Determinants of Health-Related Quality of Life in Outpatients with Myocardial Infarction.

Background: The health-related quality of life (HRQOL) of patients with myocardial infarction (MI) is suboptimal because of the disease's life-threatening nature, the requirement for long-term lifestyle modifications, and the treatment regimens following MI. This study aimed to evaluate HRQOL and its associated factors in MI patients. Material and Methods: This study was conducted on patients with MI who attended the outpatient cardiology clinic at a major teaching hospital in Jordan. The EQ-5D-3L questionnaire was used to assess HRQOL of the study participants. Quantile regression analysis was conducted to identify the variables associated with HRQOL. Results: The study included 333 patients with a history of MI, with a median age of 58 (57-60). The median of the total EQ-5D score was 0.65 (0.216-0.805). Regression results revealed that male patients (Coefficient= 0.110, 95%Cl (0.022-0.197), P=0.014) and not being diagnosed with diabetes (Coefficient= 0.154, 95%Cl (0.042-0.266), P=0.007) were associated with increased HRQOL. On the other hand, low income (Coefficient= -0.115, 95%Cl (-0.203 - -0.026), P=0.011), not receiving DPP-4 (Dipeptidyl Peptidase -4) inhibitors (Coefficient= -0.321 95%Cl (-0.462 - -0.180), P<0.001), and having low (Coefficient= -0.271, 95%Cl (-0.395 - -0.147), P<0.001) or moderate (Coefficient= -0.123, 95%Cl (-0.202 - -0.044), P=0.002) medication adherence was associated with decreased HRQOL. Conclusion: The current study demonstrated diminished HRQOL among patients with MI, highlighting the necessity of tailoring interventions to tackle medication adherence barriers in this population. Personalized interventions such as educational programs, counseling, and reminders that consider each patient's needs and circumstances can greatly enhance medication adherence and, thus, the HRQOL of MI patients. Individuals with lower income levels, female patients, and those with diabetes should be the specific targets of these interventions.

Autonomic brain functioning and age-related health concerns.

The autonomic nervous system (ANS) regulates involuntary bodily functions such as blood pressure, heart rate, breathing, and digestion, in addition to controlling motivation and behavior. In older adults, the ANS is dysregulated, which changes the ability of the ANS to respond to physiological signals, regulate cardiovascular autonomic functionality, diminish gastric motility, and exacerbate sleep problems. For example, a decrease in heart rate variability, or the variation in the interval between heartbeats, is one of the most well-known alterations in the ANS associated with health issues, including cardiovascular diseases and cognitive decline. The inability to perform fundamental activities of daily living and compromising the physiological reactivity or motivational responses of older adults to moving toward or away from specific environmental stimuli are significant negative consequences of chronic and geriatric conditions that pose grave threats to autonomy, health, and well-being. The most updated research has investigated the associations between the action responsiveness of older adults and the maintenance of their physiological and physical health or the development of mental and physical health problems. Once autonomic dysfunction may significantly influence the development of different age-related diseases, including ischemic stroke, cardiovascular disease, and autoimmune diseases, this review aimed to assess the relationship between aging and autonomic functions. The review explored how motivational responses, physiological reactivity, cognitive processes, and lifelong developmental changes associated with aging impact the ANS and contribute to the emergence of health problems.

Role of Community Pharmacist in Asthma Management: Knowledge, Attitudes and Practice.

Purpose: To investigate knowledge, attitude, and practice of asthma management counseling and the perceived barriers by community pharmacists. Methods: This cross-sectional study was conducted on 416 community pharmacists using an online-based questionnaire. The questionnaire included five parts that assessed socio-demographics and medical references used to seek drug-related information, pharmacists' knowledge (7 items), attitudes (5 items), practice (22 items) and the barriers for the provision of asthma management counseling (10 items). Binary logistic regression was conducted to find the variables that were significantly and independently associated with knowledge, attitude and asthma management counseling practice. Results: Increased years of experience was associated with decreased knowledge (OR = 0.918, 95% Cl (0.869:0.970), P = 0.002) and less positive attitude toward asthma management (OR = 0.876, 95% Cl. (0.821:0.935), P < 0.001), while working in independent community pharmacy (OR = 2.097, 95% Cl. (1.273:3.454), P = 0.004) and increased awareness of asthma management guidelines (OR = 1.60, 95% CI. (1.044:2.453), P = 0.031) increased the odds of being in the high knowledge group. In contrast, increasing the daily number of pharmacy visitors OR = 1.009, 95% Cl. (1.001:1.016), P = 0.024) and having a pharmacy degree (OR = 2.330, 95% Cl. (1.256:4.326), P = 0.007) increased the odds of having a positive attitude. Male pharmacists (OR = 0.553, 95% Cl. (0.350:0.873), P = 0.011) and having bachelor in pharmacy (OR = 0.354, 95% Cl. (0.179:0.700), P = 0.003) decreased the odds of being in the high practice group. On the other hand, increased awareness of asthma management guidelines tripled the odds of being in the high practice group (OR = 3.067, 95% Cl. (1.964:4.787), P < 0.001). Conclusion: The current study findings offer valuable insights into the gaps in knowledge, attitude, and practice of asthma management counseling among community pharmacists, as well as the barriers and factors that impede the provision of these services. These insights serve as a guide for developing future strategies aimed at enhancing the role of pharmacists in asthma care.

Coordinated interplay between palmitoylation, phosphorylation and SUMOylation regulates kainate receptor surface expression.

Kainate receptors (KARs) are key regulators of neuronal excitability and synaptic transmission. KAR surface expression is tightly controlled in part by post-translational modifications (PTMs) of the GluK2 subunit. We have shown previously that agonist activation of GluK2-containing KARs leads to phosphorylation of GluK2 at S868, which promotes subsequent SUMOylation at K886 and receptor endocytosis. Furthermore, GluK2 has been shown to be palmitoylated. However, how the interplay between palmitoylation, phosphorylation and SUMOylation orchestrate KAR trafficking remains unclear. Here, we used a library of site-specific GluK2 mutants to investigate the interrelationship between GluK2 PTMs, and their impact on KAR surface expression. We show that GluK2 is basally palmitoylated and that this is decreased by kainate (KA) stimulation. Moreover, a non-palmitoylatable GluK2 mutant (C858/C871A) shows enhanced S868 phosphorylation and K886 SUMOylation under basal conditions and is insensitive to KA-induced internalisation. These results indicate that GluK2 palmitoylation contributes to stabilising KAR surface expression and that dynamic depalmitoylation promotes downstream phosphorylation and SUMOylation to mediate activity-dependent KAR endocytosis.