Aims This study evaluated the possible barriers to the permanence of physical exercise (PE) of old women. Methods The study population comprised 61 old women participants for at least one year of a supervised PE program, who underwent anamnesis, and applied the Barriers Questionnaire to Physical Activity Practice in the Elderly (QBPAFI). Exploratory factorial analysis was used to evaluate QBPAFI data. The analysis of principal component was applied to the 22 questions through orthogonal rotation to analyze the correlation between the questions. The Kaiser-Meyer-Olkin test was applied to evaluate the suitability of the sample size, and the Bartlett's test to assess whether the original matrix correlation is an identity matrix. Eigenvalues greater than 1 were considered for analysis. Results The motivational factor was the major determinant of perceived barriers (43.3%), followed by psychosocial (12.29%), facilities and appearance (8.75%), and exercise conditions (8.10%) factors. Conclusion Knowing the benefits of physical activity, and the main barriers that prevent the permanence of active old people to physical exercise programs, new strategies must be taken to increase the rate of adherence of this group.

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Perception of barriers to physical exercise in women population over 60

https://onlinelibrary.wiley.com/doi/pdf/10.1111/cpsp.12309

Prescriptive authority: Psychologists’ abridged training relative to other professions’ training

In recent years, the subject of integrated healthcare, including the integration of behavioral health services into primary care, within the healthcare field has been increasingly of interest to researchers, providers, and policy makers. However, little is known about the experiences of providers within integrated care and the impact of these experiences on inter-professional relationships and collaboration. The researchers aimed to explore differences in providers' perspectives, including inter-professional collaboration and overall job satisfaction, by provider type and level of integration. The current study uses a mixed method exploratory approach, gathering both qualitative and quantitative data to investigate the perspectives of providers (both psychologists and physicians) on their work together. This study included 30 psychologists and 30 primary care physicians from three levels of healthcare integration (traditional/coordinated, co-located, and integrated). As hypothesized, results indicated that providers in integrated settings were the most satisfied with their collaboration with other providers. Furthermore, the providers' narratives revealed promising insights which contribute to a broader understanding of how to improve the relationships between psychologists and primary care physicians in integrated healthcare and other settings.

Psychologist and Physician Inter-Professional Collaborative Experiences in Primary Care Integration

https://doi.org/10.1016/j.ynpai.2022.100098

Stimulation of CGRP-expressing neurons in the medial cerebellar nucleus induces light and touch sensitivity in mice

Purpose To explore the nursing research of prostatic hyperplasia based on continuous nursing and based on the combination of medical care and nursing. Methods A prospective study of 96 patients with benign prostatic hyperplasia admitted to our hospital from November 2019 to May 2021 was selected. According to the random number table method, they were divided into an observation group and a control group with 48 cases each. The control group used routine nursing and discharge guidance, and the observation group implemented continuous care based on the combination of medical care and nursing on the basis of the control group. The differences in the scores of quality of life, self-care ability, quality of life score, and sleep quality were compared between the two groups. Results After 3 months of nursing, the quality of life scores (health status, psychology, social relationship, environment, physiology, and quality of life scores) of the observation group was higher than those of the control group (P < 0.05). After 3 months of nursing, the quality of life scores of disease, physiology, society, psychology, and satisfaction of the observation group was significantly higher than those of the control group, which was statistically significant (P < 0.05). After 3 months of nursing, the observation group's sleep quality scores in all dimensions (time to fall asleep, sleep time, sleep quality, sleep efficiency, hypnotics, sleep disorders, and day disorders) were higher than those of the control group (P < 0.05). After 3 months of nursing, the observation group's self-care skill score, self-responsibility score, health knowledge score, and self-concept score were better than those of the control group (P < 0.05). Conclusion Continued nursing care based on the combination of medical and health care for prostate hyperplasia is beneficial to improve sleep quality and improve the patient's quality of life score and self-care ability and provide certain references for clinical care of patients with benign prostatic hyperplasia.

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Nursing Research on Benign Prostatic Hyperplasia Based on Continuous Nursing Care

The Affordable Care Act has greatly expanded health care coverage and recognizes mental health as a major priority. However, individuals suffering from mental health disorders still face layered barriers to receiving health care, especially Asian Americans. Integration of behavioral health services within primary care is a viable way of addressing underutilization of mental health services. This paper provides insight into a comprehensive care approach integrating behavioral health services into primary care to address underutilization of mental health services in the Asian American population. True integration of behavioral health services into primary care will require financial support and payment reform to address multi-disciplinary care needs and optimize care coordination, as well as training and workforce development early in medical and mental health training programs to develop the skills that aid prevention, early identification, and intervention. Funding research on evidence-based practice oriented to the Asian American population needs to continue.

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The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans

Urinothorax is a cause of pleural effusion that is often missed due to its perceived rarity. Here, we present a case of urinothorax secondary to percutaneous nephrolithotomy resulting in lung collapse and death. This case highlights urinothorax as a cause of death, its biochemical profile, and diagnostic features on autopsy. A 39-year-old female presented to the ED with low back pain and dysuria. Abdominal and pelvic CT showed a large staghorn calculus in the right kidney which was then treated with percutaneous nephrolithotomy. On post-operative day (POD) 1, the patient was febrile, had decreased breath sounds, and complained of pain with deep inspiration. Chest x-ray revealed increased right pleural fluid. On POD 3, the patient continued to have difficulty breathing and was eventually found apneic. Resuscitation was unsuccessful. Autopsy revealed a collapsed right lung associated with a 1200 mL pleural effusion, which was cloudy, yellow, and smelled like urine. The cause of death was listed as complications of percutaneous nephrolitotomy, with urinothorax and collapse of lung. While rare, urinothoraces must be considered as a cause of pleural effusion due to risk of respiratory failure and death. Diagnosis relies on pleural fluid analysis and history, especially with regard to genitourinary obstruction and surgeries.

Death due to atypical urinothorax following percutaneous nephrolithotomy.

Forensic DNA testing can play a critical role in homicide investigations. Selecting the appropriate evidence on which to perform DNA testing requires foresight and reasoning based on experience and science. Although successful DNA testing can occur using many substrates, including blood, hair, and sweat/epithelial cells, positive results can also result from testing various unorthodox samples. The authors report on a triple-murder investigation where DNA testing of dog feces at the crime scene matched DNA testing of feces found on the shoe of a suspect resulting in successful prosecution of the case.

Crime Scene Analysis Through DNA Testing of Canine Feces-A Case Report.

While falls are highly prevalent and costly for older adults, little is known about falls for Asian Americans. Using a custom, evidence-based, bilingual fall risk assessment and management tool, our study examined the prevalence of falls among older Chinese-speaking patients at a community health center. We identified the risks for falls and explored an association of fall risk with emergency room (ER) and hospital use in this population. The setting was at a community health center in Oakland, CA. Participants included 839 older Asian American adults (ages 65–80 years) who spoke Cantonese/Mandarin. Primary care clinic staff administered a fall risk assessment and management tool at the time of clinic visits to assess patients’ risk factors for falls. Of the total, 173 (20.6%) reported having fallen in the past year, with women comprising a majority (71.7%). 362 patients in the cohort (43.1%) reported fear of falling. For the subset of Medicaid managed care patients (n = 455, 54.3% of total) for whom we were able to obtain ER and hospital utilization data, 31 patients (14.5%) who reported a fall risk had an ER/hospital episode compared to 15 (6.2%) of those who did not self-report fall risks (statistically significant, p < 0.05). A targeted fall risk assessment and management tool designed by community-based primary care practitioners and utilized with linguistic and cultural competence to focus on Asian American older adults, can help establish the prevalence of falls in this understudied population and effectively identify those at higher risk for falls and subsequent ER/hospital utilization. More research is needed to understand the risk and impacts of falls in understudied populations and identify ways to prevent these costly falls.

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Understanding Falls Risk and Impacts in Chinese American Older Patients at a Community Health Center.

The neuropeptide calcitonin gene-related peptide (CGRP) is a major player in migraine pathophysiology. Previous preclinical studies demonstrated that intracerebroventricular administration of CGRP caused migraine-like behaviors in mice, but the sites of action in the brain remain unidentified. The cerebellum has the most CGRP binding sites in the central nervous system and is increasingly recognized as both a sensory and motor integration center. The objective of this study was to test whether the cerebellum, particularly the medial cerebellar nuclei (MN), might be a site of CGRP action. In this study, CGRP was directly injected into the right MN of C57BL/6J mice via a cannula. A battery of behavioral tests was done to assess migraine-like behaviors. CGRP caused light aversion measured as decreased time in the light zone even with dim light. The mice also spent more time resting in the dark zone, but not the light, along with decreased rearing and transitions between zones. These behaviors were similar for both sexes. In contrast, significant responses to CGRP were seen only with female mice in the open field assay, von Frey test, and automated squint assay, indicating anxiety, tactile hypersensitivity, and spontaneous pain, respectively. In male mice, the responses had the same trend as females but did not reach statistical significance. No detectable effect of CGRP on gait was observed in either sex. These results suggest that CGRP in the MN causes light aversion in males, while in females, light aversion is accompanied by increased anxiety, tactile hypersensitivity, and spontaneous pain. A caveat is that we cannot exclude contributions from other cerebellar regions in addition to the MN due to diffusion of the injected peptide. These results reveal the cerebellum as a new site of CGRP actions that may contribute to migraine pathophysiology and possibly its prevalence in females.

/pdf/cgrp-administration-into-the-cerebellum-evokes-migraine-like-39kw9j4m.pdf

Thomas Duong

Papers

The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans

Death due to atypical urinothorax following percutaneous nephrolithotomy.

Crime Scene Analysis Through DNA Testing of Canine Feces-A Case Report.

Understanding Falls Risk and Impacts in Chinese American Older Patients at a Community Health Center.

CGRP Administration into the Cerebellum Evokes Migraine-like Behaviors Predominately in Female Mice