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Find video protocols related to scientific articles indexed in Pubmed.
Mexican American Men's Experience of Living With Tuberculosis on the U.S.-Mexico Border.
Am J Mens Health
PUBLISHED: 11-01-2014
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The Texas-Mexico border incidence rate of tuberculosis (TB) is 10 times the rate of TB in the United States. Additionally, this area is plagued by antibiotic-resistant TB at a rate that is 70% higher among those living along the border than among nonborder residents. Both the high rate of TB and the emergence of drug-resistant TB increases the importance of controlling TB along the U.S.-Mexico border. Men have higher rates of TB than women, which can be attributed to biological differences and increased environmental exposure. The purpose of this article is to describe the experience of TB for Mexican American men living on the Texas-Mexico border. This a qualitative descriptive study, using participants from a larger study. A purposeful sample was recruited through two south Texas TB clinics. Interviews were audio recorded, transcribed, and translated into English. Data analysis consisted of line-by-line coding, labeling, organizing, and discovering common codes to describe participants' experience of TB and TB treatment. The participants include 13 Mexican American men. Ages ranged from 22 to 76 years. Only one participant was employed during treatment. Years of education ranged from no school to an associate's degree. Five themes were discovered: misinformation, delayed diagnosis, stigma, depression, and loss of community. Participants without social support were further isolated and felt a greater burden of treatment. Two participants contemplated suicide and two others told their families to leave them because they were a burden and infectious. The burden of treatment on the patient is great, especially for Hispanic men.
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Patient-Centered, Direct-Access Online Care for Management of Atopic Dermatitis: A Randomized Clinical Trial.
JAMA Dermatol
PUBLISHED: 10-23-2014
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New models of health care delivery for dermatological care have the potential to increase access and improve patient-centered outcomes.
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Sustained Neuroprotection From a Single Intravitreal Injection of PGJ2 in a Nonhuman Primate Model of Nonarteritic Anterior Ischemic Optic Neuropathy.
Invest. Ophthalmol. Vis. Sci.
PUBLISHED: 10-10-2014
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Prostaglandin J2 (PGJ2) is neuroprotective in a murine model of nonarteritic anterior ischemic optic neuropathy (NAION). After assessing for potential toxicity, we evaluated the efficacy of a single intravitreal (IVT) injection of PGJ2 in a nonhuman primate model of NAION (pNAION).
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Magnetic resonance cholangiopancreatography: utilization and usefulness in suspected choledocholithiasis.
ANZ J Surg
PUBLISHED: 08-26-2014
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The aim of this study was to evaluate the role of magnetic resonance cholangiopancreatography in cases of suspected choledocholithiasis.
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Ethical Considerations in the Recruitment of Military Partners in Combat-Related Posttraumatic Stress Disorder Research.
Nurs Forum
PUBLISHED: 08-25-2014
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The recruitment of military partners in combat-related posttraumatic disorder (PTSD) research necessitates nurses' awareness to their unique ethical concerns. Safeguarding the ethical rights of partners living with veterans with PTSD is crucial to the development and implementation of quality, rigorous research designs. Nurses should understand the unique ethical considerations that pertain to partners' participation in PTSD research.
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Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women.
Menopause
PUBLISHED: 08-18-2014
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Feelings of fatigue and low energy are widespread among middle-aged women and have been shown to negatively affect quality of life. The aim of the present study was to examine the associations among adiposity, physical activity, and feelings of fatigue and energy in postmenopausal women.
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Regional Multiple Pathology Scores Are Associated with Cognitive Decline in Lewy Body Dementias.
Brain Pathol.
PUBLISHED: 08-08-2014
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Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are characterized by the presence of ?-synuclein-containing Lewy bodies and Lewy neurites. However, both dementias also show variable degrees of Alzheimer's disease (AD) pathology (senile plaques and neurofibrillary tangles), particularly in areas of the cortex associated with higher cognitive functions. This study investigates the contribution of the individual and combined pathologies in determining the rate of cognitive decline. Cortical ?-synuclein, phosphorylated tau (phosphotau) and A? plaque pathology in 34 PDD and 55 DLB patients was assessed semi-quantitatively in four regions of the neocortex. The decline in cognition, assessed by Mini Mental State Examination, correlated positively with the cortical ?-synuclein load. Patients also had varying degrees of senile A? plaque and phosphotau pathology. Regression analyses pointed to a combined pathology (A? plaque plus phosphotau plus ?-synuclein-positive features), particularly in the prefrontal cortex (BA9) and temporal lobe neocortex with the superior and middle temporal gyrus (BA21, 22), being a major determining factor in the development of dementia. Thus, cognitive decline in Lewy body dementias is not a consequence of ?-synuclein-induced neurodegeneration alone but senile plaque and phosphorylated tau pathology also contribute to the overall deficits.
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Assessment of ZnT3 and PSD95 protein levels in Lewy body dementias and Alzheimer's disease: association with cognitive impairment.
Neurobiol. Aging
PUBLISHED: 06-17-2014
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The loss of zinc transporter 3 (ZnT3) has been implicated in age-related cognitive decline in mice, and the protein has been associated with plaques. We investigated the levels of ZnT3 and postsynaptic density protein 95 (PSD95), a marker of the postsynaptic terminal, in people with Parkinson's disease dementia (PDD, n = 31), dementia with Lewy bodies (DLB, n = 44), Alzheimer's disease (AD, n = 16), and controls (n = 24), using semiquantitative western blotting and immunohistochemistry in 3 cortical regions. Standardized cognitive assessments during life and semiquantitative scoring of amyloid ? (A?), tau, and ?-synuclein at postmortem were used to investigate the relationship between ZnT3 and PSD95, cognition and pathology. Associations were observed between ZnT3 and PSD95 levels in prefrontal cortex and cognitive impairment (p = 0.001 and p = 0.002, respectively) and between ZnT3 levels in the parietal cortex and cognitive impairment (p = 0.036). Associations were also seen between ZnT3 levels in cingulate cortex and severity of A? (p = 0.003) and tau (p = 0.011) pathologies. DLB and PDD were characterized by significant reductions of PSD95 (p < 0.05) and ZnT3 (p < 0.001) in prefrontal cortex compared with controls and AD. PSD95 levels in the parietal cortex were found to be decreased in AD cases compared with controls (p = 0.02) and PDD (p = 0.005). This study has identified Zn(2+) modulation as a possible novel target for the treatment of cognitive impairment in DLB and PDD and the potential for synaptic proteins to be used as a biomarker for the differentiation of DLB and PDD from AD.
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Predictive relationship of osteopathic manual medicine grades and COMLEX-USA Level 1 total scores and osteopathic principles and practice subscores.
J Am Osteopath Assoc
PUBLISHED: 06-12-2014
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Osteopathic manual medicine (OMM) encompasses hands-on diagnosis and treatment as part of patient care. The area of osteopathic principles and practice (OPP) is considered a core competency for students and practitioners of this medical tradition. The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) is a useful tool for assessing candidates' competency.
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GRAPPA Trainees Symposium 2013: a report from the GRAPPA 2013 Annual Meeting.
J. Rheumatol.
PUBLISHED: 06-03-2014
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At the 2013 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Toronto, Ontario, Canada, 26 dermatology and rheumatology fellows engaged in psoriasis or psoriatic arthritis research were invited to present their work at the Trainees Symposium, which preceded the annual meeting and was also attended by GRAPPA members from around the world. Herein, we provide a brief overview of the 6 oral presentations and 25 posters presented, which reflect the focus and diversity of current basic and clinical research in psoriatic disease.
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Maternal nutrient restriction during pregnancy impairs an endothelium-derived hyperpolarizing factor-like pathway in sheep fetal coronary arteries.
Am. J. Physiol. Heart Circ. Physiol.
PUBLISHED: 05-09-2014
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The mechanisms underlying developmental programming are poorly understood but may be associated with adaptations by the fetus in response to changes in the maternal environment during pregnancy. We hypothesized that maternal nutrient restriction during pregnancy alters vasodilator responses in fetal coronary arteries. Pregnant ewes were fed a control [100% U.S. National Research Council (NRC)] or nutrient-restricted (60% NRC) diet from days 50 to 130 of gestation (term = 145 days); fetal tissues were collected at day 130. In coronary arteries isolated from control fetal lambs, relaxation to bradykinin was unaffected by nitro-l-arginine (NLA). Iberiotoxin or contraction with KCl abolished the NLA-resistant response to bradykinin. In fetal coronary arteries from nutrient-restricted ewes, relaxation to bradykinin was fully suppressed by NLA. Large-conductance, calcium-activated potassium channel (BKCa) currents did not differ in coronary smooth muscle cells from control and nutrient-restricted animals. The BKCa openers, BMS 191011 and NS1619, and 14,15-epoxyeicosatrienoic acid [a putative endothelium-derived hyperpolarizing factor (EDHF)] each caused fetal coronary artery relaxation and BKCa current activation that was unaffected by maternal nutrient restriction. Expression of BKCa-channel subunits did not differ in fetal coronary arteries from control or undernourished ewes. The results indicate that maternal undernutrition during pregnancy results in loss of the EDHF-like pathway in fetal coronary arteries in response to bradykinin, an effect that cannot be explained by a decreased number or activity of BKCa channels or by decreased sensitivity to mediators that activate BKCa channels in vascular smooth muscle cells. Under these conditions, bradykinin-induced relaxation is completely dependent on nitric oxide, which may represent an adaptive response to compensate for the absence of the EDHF-like pathway.
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Pathways to Healing: Person-centered Responses to Complementary Services.
Glob Adv Health Med
PUBLISHED: 04-23-2014
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This research study assessed perceived changes in quality-of-life measures related to participation in complementary services consisting of a variety of nontraditional therapies and/or programs at Pathways: A Health Crisis Resource Center in Minneapolis, Minnesota.
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Expression, purification and characterization of soluble red rooster laforin as a fusion protein in Escherichia coli.
BMC Biochem.
PUBLISHED: 03-27-2014
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The gene that encodes laforin, a dual-specificity phosphatase with a carbohydrate-binding module, is mutated in Lafora disease (LD). LD is an autosomal recessive, fatal progressive myoclonus epilepsy characterized by the intracellular buildup of insoluble, hyperphosphorylated glycogen-like particles, called Lafora bodies. Laforin dephosphorylates glycogen and other glucans in vitro, but the structural basis of its activity remains unknown. Recombinant human laforin when expressed in and purified from E. coli is largely insoluble and prone to aggregation and precipitation. Identification of a laforin ortholog that is more soluble and stable in vitro would circumvent this issue.
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Metasynthesis of research on the role of psychiatric inpatient nurses: what is important to staff?
J Am Psychiatr Nurses Assoc
PUBLISHED: 03-25-2014
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Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community.
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Prion (PrPC) expression in ovine uteroplacental tissues increases after estrogen treatment of ovariectomized ewes and during early pregnancy.
Reproduction
PUBLISHED: 03-24-2014
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Scrapie in sheep is spread laterally by placental transmission of an infectious misfolded form (PrPSc) of a normal prion protein (PrPC) used as a template in PrPSc formation. We hypothesized that PrPC would be expressed in uterine and placental tissues and estradiol-17? (E2) would affect uterine PrPC expression. PrPC expression was evaluated in the uterus of long-term ovariectomized (OVX) ewes treated with an E2 implant for 2-24?h and in uteroplacental tissues from day 20 to day 30 of pregnancy. Expression of PrPC mRNA and PrPC protein increased in the uterus after E2 treatment of OVX ewes. In the maternal placenta, expression of PrPC mRNA and PrPC protein were unchanged, but in the fetal membranes (FM) PrPC mRNA and PrPC protein expression increased from day 20 to day 28. In the nonpregnant uterus, PrPC protein was immunolocalized at apical borders of the surface epithelium, in outer smooth muscle layers of large blood vessels, and in scattered stromal cells of the deep intercaruncular areas of the uterus. In the maternal placenta, PrPC protein was immunolocalized in the cytoplasm of flattened luminal epithelial cells apposed to the FM, whereas in the FM PrPC protein was in trophoblast cells and was also in several tissues of the developing embryo during early pregnancy. These data linking estrogen stimulation to increases in PrPC expression in uteroplacental tissues suggest that PrPC has a specific function during the estrous cycle and early pregnancy. Future studies should determine whether or not estrogen influences PrPC expression in other tissues, such as the nervous system and brain.
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Evidence for ASD Recurrence Rates and Reproductive Stoppage From Large UK ASD Research Family Databases.
Autism Res
PUBLISHED: 03-17-2014
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Following a diagnosis of a developmental disorder such as autism spectrum disorder (ASD) in early childhood, parents may decide to have fewer children than previously planned. The tendency for families to halt reproduction after receiving a diagnosis for one child is known as reproductive stoppage. Stoppage may lead to an underestimate of recurrence risk estimates of parents having more than one child with ASD. Using two large UK ASD family databases, we investigated recurrence rates for ASD and evidence for reproductive stoppage for both ASD and undiagnosed ASD/broader autism phenotype in a subgroup of families. Reproductive stoppage was tested for using the Mann-Whitney U-test to disprove the null hypothesis that affected and nonaffected children were distributed randomly by birth order. Dahlberg's later-sib method was used to estimate recurrence risk and take stoppage into account. Data were available from 299 families (660 children) including 327 with ASD. Ten percent of the complete families had more than one child with an ASD. Using Dahlberg's later-sib method, the recurrence risk for ASD was 24.7% overall and 50.0% in families with two or more older siblings with ASD. Children with ASD were born significantly later in families than those without ASD in all sibship combinations. This study shows strong evidence that ASD is associated with reproductive stoppage. These data have important implications for family planning and genetic counseling. Autism Res 2014, ??: ??-??. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.
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Adiposity, physical activity, and muscle quality are independently related to physical function performance in middle-aged postmenopausal women.
Menopause
PUBLISHED: 03-13-2014
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Poor physical function performance is associated with risks for disability in late life; however, determinants of physical function are not well characterized in middle-aged women. The aim of this cross-sectional study was to examine the contributions of body composition, physical activity, muscle capacity, and muscle quality to physical function performance.
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Clinically significant hemolytic disease of the newborn secondary to passive transfer of anti-D from maternal RhIG.
Transfusion
PUBLISHED: 03-10-2014
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RhIG is used worldwide to reduce the incidence of alloimmunization to D during pregnancy. We report a case of clinically significant neonatal hemolysis mediated by maternally administered RhIG.
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Vitamin D status is associated with grip strength in centenarians.
J Nutr Gerontol Geriatr
PUBLISHED: 03-07-2014
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Low serum concentrations of 25-hydroxyvitamin D (25(OH)D) have been associated with poor physical function in older adults, but few, if any, studies have examined this relationship in the very old. Therefore, the purpose of this study is to examine this relationship in the very old. Serum 25(OH)D concentrations were obtained from 194 centenarians and near centenarians (98 years and older). The associations between 25(OH)D concentrations and measures of physical function were evaluated with unadjusted and adjusted regression models. We found that 35% of centenarians had 25(OH)D concentrations less than 50 nmol/L. Adjusted mean grip strength was lower for centenarians with 25(OH)D concentrations less than 75 nmol/L than for centenarians with higher concentrations (P<0.05). However, there were no differences in the Georgia Centenarian Study (GCS) Composite Scale, a global measure of physical function, between those with higher and lower 25(OH)D concentrations. We conclude that low 25(OH)D concentrations are associated with poor grip strength, but not GCS Composite Scale, in the very old. Considering the high burden of poor physical function in older adults, understanding the relationship between vitamin D and different measures of physical function, including strength, becomes increasingly important.
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Proliferation of murine c-kit(pos) cardiac stem cells stimulated with IGF-1 is associated with Akt-1 mediated phosphorylation and nuclear export of FoxO3a and its effect on downstream cell cycle regulators.
Growth Factors
PUBLISHED: 03-03-2014
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Insulin-like growth factor-1 (IGF-1) is known to promote proliferation in many cell types including c-kit(pos) cardiac stem cells (CSCs). Downstream signaling pathways of IGF-1 induced CSC proliferation have not been investigated. An important downstream target of IGF-1/Akt-1 signaling is FoxO3a, a key negative regulator of cell-cycle progression. We studied the effect of IGF-1 on proliferation of c-kit(pos) murine CSCs and found that IGF-1-mediated cell proliferation is associated with FoxO3a phosphorylation and inactivation of its transcriptional activity. PI3 inhibitors LY294002 and Wortmannin abolished the effect of IGF-1 on FoxO3a phosphorylation indicating that FoxO3a phosphorylation is mediated by PI3/Akt-1 pathway. In cells with FoxO3a translocation to the cytoplasm, there is decreased expression of cell-cycle inhibitors such as p27(kip1) and p57(kip2) and increased expression of CyclinD1. Our study provides evidence that IGF-1 induced CSC proliferation could be the result of FoxO3a inactivation and its downstream effect on cell-cycle regulators.
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Stage-Specific Changes in Neurogenic and Glial Markers in Alzheimer's Disease.
Biol. Psychiatry
PUBLISHED: 02-08-2014
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Reports of altered endogenous neurogenesis in people with Alzheimer's disease (AD) and transgenic AD models have suggested that endogenous neurogenesis may be an important treatment target, but there is considerable discrepancy among studies. We examined endogenous neurogenesis and glia changes across the range of pathologic severity of AD in people with and without dementia to address this key question.
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An integrative review of the mental health of partners of veterans with combat-related posttraumatic stress disorder.
J Am Psychiatr Nurses Assoc
PUBLISHED: 01-17-2014
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The aim of this article is to present an integrative review of the mental health of veteran partners living with veterans with combat-related posttraumatic stress disorder (PTSD). Living with a veteran with PTSD affects the psychological well-being and health outcomes of a veteran partner. Fourteen research articles that focused on the mental health of military partners, which directly influence the psychological well-being of veteran partners, were reviewed. Findings indicate that a range of mental health concerns exist among veteran partners living with veterans with PTSD. The mental well-being of veteran partners is affected by the emotional strain of living and caring for veterans with PTSD. For years, the partner's presence has been overlooked in the PTSD treatment. However, to promote the comprehensive health of veterans with PTSD, it is paramount to understand the mental health state of veteran partners. Understanding the mental health state of veteran partners will provide a broader perspective to the plight of veteran partners.
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Establishing a program of global initiatives for nursing education.
J Nurs Educ
PUBLISHED: 01-15-2014
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In the global nursing community, schools of nursing are increasingly developing initiatives and networks across national boundaries. This article describes the process undertaken at a school of nursing to determine its global health priorities and develop a program of global initiatives for nursing education. A series of meetings were held to determine faculty global activities and gauge interest in designing a 5-year strategic plan for the program. A volunteer Strategic Planning Work-group was convened to formalize a mission, vision, and strategic plan for the program, which were presented to, refined by, and vetted by an advisory board and the faculty at large. We recommend this process to schools committed to developing or expanding a program dedicated to global initiatives and a global perspective in educational planning. Involving stakeholders, building on current strengths, and aligning with mission and vision are essential elements for developing a meaningful program of global initiatives for nursing education.
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Tuberculosis treatment for Mexican Americans living on the U.S.-Mexico border.
J Nurs Scholarsh
PUBLISHED: 01-12-2014
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This study produced a rich description of the lived experiences of tuberculosis (TB) treatment among Mexican Americans living in the Lower Rio Grande Valley (LRGV) of Texas.
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Placental development during early pregnancy in sheep: effects of embryo origin on vascularization.
Reproduction
PUBLISHED: 01-01-2014
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Utero-placental growth and vascular development are critical for pregnancy establishment that may be altered by various factors including assisted reproductive technologies (ART), nutrition, or others, leading to compromised pregnancy. We hypothesized that placental vascularization and expression of angiogenic factors are altered early in pregnancies after transfer of embryos created using selected ART methods. Pregnancies were achieved through natural mating (NAT), or transfer of embryos from NAT (NAT-ET), or IVF or in vitro activation (IVA). Placental tissues were collected on day 22 of pregnancy. In maternal caruncles (CAR), vascular cell proliferation was less (P<0.05) for IVA than other groups. Compared with NAT, density of blood vessels was less (P<0.05) for IVF and IVA in fetal membranes (FM) and for NAT-ET, IVF, and IVA in CAR. In FM, mRNA expression was decreased (P<0.01-0.08) in NAT-ET, IVF, and IVA compared with NAT for vascular endothelial growth factor (VEGF) and its receptor FLT1, placental growth factor (PGF), neuropilin 1 (NP1) and NP2, angiopoietin 1 (ANGPT1) and ANGPT2, endothelial nitric oxide synthase 3 (NOS3), hypoxia-inducible factor 1A (HIF1A), fibroblast growth factor 2 (FGF2), and its receptor FGFR2. In CAR, mRNA expression was decreased (P<0.01-0.05) in NAT-ET, IVF, and IVA compared with NAT for VEGF, FLT1, PGF, ANGPT1, and TEK. Decreased mRNA expression for 12 of 14 angiogenic factors across FM and CAR in NAT-ET, IVF, and IVA pregnancies was associated with reduced placental vascular development, which would lead to poor placental function and compromised fetal and placental growth and development.
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Sustained neuroprotection from a single intravitreal injection of PGJ2 in a rodent model of anterior ischemic optic neuropathy.
Invest. Ophthalmol. Vis. Sci.
PUBLISHED: 10-10-2013
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Nonarteritic anterior ischemic optic neuropathy (NAION) is the most common cause of sudden optic nerve-related vision loss in persons older than 50 in the United States. There currently is no treatment for this disorder. We previously showed that systemic administration of 15-deoxy, delta (12, 14) prostaglandin J2 (PGJ2) is neuroprotective in our rodent model of AION (rAION). In this study, we determined if a single intravitreal (IVT) injection of PGJ2 is neuroprotective after rAION, and if this method of administration is toxic to the retina, optic nerve, or both.
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Clinical and histologic diagnostic guidelines for psoriasis: a critical review.
Clin Rev Allergy Immunol
PUBLISHED: 09-10-2013
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Psoriasis is a common inflammatory skin disease that is associated with joint, psychiatric, and cardiovascular comorbidities. Diagnosis of plaque psoriasis is dependent primarily on characteristic physical findings and history. Given the varied clinical presentations of psoriasis and its mimicry to other papulosquamous skin diseases, it may be difficult for nondermatologists to diagnose psoriasis. Currently, no diagnostic criteria for plaque psoriasis have been validated in clinical studies. In this paper, we provide diagnostic guidelines for the nondermatologist to aid them in recognizing psoriasis.
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APOE ? 4, rated life experiences, and affect among centenarians.
Aging Ment Health
PUBLISHED: 09-02-2013
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Objectives: The purpose of this study was to assess the relationship between apolipoprotein E (APOE), life events and engagement, and subjective well-being (as measured by positive and negative affect) among centenarians. Based on the life stress paradigm, we predicted that higher levels of stress would allow APOE to influence positive and negative affect. Method: 196 centenarians and near-centenarians (98 years and older) of the Georgia Centenarian Study participated in this research. The APOE, positive and negative affect, the number of recent (last 2 years) and lifelong (more than 20 years prior to testing) events, as well as a number of life engagement tasks were assessed. Results: Results suggested that centenarians carrying the APOE ?4 allele rated lower in positive affect, the number of lifelong events, and in engaged lifestyle, when compared to centenarians without the APOE ?4 allele (t = 3.43, p < .01; t = 3.19, p < .01; and t = 2.33, p < .05, respectively). Blockwise multiple regressions indicated that the APOE ?4 predicted positive but not negative affect after controlling for demographics. Gene-environment interactions were obtained for the APOE ?4 and lifelong events, suggesting that carriers of the APOE ?4 allele had higher scores of negative affect after having experienced more events, whereas noncarriers had reduced negative affect levels after having experienced more events. Conclusion: APOE ?4 is directly related to positive affect and is related to negative affect in interaction with life events.
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A bioassay for Lafora disease and laforin glucan phosphatase activity.
Clin. Biochem.
PUBLISHED: 05-30-2013
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Lafora disease is a rare yet invariably fatal form of progressive neurodegenerative epilepsy resulting from mutations in the phosphatase laforin. Several therapeutic options for Lafora disease patients are currently being explored, and these therapies would benefit from a biochemical means of assessing functional laforin activity following treatment. To date, only clinical outcomes such as decreases in seizure frequency and severity have been used to indicate success of epilepsy treatment. However, these qualitative measures exhibit variability and must be assessed over long periods of time. In this work, we detail a simple and sensitive bioassay that can be used for the detection of functional endogenous laforin from human and mouse tissue.
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Transitions of care in patients receiving oral anticoagulants: general principles, procedures, and impact of new oral anticoagulants.
J Cardiovasc Nurs
PUBLISHED: 05-29-2013
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Most patients requiring anticoagulation therapy while hospitalized will continue this therapy as outpatients. This transition can be associated with gaps in care related to anticoagulation therapy that increase the risk of adverse events, rehospitalizations, and death. Warfarin, the most commonly used oral anticoagulant, presents distinct management challenges, including drug-food and drug-drug interactions, a narrow therapeutic window, and the requirements for periodic blood monitoring and dose adjustments, particularly during the hospital discharge process.
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Spiritual quality of life in advanced cancer patients receiving radiation therapy.
Psychooncology
PUBLISHED: 03-26-2013
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The aim of this randomized controlled trial for patients with advanced cancer receiving radiation therapy was to determine the effect of a multidisciplinary intervention on spiritual quality of life (QOL) at the end of the intervention (week 4) and at two follow-up time points (weeks 26 and 52).
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Psoriasis, electrocardiographic characteristics, and incidence of atrial fibrillation.
Arch. Dermatol. Res.
PUBLISHED: 03-12-2013
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Psoriasis patients have an increased incidence of cardiovascular disease. Atrial fibrillation is the most common cardiac arrhythmia and is associated with increased morbidity and risk of stroke. In this study, we assessed the association between psoriasis, electrocardiographic characteristics, and incident atrial fibrillation. Two cohorts were studied to address this question. First, the electrocardiograms of 169 subjects with psoriasis and coronary heart disease were reviewed and matched to patients without psoriasis. The Framingham risk score for atrial fibrillation was calculated to predict incident atrial fibrillation. Second, a larger cohort of 2,078 patients with psoriasis was matched to 6,234 patients without psoriasis. In the first group, psoriasis patients had no significantly different electrocardiographic characteristics, but a trend towards a decreased predicted incidence of atrial fibrillation using the Framingham risk score (12.8 vs. 14.6 % over a 10-year period, P = 0.06), suggesting that patients with psoriasis do not have a higher prevalence of risk factors for atrial fibrillation based on established risk scores. In the second group, the 5-year incidence of atrial fibrillation among patients with psoriasis was 2.5, vs. 3.3 % for matched controls (P = 0.4). The rates of atrial fibrillation per 1,000 person-years ranged from 4.8 events/1,000 person-years for mild psoriasis to 5.4 for patients with moderate/severe psoriasis. On multivariable analysis, there remained no association between mild psoriasis (adjusted HR 1.32, 95 % CI 0.91-1.89) or moderate-to-severe psoriasis (adjusted HR 1.27, 95 % CI 0.54-3.03) and incident atrial fibrillation.
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Profiles of cognitive functioning in a population-based sample of centenarians using factor mixture analysis.
Exp Aging Res
PUBLISHED: 02-21-2013
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BACKGROUND/STUDY CONTEXT: The goal of the study was to identify and characterize latent profiles (clusters) of cognitive functioning in centenarians and the psychometric properties of cognitive measures within them.
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Spiritual well-being in lung cancer survivors.
Support Care Cancer
PUBLISHED: 02-04-2013
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Spiritual well-being (SWB) among lung cancer survivors has not been well-delineated. Additionally, little is known about how SWB is affected over the trajectory of the disease process. The aims of this study were to examine the SWB of individuals with a diagnosis of lung cancer, to assess the stability of SWB over time, and to identify the factors associated with SWB.
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Relationship between Serum and Brain Carotenoids, ?-Tocopherol, and Retinol Concentrations and Cognitive Performance in the Oldest Old from the Georgia Centenarian Study.
J Aging Res
PUBLISHED: 01-04-2013
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Oxidative stress is involved in age-related cognitive decline. The dietary antioxidants, carotenoids, tocopherols, and vitamin A may play a role in the prevention or delay in cognitive decline. In this study, sera were obtained from 78 octogenarians and 220 centenarians from the Georgia Centenarian Study. Brain tissues were obtained from 47 centenarian decedents. Samples were analyzed for carotenoids, ?-tocopherol, and retinol using HPLC. Analyte concentrations were compared with cognitive tests designed to evaluate global cognition, dementia, depression and cognitive domains (memory, processing speed, attention, and executive functioning). Serum lutein, zeaxanthin, and ?-carotene concentrations were most consistently related to better cognition (P < 0.05) in the whole population and in the centenarians. Only serum lutein was significantly related to better cognition in the octogenarians. In brain, lutein and ?-carotene were related to cognition with lutein being consistently associated with a range of measures. There were fewer significant relationships for ?-tocopherol and a negative relationship between brain retinol concentrations and delayed recognition. These findings suggest that the status of certain carotenoids in the old may reflect their cognitive function. The protective effect may not be related to an antioxidant effect given that ?-tocopherol was less related to cognition than these carotenoids.
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Protein, lipid, and hematological biomarkers in centenarians: definitions, interpretation and relationships with health.
Maturitas
PUBLISHED: 12-02-2011
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As increasing numbers of individuals reach very advanced age, it is important to understand the influence of modifiable lifestyle factors such as diet and nutrition on both the achievement of exceptional longevity as well as the maintenance of optimal functional capacity. This includes determining the most appropriate biomarkers for monitoring changes in health and nutrition status and response to therapy in oldest old individuals. In an earlier work (Hausman et al., Maturitas 2011;68:203-9), we summarized studies of dietary intake and patterns of long-lived peoples and presented the current knowledge regarding vitamin B12, folate, 25(OH) vitamin D and other specific indicators of nutritional status in centenarians. The present review focuses on less specific biochemical indices of health and nutritional status and summarizes studies comparing protein, lipid and hematological biomarkers in centenarians and older adult controls. Such studies, from many countries worldwide, are often small, convenience samples of healthy and/or community-dwelling centenarians, although a few population-based studies including participants with a broader range of physical and cognitive functioning are also presented. Though heterogeneous in design and demographic region, these studies typically show lower levels of protein and hematological indicators and improved levels of some lipid biomarkers in centenarians as compared with regionally matched older adult controls. As these biomarkers can be influenced by many factors interpretation of results must be approached with caution. Importantly, studies examining potential associations of these biomarkers with cognitive, mental and physical function must carefully control for potential confounders including genetics and chronic disease, an increasing burden at advanced age.
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Regionally increasing baccalaureate-prepared nurses in North Carolina: the RIBN Project.
N C Med J
PUBLISHED: 12-02-2011
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A more highly educated nursing workforce is needed to address the increasingly complex health care needs of our citizens and to expand the pool for future faculty and advanced practice nurses. North Carolina must create new partnerships between community colleges and universities to support seamless progression toward a baccalaureate degree. The RIBN model provides one option to meet this goal.
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Evidence-based transition to practice: developing a model for North Carolina.
N C Med J
PUBLISHED: 12-02-2011
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To enhance patient safety and increase retention of new nurses, structures and processes should be developed to ensure that newly licensed nurses are afforded the opportunity to gain confidence and competence as they enter the workforce. This commentary provides an overview of the work performed to date in North Carolina to build an evidence-based transition-to-practice model.
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The use of nonphysician providers in adult intensive care units.
Am. J. Respir. Crit. Care Med.
PUBLISHED: 12-01-2011
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In the United States there are not currently enough critical care-trained practitioners to provide care to all critically ill patients. With calls for "high-intensity" staffing and 24-hour coverage of our intensive care units, the board-certified intensivists we do have are being stretched ever more thin. Nonphysician providers (physician assistants and nurse practitioners) are being used with increasing frequency in critical care settings to provide care to critically ill patients. In this review, we explore the impact of introducing nonphysician providers into the adult intensive care unit.
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Obesity is more strongly associated with inappropriate eating behaviors than with mental health in older adults receiving congregate meals.
J Nutr Gerontol Geriatr
PUBLISHED: 11-22-2011
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This study explored the relationships of inappropriate eating behaviors and mental health with obesity in congregate meal participants in Georgia (N = 120, mean age = 75 years, 75% female, 43% African American). Inappropriate eating behaviors were evaluated with the Three-Factor Eating Questionnaire (18 questions); mental health was assessed with the Depression Anxiety Stress Scale (21 questions); history of depression was assessed with the Behavioral Risk Factor Surveillance Survey; and height and weight were measured to calculate body mass index (BMI) and obesity (52% ? 30 kg/m(2)). In bivariate analyses, obesity was associated with cognitive restraint (rho = 0.49, p < 0.0001), uncontrolled eating (rho = 0.22; p < 0.01), emotional eating (rho = 0.32, p < 0.001), and stress (rho = 0.18, p < 0.05), but not with depression or anxiety. In multivariate regression analyses including all six eating behavior and mental health indices, only cognitive restraint and emotional eating were consistently associated with obesity (p < 0.05) when controlled for potential confounders (demographics, food insecurity, and chronic health conditions). Thus, mental health symptoms and inappropriate eating behaviors, particularly cognitive restraint and emotional eating, may be important targets for future research and intervention. Additional research is needed to better understand how cognitive restraint and emotional eating contribute to obesity in this population so that interdisciplinary research and health care teams can appropriately prevent and manage obesity in congregate meal participants.
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Store type and demographic influence on the availability and price of healthful foods, Leon County, Florida, 2008.
Prev Chronic Dis
PUBLISHED: 10-17-2011
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The availability of healthful foods varies by neighborhood. We examined the availability and price of more healthful foods by store type, neighborhood income level, and racial composition in a community with high rates of diet-related illness and death.
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Prevalence and predictors of anemia in a population-based study of octogenarians and centenarians in Georgia.
J. Gerontol. A Biol. Sci. Med. Sci.
PUBLISHED: 09-05-2011
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Anemia has been associated with increased physical and financial costs and occurs more frequently in older individuals. Therefore, the primary objectives of this study were to examine the prevalence and possible predictors of anemia in the very old.
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Acculturation factors are associated with folate intakes among Mexican American women.
J. Nutr.
PUBLISHED: 08-24-2011
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Folic acid can prevent neural tube defects (NTD). Hispanic women have a higher prevalence of NTD than non-Hispanic white (NHW) women and consume less folic acid. Among Hispanics, acculturation has been associated with lower intakes of natural folate. It is unknown if this same relationship is seen for fortified foods. This article describes the associations of acculturation factors with usual folate intakes from foods and supplements and compares the proportion that meets recommended intakes of folic acid of US Mexican American (MA) women with those of NHW women. For US NHW and MA women aged 15-44 y (n = 3167), usual folate intakes (i.e., natural food folate, folic acid from food, total folic acid [fortified foods plus supplements], and total folate) were estimated using measurement error models from NHANES 2001-2008. Compared with NHW women, MA women did not differ in their intake of natural food folate or folic acid from food. Similarly, compared with NHW women (332 ± 17.3 ?g/d), the mean total usual folic acid intakes were lower among MA women who reported speaking Spanish (224 ± 24.9 ?g/d) but not for MA women who reported speaking English (283 ± 36.2 ?g/d). MA women were more likely than NHW women to consume a total folic acid intake <400 ?g/d. MA women with lower acculturation factors were the most likely to have an intake <400 ?g/d compared to NHW women. Public health efforts should focus on increasing total folic acid intake among MA women, emphasizing those with lower acculturation factors (e.g., MA women who report speaking Spanish).
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Multidimensional predictors of fatigue among octogenarians and centenarians.
Gerontology
PUBLISHED: 08-18-2011
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Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited.
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Diffuse retinal injury from a non-penetrating TASER dart.
Doc Ophthalmol
PUBLISHED: 08-09-2011
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To describe a non-penetrating TASER gun injury resulting in a small exudative retinal detachment but significant visual acuity and retinal function loss as demonstrated by electroretinography (ERG). A 39-year-old man presented to the emergency department with a TASER barb embedded in his right lower lid. A complete clinical ophthalmologic examination and surgical extrication were performed, as well as radiologic imaging and Ganzfeld electroretinography. No scleral penetration was observed on surgical exploration. Retinal examination showed a peripheral exudative detachment. Subsequent follow-up revealed progressive resolution of the detachment and improvement in visual acuity. The ERG showed a 63-70% decrease in rod a- and b-waves, while isolated cone responses were reduced by only 10%, with a minimal increase in implicit time. This case shows that periocular TASER injuries, even if apparently superficial, may result in significant ocular damage. ERG may be useful in the diagnosis of visual loss attributed to disturbance in photoreceptor function, in the absence of anatomically evident damage.
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Improved physical function and physical activity in older adults following a community-based intervention: Relationships with a history of depression.
Maturitas
PUBLISHED: 07-27-2011
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The purpose of this study was to explore the relationship of a history of depression with moderate physical activity and physical function before and after a physical activity intervention of congregate meal participants in senior centers from all 12 Georgia Area Agencies on Aging (AAA). Participants were a convenience sample of older adults (n=376, mean age=76 years, 82% female, 64% Caucasian, 36% African American, 22% a history of depression). The physical activity intervention included educator-led chair exercises that incorporated balls and bands. Pre- and post-tests assessed moderate physical activity and physical function. At the pre-test, a history of depression was not related to moderate physical activity or physical function. Following the intervention there were significant increases in both moderate physical activity and physical function, but a history of depression was a negative predictor of improvements in physical activity when controlled for site, demographics, and health-related conditions. These results provide an evidence base for the effectiveness of this intervention in improving moderate physical activity and physical function in a community setting, but additional efforts may be needed to improve the impact of this type of intervention among older adults with a history of depression.
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Effect of apoptosis-inducing antitumor agents on endocardial endothelial cells.
Cardiovasc. Toxicol.
PUBLISHED: 06-15-2011
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Chemotherapy is one of the common treatment modalities for cancer. Some of the antineoplastic drugs have, however, been found to be toxic for vascular endothelium, resulting in complications such as endothelial dysfunction, thromboembolism, heart failure, and cardiomyopathy. In this study, we investigated the cytotoxic effect of widely used antitumor agents doxorubicin, camptothecin, and thapsigargin on primary and immortalized porcine endocardial endothelial cells and compared with the effects of these agents on human umbilical vein endothelial cells, human aortic endothelial cells, and EA.hy926 cells. Our study revealed that endocardial endothelial cells are relatively resistant to apoptosis induced by these drugs. Interestingly, our study indicates that response to antitumor agents greatly differs depending on the site of origin of endothelial cells. Doxorubicin, camptothecin, and thapsigargin induce mitochondrial-dependent cell death following loss of mitochondrial membrane potential (MMP) in vascular endothelial cells, with subsequent increase in sub-G0 population. In endocardial endothelial cells, there was no MMP loss; and only cell cycle arrest either at G1 or S phases was observed when the cells were treated with doxorubicin, camptothecin, and thapsigargin.
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Reflective practice: a framework for case manager development.
Prof Case Manag
PUBLISHED: 06-08-2011
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The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article.
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Age differences and changes in resources essential to aging well: a comparison of sexagenarians, octogenarians, and centenarians.
Curr Gerontol Geriatr Res
PUBLISHED: 05-29-2011
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THIS STUDY EXAMINED CHANGE OVER TIME IN FIVE RESOURCES ASSESSED BY THE DUKE OARS MULTIDISCIPLINARY FUNCTIONAL ASSESSMENT QUESTIONNAIRE: social, economic, mental, physical, and functional resources. Two hundred and one participants in the Georgia Centenarian Study provided data for this longitudinal study: 70 sexagenarians, 63 octogenarians, and 68 centenarians. Those in their 60s and 80s were followed up within 60 months; due to mortality attrition, centenarians were followed up within 20 months. Centenarians experienced the lowest levels of resources relative to those in their 80s and 60s. Over time they primarily experienced loss in activities of daily living, highlighting that the ability to maximize gains and mitigate losses over time for older adults is highly associated with various resources essential to well-being. Findings suggest that older adults-especially the very old-resources should be concurrently assessed in a multidimensional analysis by researchers and practitioners who work with older adults in various settings.
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Radiographic assessment of uncemented total hip arthroplasty: reliability of the Engh Grading Scale.
Can J Surg
PUBLISHED: 05-26-2011
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Radiographic evaluation has a prominent place in the follow-up of long-term results of uncemented total hip arthroplasty (THA). The most prominent scale reported in studies is the Engh Grading Scale, but there is a lack of literature on the reliability of the scale.
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Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students.
Med Teach
PUBLISHED: 05-26-2011
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The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinees answers.
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Older Americans Act Nutrition Program improves participants food security in Georgia.
J Nutr Gerontol Geriatr
PUBLISHED: 05-21-2011
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It is critical to use convincing research methodology to demonstrate the benefits of nutrition assistance programs targeted to vulnerable older adults. We examined the impact of Older Americans Act Nutrition Program (OAANP) participation on food security in participants and waitlisted people in Georgia using two waves of self-administered mail surveys conducted 4 months apart (n = 717, mean age 74.6 ± 9.5, 70.9% female, 33.2% black). At baseline, 54% of the sample was food insecure. Waitlisted people reported higher levels of persistent food insecurity (45.9%) or becoming food insecure (10.0%) than participants (29.3% and 7.1%, respectively) over 4 months. While considering potential confounders, the estimated odds of achieving food security were 1.65 times (95% CI: 1.10-2.48) higher in participants than in waitlisted people over 4 months. Our data suggest the feasibility of using food insecurity measures to detect the benefits of OAANP participation as well as the need to increase the capacity of OAANP.
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Food security of older adults requesting Older Americans Act Nutrition Program in Georgia can be validly measured using a short form of the U.S. Household Food Security Survey Module.
J. Nutr.
PUBLISHED: 05-11-2011
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Food security is a newly recommended outcome measure for the Older Americans Act Nutrition Program (OAANP); however, it is unknown how best to evaluate the need for this program and assess its impact on a large scale. Therefore, we measured food security in all new OAANP participants and waitlisted applicants in Georgia between July and early November, 2008 (n = 4731) with the self-administered mail survey method used in the ongoing Georgia Performance Outcomes Measures project. We used a modified 6-item U.S. Household Food Security Survey Module (HFSSM) with a 30-d reference period and 2 reminder postcards. Approximately 33% of those identified completed the survey (n = 1594, mean age 74.6 ± 9.5 y, 68.6% female, 30.6% black). Most of the respondents (91%) completed all 6 food security questions, whereas 26 did not respond to any question. Infit and outfit statistics for each of the 6 questions were within an acceptable range. Psychometric properties observed in our food security data were generally similar to those in the nationally representative survey conducted by the Census Bureau and suggest that our food security statistics may be meaningfully compared with national food security statistics published by the USDA. Our findings suggest that food security can be reasonably measured by a short form of HFSSM in older adults requesting OAANP. Such methodology also can be used to estimate the extent of food insecurity and help guide program and policy decisions to meet the nutrition assistance needs of vulnerable older adults.
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Cardiac e-learning: Development of a web-based implantable cardioverter defibrillator educational system.
Telemed J E Health
PUBLISHED: 04-20-2011
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The objective of this study was to design a Web-based implantable cardioverter defibrillator (ICD) module that would allow greater access to learning which could occur at an individuals convenience outside the fast-paced clinical environment.
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Molecular basis of virulence in clinical isolates of Escherichia coli and Salmonella species from a tertiary hospital in the Eastern Cape, South Africa.
Gut Pathog
PUBLISHED: 03-24-2011
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Apart from localized gastrointestinal infections, Escherichia coli and Salmonella species are major causes of systemic disease in both humans and animals. Salmonella spp. cause invasive infections such as enteric fever, septicemia, osteomyelitis and meningitis while certain types of E. coli can cause systemic infections, includingpyelonephritis, meningitis and septicemia. These characteristic requires the involvement of a myriad of virulence factors.
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Spiritual well-being and quality of life of women with ovarian cancer and their spouses.
J Support Oncol
PUBLISHED: 03-15-2011
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There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses.
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Body mass index is associated with dietary patterns and health conditions in georgia centenarians.
J Aging Res
PUBLISHED: 03-02-2011
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Associations between body mass index (BMI) and dietary patterns and health conditions were explored in a population-based multiethnic sample of centenarians from northern Georgia. BMI ?20 and ?25 was prevalent in 30.9% and 25.3% of study participants, respectively. In a series of logistic regression analyses controlled for gender and place of residence, the probability of having BMI ?25 was increased by being black versus white and having a low citrus fruit, noncitrus fruit, orange/yellow vegetable or total fruit and vegetable intake. The probability of having BMI ?20 was not associated with dietary intake. When controlled for race, gender, residence, and total fruit and vegetable intake, BMI ?25 was an independent risk factor for diabetes or having a systolic blood pressure ?140?mmHg or diastolic blood pressure ?90?mmHg, whereas BMI ?20 was a risk factor for anemia. Given the many potential adverse consequences of under- and overweight, efforts are needed to maintain a healthy weight, even in the oldest old.
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Nonarteritic anterior ischemic optic neuropathy (NAION) and its experimental models.
Prog Retin Eye Res
PUBLISHED: 02-20-2011
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Anterior ischemic optic neuropathy (AION) can be divided into nonarteritic (NAION) and arteritic (AAION) forms. NAION makes up ~85% of all cases of AION, and until recently was poorly understood. There is no treatment for NAION, and its initiating causes are poorly understood, in part because NAION is not lethal, making it difficult to obtain fresh, newly affected tissue for study. In-vivo electrophysiology and post-mortem studies reveal specific responses that are associated with NAION. New models of NAION have been developed which enable insights into the pathophysiological events surrounding this disease. These models include both rodent and primate species, and the power of a vertically integrated multi-species approach can help in understanding the common cellular mechanisms and physiological responses to clinical NAION, and to identify potential approaches to treatment. The models utilize laser light to activate intravascular photoactive dye to induce capillary vascular thrombosis, while sparing the larger vessels. The observable optic nerve changes associated with rodent models of AION (rAION) and primate NAION (pNAION) are indistinguishable from that seen in clinical disease, including sectoral axonal involvement, and in-vivo electrophysiological data from these models are consistent with clinical data. Early post-infarct events reveal an unexpected inflammatory response, and changes in intraretinal gene expression for both stress response, while sparing outer retinal function, which occurs in AAION models. Histologically, the NAION models reveal an isolated loss of retinal ganglion cells by apoptosis. There are changes detectable by immunohistochemistry suggesting that other retinal cells mount a brisk response to retinal ganglion cell distress without themselves dying. The optic nerve ultimately shows axonal loss and scarring. Inflammation is a prominent early histological feature. This suggests that clinically, specific modulation of inflammation may be a useful approach to NAION treatment early in the course of the disease.
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Evaluation of the antibacterial and anticancer activities of some South African medicinal plants.
BMC Complement Altern Med
PUBLISHED: 02-17-2011
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Several herbs are traditionally used in the treatment of a variety of ailments particularly in the rural areas of South Africa where herbal medicine is mainly the source of health care system. Many of these herbs have not been assessed for safety or toxicity to tissue or organs of the mammalian recipients.
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Exploring Positive and Negative Affect as Key Indicators of Life Satisfaction among Centenarians: Does Cognitive Performance Matter?
J Aging Res
PUBLISHED: 02-16-2011
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The aim of this investigation was to determine how cognitive performance was associated with positive and negative affect and life satisfaction over time. This study involved a secondary longitudinal analysis of cross-section data collected at Phase I (1988-1992) and during an 18-month longitudinal followup at Phase II (1992-1998) of the Georgia Centenarian Study. Participants included N = 137 centenarians at Time 1 and N = 68 survivors at Time 2. Significant stability in cognitive impairment existed at Time 1 and Time 2 for positive (? = .55, P < .01) and negative affect (? = .54, P < .01) models. Negative affect at Time 1 was associated with lower life satisfaction at Time 1 (? = -.42, P < .01 ). In addition, cognitive impairment at Time 2 was associated with decreased positive emotionality at Time 2 (? = -.39, P > .01). Furthermore, greater positive affect at Time 2 was associated with greater satisfaction with life at Time 2 (? = .35, P < .01). It appears that positive emotionality contemporaneously influences the association between cognitive impairment and life satisfaction among centenarians. Implications relative to improving life satisfaction among centenarians are discussed.
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Change in 25-hydroxyvitamin D and physical performance in older adults.
J. Gerontol. A Biol. Sci. Med. Sci.
PUBLISHED: 02-16-2011
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Vitamin D deficiency is common among older adults and is associated with poor physical performance; however, studies examining longitudinal changes in 25-hydroxyvitamin D (25[OH]D) and physical performance are lacking. We examined the association between 25(OH)D and physical performance over 12 months in older adults participating in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P), a multicenter physical activity intervention trial.
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Placental development during early pregnancy in sheep: cell proliferation, global methylation, and angiogenesis in the fetal placenta.
Reproduction
PUBLISHED: 01-27-2011
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To characterize early fetal placental development, gravid uterine tissues were collected from pregnant ewes every other day from day 16 to 30 after mating. Determination of 1) cell proliferation was based on Ki67 protein immunodetection; 2) global methylation was based on 5-methyl-cytosine (5mC) expression and mRNA expression for DNA methyltransferases (DNMTs) 1, 3a, and 3b; and 3) vascular development was based on smooth muscle cell actin immunolocalization and on mRNA expression of several factors involved in the regulation of angiogenesis in fetal membranes (FMs). Throughout early pregnancy, the labeling index (proportion of proliferating cells) was very high (21%) and did not change. Expression of 5mC and mRNA for DNMT3b decreased, but mRNA for DNMT1 and 3a increased. Blood vessels were detected in FM on days 18-30 of pregnancy, and their number per tissue area did not change. The patterns of mRNA expression for placental growth factor, vascular endothelial growth factor, and their receptors FLT1 and KDR; angiopoietins 1 and 2 and their receptor TEK; endothelial nitric oxide synthase and the NO receptor GUCY13B; and hypoxia inducing factor 1 ? changed in FM during early pregnancy. These data demonstrate high cellular proliferation rates, and changes in global methylation and mRNA expression of factors involved in the regulation of DNA methylation and angiogenesis in FM during early pregnancy. This description of cellular and molecular changes in FM during early pregnancy will provide the foundation for determining the basis of altered placental development in pregnancies compromised by environmental, genetic, or other factors.
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Challenges and new opportunities for clinical nutrition interventions in the aged.
J. Nutr.
PUBLISHED: 01-26-2011
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Nutritional status plays a critical role in the prevention and management of many chronic health conditions that are common in the elderly and are likely to become more prevalent as the population ages. This paper highlights several aspects of nutrition that require additional basic science and clinical application research to improve the health and well-being of older adults. Topics addressed are selected demographic and health indices, the uncertain benefits of energy restriction in aged humans compared with other species, the impact of food insecurity on health, the relationship between dietary protein and sarcopenia, the prevention and management of obesity while maintaining muscle mass and functional status, and controversy regarding high intakes of folic acid. Research needs regarding the safety, efficacy, and application of clinical interventions related to these topics also are discussed.
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Nutrition in centenarians.
Maturitas
PUBLISHED: 01-05-2011
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The oldest old are among the fastest growing segment of the population and it is important to understand not only the influence of modifiable lifestyle factors such as diet and nutrition on the achievement of exceptional longevity but also the role, if any, of these factors on maintaining optimal cognitive, mental and physical health into advanced age. This review summarizes studies of dietary intake and patterns of long-lived peoples and presents current knowledge of nutritional status of centenarians as determined with nutritionally relevant biomarkers, providing information on comparative levels of the various biomarkers between centenarians and older adult controls and on the prevalence and predictors of nutritional deficiencies in centenarians. The studies indicate that BMI and nutritional status as indicated by circulating levels of antioxidant vitamins, vitamin B12, folate, homocysteine and 25(OH) vitamin D of centenarians are quite heterogeneous and influenced by region of residency and many of the demographic, dietary and lifestyle factors that influence nutritional status in other older adults. While many of the studies have been small, convenience samples of relatively healthy community-dwelling centenarians, a few have population-based or included participants of varying cognitive functioning. These and future studies examining associations between nutritional status and cognitive, mental and physical function should be instrumental in determining the role of nutrition in promoting longevity and improving the quality of life in these exceptional survivors.
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Older adults attending Georgia senior centers increase preventive behaviors for falls and fractures following a community-based intervention.
J Nutr Gerontol Geriatr
PUBLISHED: 01-01-2011
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A community-based intervention to reduce risk factors related to falls and fractures administered to Georgians participating in the Older Americans Act (OAA) congregate meal-site program (N = 691, mean age = 75, 84% female, 45% Black and 55% White, convenience sample) was evaluated. The intervention consisted of 16 weekly sessions, with 8 focused on prevention of falls and fractures, and all 16 including a physical activity component. Interviewer-administered pre- and posttests evaluated fall preventive home safety behavior, intakes of calcium- and vitamin D-rich foods, use of calcium- and vitamin D-containing supplements, and five modifiable fall- and fracture-related risk factors. Following the intervention, there were significant increases in the intake of calcium- and vitamin D-rich foods (p < 0.001), the use of calcium- or vitamin D-containing supplements (p < 0.05), days of week with physical activity (p < 0.001) and fall preventive home safety behaviors (p < 0.001), and decreases in overall modifiable fall- and fracture-related risk factors (?4 to 5 risk factors: pre: 32% vs. post: 18%; p < .001). This evaluation provides evidence that a multi-factorial fall prevention intervention offered at senior centers and delivered by trained staff can be beneficial for improving behaviors that may contribute to decreasing the risk of falls and fractures in older adults.
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The association of acculturation factors with biochemical indices of folate status among Mexican Americans 60 years of age or older in the post-fortification era: National Health and Nutrition Examination Survey (NHANES) 2001-2006.
J Nutr Gerontol Geriatr
PUBLISHED: 01-01-2011
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Acculturation factors have been found to affect dietary intakes of folate among older Mexican Americans (MAs) (?60 years). The association of acculturation with folate biomarkers is unknown. We determined whether acculturation factors were associated with folate biomarkers (e.g., serum folate, red blood cell [RBC] folate, and total homocysteine concentrations) and whether this association could be explained by dietary folate. Using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2006, we estimated that 42.8% and 40.1% of older MAs reported speaking Spanish all or most of the time or being born in Mexico, respectively (lower acculturation factors). Lower acculturation factors were not associated with total homocysteine concentrations but were, in general, associated with lower serum folate and RBC folate concentrations, but these associations were not always independent of factors such as sex, education, and poverty, and possibly were mediated by dietary and supplemental folate. Thus, the lower folate status observed among older MA with lower acculturation factors may be modifiable by changes in the intake of folic acid. [Supplementary materials are available for this article. Go to the publishers online edition of the Journal of Nutrition in Gerontology and Geriatrics for the following free supplemental resource: a table of the predictors of serum folate or red blood cell folate concentrations among Mexican Americans 60 years of age or older using country of origin or language preference, respectively, as acculturation factors, from the National Health and Nutrition Examination Survey 2001-2006.].
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Association of acculturation factors with dietary intakes of folate among older Mexican Americans in the post-fortification era: National Health and Nutrition Examination Survey (NHANES) 2001-2006.
J Nutr Gerontol Geriatr
PUBLISHED: 01-01-2011
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Previous studies have shown that acculturation factors are associated with dietary patterns of older Mexican Americans (MAs), but the association of these factors with post-fortification folate intake is unknown. We estimated usual folate intakes for U.S. MAs aged ?60 years (N = 712) by acculturation factors using data from the National Health and Nutrition Examination Survey 2001-2006. Mean total folic acid and total folate, but not natural folate intakes, were lower for MAs with lower acculturation factors, and 16% of MAs had total folate intakes less than the estimated average requirement (EAR) of 320 µg/day. Most older U.S. MAs did not meet requirements from natural food folate intake alone, regardless of acculturation status, but their intakes were adequate when fortified foods and supplement sources were taken into account. Logistic regression models including age, sex, education, poverty, and acculturation factors indicated that low income, not acculturation, was significantly associated with intake below the EAR. Thus our findings indicate that the association of low acculturation with folate intake below the EAR is not independent of poverty. [Supplementary materials are available for this article. Go to the publishers online edition of the Journal of Nutrition in Gerontology and Geriatrics for the following free supplemental resource: a table of the distribution of usual folate intake among Mexican Americans aged ?60 years by sex, age, education level, poverty income ratio, and acculturation factors, from the National Health and Nutrition Examination Survey 2001-2006.].
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The validity of Nutrition Screening Initiative DETERMINE Checklist responses in older Georgians.
J Nutr Elder
PUBLISHED: 11-25-2010
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The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.
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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.