Saint Louis University

About: Saint Louis University is a education organization based out in St Louis, Missouri, United States. It is known for research contribution in the topics: Population & Health care. The organization has 18927 authors who have published 34895 publications receiving 1267475 citations. The organization is also known as: SLU & St. Louis University.

Polypharmacy and Hospitalization Among Older Home Care Patients

Abstract: Methods. A retrospective chart review of 833 discharged older home care patients was performed. These patients were consecutive discharges from a single home care agency who either (a) returned to independent self-care or care of the family (S/F Care group) or (b) were admitted to the hospital (Hospitalized group). Medication assessment within these two groups included total number of medications (prescription and nonprescription); degree of polypharmacy (percentage of patients taking 5 or more, 7 or more, and 10 or more medications); and prevalence for different types of medications, including different types of inappropriate medications. Inappropriate medications were designated according to a list that was previously developed through a modified Delphi consensus technique by a panel of 13 experts in geriatric pharmacology and has been utilized in other studies. Student’s t test was used for continuous variables and chi-square test was used for categorical variables to evaluate for differences between the S/F Care group and the Hospitalized group ( p , .05). For comparisons of types of medications, p , .01 was used for significant differences, because of the high number of comparisons made. Results. Of 833 discharges, 644 (77.3%) returned to self-care or care of the Family (S/F Care group) and 189 (22.7%) were hospitalized. The Hospitalized group, compared with the S/F Care group, was taking a higher number of medications (mean 6 SD : 6.6 6 3.9 vs 5.7 6 3.4, p 5 .004), and had a higher percentage of patients taking 7 or more medications (46% vs 26%, p 5 .002) and 10 or more medications (21% vs 10%, p 5 .005), but not 5 or more medications. Only three types of medications were more commonly used among patients in the Hospitalized group than among patients in the S/F Care group: clonidine (4.2% vs 1.1%, p 5 .004); mineral supplements (23.8% vs 14.8%, p 5 .003); and metoclopramide (5.8% vs 2.0%, p 5 .006). The Hospitalized group had a lower percentage of patients taking inappropriate medications than did the S/F Care group (20% vs 27%, p 5 .040), but none of the types of inappropriate medications was used more often in either group. Conclusions. This study shows a relationship between high levels of polypharmacy and hospitalization. Although it cannot be determined from this study whether a higher number of medications was an indicator of sicker patients at risk for hospitalization, or whether a higher number of medications might have directly led to hospitalization, polypharmacy should still be considered a marker for older home care patients for whom prevention of hospitalization is the goal.

The Dysfunctional Attitude Scale: Psychometric properties and relation to depression in an unselected adult population

Abstract: The Dysfunctional Attitude Scale (DAS), a self-report inventory of beliefs derived from Beck's (1967) cognitive theory of depression to measure depressionogenic “schemas” constituting predispositions to depression, was developed in student populations. The DAS was jointly administered with the Beck Depression Inventory (BDI) to 275 hospital employees and their spouses, 105 males and 170 females, and its psychometric properties were examined. Six-week test-retest reliability of the DAS was .73 (p <.001). Modest item-total correlations and lack of factorial equivalence between the two short forms of the DAS suggest it is best conceptualized and treated as a whole. This conclusion is lent support by the DAS's alpha coefficient of .90. The DAS and the BDI were correlated .41. Reliability and validity data for the DAS thus support its use as a measure of depressionogenic beliefs in the unselected adult population. Mean scores on the DAS did not differ significantly as a function of gender, failing to support differential distribution of a predisposition to depression that is cognitive in nature.

The RNA polymerase II elongation complex

Abstract: Synthesis of eukaryotic mRNA by RNA polymerase II is an elaborate biochemical process that requires the concerted action of a large set of transcription factors. RNA polymerase II transcription proceeds through multiple stages designated preinitiation, initiation, and elongation. Historically, studies of the elongation stage of eukaryotic mRNA synthesis have lagged behind studies of the preinitiation and initiation stages; however, in recent years, efforts to elucidate the mechanisms governing elongation have led to the discovery of a diverse collection of transcription factors that directly regulate the activity of elongating RNA polymerase II. Moreover, these studies have revealed unanticipated roles for the RNA polymerase II elongation complex in such processes as DNA repair and recombination and the proper processing and nucleocytoplasmic transport of mRNA. Below we describe these recent advances, which highlight the important role of the RNA polymerase II elongation complex in regulation of eukaryotic gene expression.