest (N = 368). The pre- and post-training evaluation (n =260) demonstrated that the short version of the NTG-DCCT is effective in significantly improving participants' knowledge and/or confidence in dementia capable care. The follow-up semi-structured interviews of participants (n = 7) provide some insights.

Latina/o Family Caregivers' Reactions to Limited Help From Relatives: From Frustration to Resilience.

Using a qualitative approach, the current study aimed to understand how Latina/o primary caregivers react to and cope with a lack of (or limited) help from their relatives when an elder is in need of care. In-person semistructured interviews were conducted with 32 caregivers of Mexican descent; most were female and 84% cared for an older parent or parent-in-law. Inductive thematic analyses resulted in a multifaceted process model that reveals (a) reactions to a lack of help often include anger, frustration, hurt, or resentment; (b) negative reactions can be exacerbated or mitigated by caregivers' explanations for the lack of help and by the quality of caregiver-relative interactions; and (c) coping with and acceptance of the lack of help can evolve over time, aided by caregiver cognitive reframing, realization that negative feelings are ineffectual and/or lead to conflict, and/or other self-protective strategies. Implications for research and practice are discussed.

Examining the Influence of Care-Recipient Resistance on Family Caregiver Emotional and Physical Well-Being: Average Frequency Versus Daily Fluctuation.

Although existing cross-sectional research suggests that dependent older family members' resistive behavior (care-recipient [CR] resistance: verbal or nonverbal rejection or resistance toward caregiver [CG] assistance) can be challenging for informal family CGs, we know little about the impact of the occurrence patterns of CR-resistance-average frequency versus daily fluctuation-on CG emotional and physical well-being. To document CGs' daily experiences with CR-resistance and their emotional and physical well-being, the present study applied short-term repeated measures, collecting data on 8 consecutive days from 63 CGs in Southern Arizona, the United States. Multilevel modeling of the daily data revealed that neither average frequency nor daily fluctuation in CR-resistance alone had a significant impact on CG emotional/physical health. However, the combination of experiencing relatively high frequency and high daily fluctuation in CR-resistance was associated with significant increases in CG physical health symptoms ( b = .34, p < .01). Specifically, on days when a CG faced more CR-resistance than his or her usual amount, significant increases in physical health symptoms existed for CGs with relatively high average frequency of CR-resistance, but not for CGs with relatively low average frequency of CR-resistance. Based on our results, it appears that monitoring and maintaining a reasonable level of CR-resistance are effective strategies to maintain CG resilience to the negative impact of CR-resistance daily fluctuation. The findings are interpreted in light of Stress Theory, and recommendations for future research and practical interventions are offered.

Complete Genome Sequence of the Intracellular Bacterial Symbiont TC1 in the Anaerobic Ciliate Trimyema compressum.

A free-living ciliate, Trimyema compressum, found in anoxic freshwater environments harbors methanogenic archaea and a bacterial symbiont named TC1 in its cytoplasm. Here, we report the complete genome sequence of the TC1 symbiont, consisting of a 1.59-Mb chromosome and a 35.8-kb plasmid, which was determined using the PacBio RSII sequencer.

Complete mitochondrial genome of Cacospongia mycofijiensis (Dictyoceratida: Demospongiae): the first report for the sponge family Thorectidae.

We sequenced a complete mitochondrial genome of the marine sponge, Cacospongia mycofijiensis, which is the first report for the family Thorectidae in the class Demospongiae. The mitogenome was obtained from a de novo assembly of shotgun genome sequencing using Illumina Miseq technology, which reconstructed a circular genome with 97 × of sequence coverage. The assembled mitochondrial genome consisting of 16,227 bp includes 14 protein-coding genes, 2 rRNAs and 2 tRNAs. This complete mitogenome sequence will be useful especially for the phylogenic studies of Demospongiae.

Dietary Intake of Sulforaphane-Rich Broccoli Sprout Extracts during Juvenile and Adolescence Can Prevent Phencyclidine-Induced Cognitive Deficits at Adulthood.

Oxidative stress and inflammation play a role in cognitive impairment, which is a core symptom of schizophrenia. Furthermore, a hallmark of the pathophysiology of this disease is the dysfunction of cortical inhibitory γ-aminobutyric acid (GABA) neurons expressing parvalbumin (PV), which is also involved in cognitive impairment. Sulforaphane (SFN), an isothiocyanate derived from broccoli, is a potent activator of the transcription factor Nrf2, which plays a central role in the inducible expressions of many cytoprotective genes in response to oxidative stress. Keap1 is a cytoplasmic protein that is essential for the regulation of Nrf2 activity. Here, we found that pretreatment with SFN attenuated cognitive deficits, the increase in 8-oxo-dG-positive cells, and the decrease in PV-positive cells in the medial prefrontal cortex and hippocampus after repeated administration of phencyclidine (PCP). Furthermore, PCP-induced cognitive deficits were improved by the subsequent subchronic administration of SFN. Interestingly, the dietary intake of glucoraphanin (a glucosinolate precursor of SFN) during the juvenile and adolescence prevented the onset of PCP-induced cognitive deficits as well as the increase in 8-oxo-dG-positive cells and the decrease in PV-positive cells in the brain at adulthood. Moreover, the NRF2 gene and the KEAP1 gene had an epistatic effect on cognitive impairment (e.g., working memory and processing speed) in patients with schizophrenia. These findings suggest that SFN may have prophylactic and therapeutic effects on cognitive impairment in schizophrenia. Therefore, the dietary intake of SFN-rich broccoli sprouts during the juvenile and adolescence may prevent the onset of psychosis at adulthood.

The negative impact of global perceptions of and daily care-related family conflict on Hispanic caregivers: familism as a potential moderator.

OBJECTIVES: Using selected concepts from Pearlin's care giving stress model and incorporating a daily stress-reactivity perspective, the current study surveyed Hispanic family caregivers (HCGs) to: (a) document the occurrence of family disagreements regarding care; (b) examine the impact of family disagreements regarding care on HCGs' emotional/physical well being; and (c) determine the moderating role of familism - whether strong familism beliefs buffer or exacerbate the negative impact of family disagreements on HCGs. METHODS: Participants (n = 67) reported their daily experiences of family disagreements regarding care, depressive symptoms, feelings of burden, and physical health symptoms on eight consecutive survey days; and, in a separate survey, reported their global perceptions of family disagreements regarding care and their familism beliefs. RESULTS: Multilevel-modeling indicated (a) a significant link between global perceptions of family disagreement regarding care and greater depressive symptoms, feelings of burden, and physical health symptoms and (b) significant moderating (i.e., exacerbating) effects of familism at the daily level suggesting that HCGs with stronger familism beliefs are more reactive to daily care-related family disagreement occurrences. CONCLUSIONS: The findings from the current study suggest that family disagreement regarding care is a salient aspect of the context of care giving for HCGs, and is linked to depressive symptoms, feelings of burden, and physical health symptoms. Familism may play an exacerbating role in this link. Interpretations of the results and implications for research and intervention are offered.

Effects of the antioxidant sulforaphane on hyperlocomotion and prepulse inhibition deficits in mice after phencyclidine administration.

OBJECTIVE: Accumulating evidence suggests that oxidative stress plays a role in the pathophysiology of schizophrenia and that the potent antioxidants may be potential therapeutic drugs for schizophrenia. This study was undertaken to examine the effects of the potent antioxidant sulforaphane (SFN), found in cruciferous vegetables, on behavioral abnormalities (e.g., hyperlocomotion and prepulse inhibition [PPI] deficits) in mice after a single administration of the N-methyl-D-aspartate (NMDA)-receptor antagonist phencyclidine (PCP). METHODS: Effects of SFN (3, 10, and 30 mg/kg, intraperitoneally [i.p.]) on hyperlocomotion and PPI deficits in the adult male ddY mice after administration of PCP (3.0 mg/kg, subcutaneously [s.c.]) were examined. RESULTS: Administration of SFN (30 mg/kg, intraperitoneally [i.p.]), but not low doses (3 and 10 mg/kg, i.p.), significantly attenuated hyperlocomotion in mice after PCP administration (3.0 mg/kg, subcutaneously [s.c.]). Furthermore, administration of SFN (3, 10, and 30 mg/kg, i.p.) attenuated the PPI deficits in mice after PCP administration (3.0 mg/kg, s.c.) in a dose-dependent manner. CONCLUSION: These results suggest that SFN has antipsychotic activity in an animal model of schizophrenia. Therefore, it is likely that SFN may be a potential therapeutic drug for schizophrenia.

Sociocontextual circumstances in daily stress reactivity among caregivers for elder relatives.

Using a daily diary design, we examined whether emotional and physical reactivity in the face of care-related stressors is more intense for caregivers (CGs) living with lower levels of available socioemotional support and higher numbers of extrinsic stressors. Sixty-three CGs reported their experiences based on the past 24 hr (i.e., number of caregiving tasks, care recipient problem behaviors, family disagreements regarding care, depressive symptoms, feelings of burden, physical symptoms) on eight consecutive survey days; they also reported on extrinsic stressors and available socioemotional support. Multilevel analyses indicated significant moderator effects: within-person patterns of reactivity to care-related stressors were especially strong for CGs with lower levels of available socioemotional support and higher numbers of extrinsic stressors. For example, managing additional care recipient problem behaviors on a given day was more strongly associated with increased depressive and physical health symptoms as well as feelings of burden for CGs with relatively high numbers of extrinsic stressors. Implications for intervention are discussed.

Reaping caregiver feelings of gain: the roles of socio-emotional support and mastery.

OBJECTIVES: Existing studies indicate that the presence of social support increases the likelihood of caregivers experiencing feelings of gain from caregiving; however, researchers have not yet investigated the mechanism through which social support is linked to caregiver feelings of gain. Informed by Bandura's Social Cognitive Theory, the present study investigated whether a sense of caregiving mastery serves as a key mechanism. METHOD: Sixty-three family caregivers of dependent elders completed surveys to assess caregiver feelings of gain, socio-emotional support (from family, friends, spouse/partner) and mastery. To evaluate the hypothesized mediation model, a series of structural equation modeling (SEM) analyses were conducted with the maximum likelihood method by Lisrel 8.8. RESULTS: Socio-emotional support from family members was found to be an important resource for caregiver feelings of gain. SEM analyses further revealed that the mechanisms by which socio-emotional support influences caregiver feelings of gain vary depending on its source (i.e. family members, friends, and partners). CONCLUSION: As hypothesized, caregiving mastery played a mediating role for non-partner family socio-emotional support whereas it did not for partner socio-emotional support. Based on availability or absence of specific sources of support, caregiver intervention programs should be individually tailored to enhance their potential impact.

Caregiving for elder relatives: which caregivers experience personal benefits/gains?

The present study asks whether the positive, rewarding experiences of caregiving (benefits/gains) emerge merely as a function of caregiver personality, or whether, after personality traits (agreeableness, conscientiousness, extroversion, neuroticism) are taken into account, other interpersonal factors make a difference. Survey data were collected from 63 family caregivers. Bivariate analyses revealed that caregiving benefits/gains were significantly and positively associated with two personality traits (agreeableness, extroversion), family and spouse/partner socio-emotional support, and prior relationship quality. Hierarchical regressions indicated that whereas neither family socio-emotional support nor prior relationship quality significantly predicted variance in caregiving benefits/gains beyond that accounted for by agreeableness and extroversion, spouse/partner socio-emotional support did. Implications for research and practice are discussed.