Dammccarthy3756

Objectives A relationship exists between sirtuin-1 expression and growth and survival of malignant tumors. This study aimed to investigate the prognostic value of sirtuin-1 and vascular endothelial growth factor (VEGF) expression in patients with liposarcoma by examining associations between their expression levels and clinical outcomes. Methods Clinical and histopathological characteristics and follow-up and survival information were retrospectively reviewed for 42 liposarcoma cases. Sirtuin-1 and VEGF protein expression levels were evaluated by immunohistochemistry and their associations with clinical parameters were analyzed using the Spearman-rho test. Univariate and multivariate Cox regression analyses were performed to identify potential prognostic factors. Kaplan-Meier analysis was performed to analyze overall survival. Results Sirtuin-1 and VEGF protein expression levels were significantly associated with histological grade, metastasis, and American Joint Committee on Cancer stage. A significant positive correlation was observed between sirtuin-1 and VEGF expression levels (R = 0.677). In univariate analysis, sirtuin-1 and VEGF expression were correlated with shorter overall survival, but the association was significant only for sirtuin-1 (hazard ratio = 3.752, 95% confidence interval 1.553-9.062) in multivariate analysis. Conclusion Sirtuin-1 and VEGF expression levels are significantly correlated with progression of liposarcoma, and sirtuin-1 expression significantly predicts a poor prognosis in patients with liposarcoma.Background Dominant occupational therapy theories assert that people choose their daily occupations, and participate in occupations as autonomous agents; yet scholars insist that choices are socially-structured and inequitably available.Aim To critically review the concept of choice in occupational therapy theory through an exploration of patriarchy in India.Material and methods Drawing from scholarly work that addresses patriarchy in India, we employ the commonly-used occupational categories of self-care, productivity and leisure as a framework to explore the real availability of occupational choices for women.Results Patriarchal ideology perpetuates inequitable power dynamics within Indian society. As a consequence, women, children and non-dominant men have few opportunities to make or enact occupational choices that impact their wellbeing and their lives.Conclusions The examples provided in this paper challenge those occupational therapy theories that portray occupational engagement as the product of individual volition and unconstrained choice.Significance Dominant occupational therapy theories are informed by specific Western assumptions that may have little relevance to people in other contexts. Neuronal Signaling agonist Critical approaches to professional assumptions are essential to avoid the imperialistic imposition of irrelevant theories, and the development and delivery of services that may be oppressive for clients who have few opportunities to make occupational choices.Objective The aim of this study was to determine the frequency and type of drug therapy problems (DTPs) in older institutionalized adults. Method We conducted a cross-sectional observational study from February to June 2016 at a 150-bed public nursing home in Croatia, where comprehensive medication management (CMM) services were provided. A rational decision-making process, referred to as the Pharmacotherapy Workup method, was used to classify DTPs. Results Data were prospectively collected from 73 residents, among which 71% were age 75 years or older. The median number of prescribed medications per patient was 7 (2-16) and polypharmacy (> 4) was recorded for 54 (74.0%) patients. A total 313 DTPs were identified, with an average of 4.3 ± 2 DTPs per patient. The most frequent DTP was needing additional drug therapy (n = 118; 37.7%), followed by adverse drug reaction (n = 55; 17.6%). Lactulose (14.4%), tramadol (6.7%), and potassium (6.4%) were the medications most frequently related to DTPs. Conclusion The high prevalence of DTPs identified among older institutionalized adults strongly suggests the need to incorporate new pharmacist-led CMM services within existing institutional care facilities, to improve the care provided to nursing home residents.Background As many as 30-60% of individuals living with spinal cord injury/disease (SCI/D) experience at least one pressure injury (PI) in their lifetime. Best practice guidelines in SCI/D rehabilitation emphasize the importance of providing education regarding PI prevention and management for individuals living with SCI/D. Mobile educational applications can be used for PI education however there is limited research on the user-experiences of mobile educational applications about PIs for individuals living with SCI/D.Objectives The purpose of this study was to explore the experiences of individuals living with SCI/D on the use of Pressure Ulcer Target (PUT), a mobile educational app for PI prevention and management.Methods/Overview Nine participants living with SCI/D used PUT over two weeks. Individual semi-structured interviews were conducted to explore the participants' perceptions regarding the utility, aesthetics and ease of use of PUT and suggested modifications. A conventional content analysis was used to identify themes and categories from the data.Results User-experiences with PUT fell into four themes (1) Strengths and weakness; (2) Target population; (3) Key concepts and messages; and (4) Recommendations for improvement.Conclusions PUT serves as a review of previously acquired PI knowledge and should be introduced early in rehabilitation to motivate users to prevent PIs. Future studies exploring healthcare professionals' perspectives of PUT are warranted.Implications for rehabilitationPUT aids individuals living with SCI/D in the community to review PI prevention and management strategies that they learned as inpatients.The use of pictures to deliver patient education regarding PI prevention and management through a mHealth app is recommended.PUT should be introduced early in rehabilitation to motivate users to prevent PIs.