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Resilience, the 6th Vital Sign: Conceptualizing, Contextualizing, and Operationalizing All Six Vital Signs

Health 2024年第7期16卷 657-673页

作者： Rose E. Constantino betty J. braxter Chi Ching Vivian Hui Larissa C. Allen Lillian J. Wolfe Katherine H. Endres Jezyl Cempron Cutamora Laurence L. Garcia Daisy R. Palompon Kathleen Thimsen Brayden N. Kameg Margarete L. Zalon Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh PA USA Undergraduate Affairs School of Nursing University of Pittsburgh Pittsburgh PA USA The Hong Kong Polytechnic University Hong Kong China School of Nursing Adjunct Faculty at the University of Pittsburgh Pittsburgh PA USA School of Nursing University of Pittsburgh Pittsburgh PA USA Department of Health Promotion and Development School of Nursing University of Pittsburgh Pittsburgh PA USA College of Nursing Cebu Normal University Cebu City Philippines School of Nursing University of Nevada Las Vegas USA Department of Health and Community Systems University of Pittsburgh PA USA Department of Nursing University of Scranton Scranton PA USA

There are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation i

关键词： Conceptualization Contextualization Operationalization Body Temperature Pulse Respiration Blood Pressure Pain Resilience

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Child Abuse during the Pandemic and Trauma-Informed Care: A Review of Evidence-Based Literature

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Health 2023年第9期15卷 1003-1012页

作者： Allison J. DiPlacido Linda Leitzel Brayden Kameg betty J. braxter Rose Constantino School of Nursing University of Pittsburgh Pittsburgh USA

Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.

关键词： Neonates Newborn Infant Child Abuse Perinatal Trauma-Informed Care

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Exploring the Feasibility of Text Messaging Intervention in Intimate Partner Violence

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Open Journal of Nursing 2014年第7期4卷 528-537页

作者： Rose Constantino Linden Wu Dominique de la Cruz Joseph Burroughs JuHae Grace Hwang Amanda Henderson betty braxter Department of Health and Community Systems University of Pittsburgh School of Nursing Pittsburgh USA Department of Health Promotion and Development University of Pittsburgh School of Nursing Pittsburgh USA UPMC Shadyside Emergency Department University of Pittsburgh School of Nursing Pittsburgh USA

Introduction: Intimate Partner Violence (IPV) is defined as controlling, abusive, and aggressive behavior in a romantic relationship. Women between the ages 16 and 24 experience the highest rate of IPV. IPV costs US society at least $13.6 billion annually and is expected to rise to $15.6 billion by 2021. The purpose of this study is to explore the feasibility of Text Messaging Intervention (TMI) in recognizing, responding and preventing IPV among college students. The research questions are: Will TMI 1) improve participant knowledge of warning signs of IPV? (Knowledge) and 2) improve participant confidence to intervene in IPV? (Confidence). Methods: A mixed methods design in data collection and data analysis was used. One-way ANOVA and Chi-square test were used to analyze quantitative data from the pre and post TMI survey. Results of the qualitative data analysis are included verbatim. Results: Results showed that knowledge level pre to post test increased from 2.00 ± 1.00 to 2.7 ± 0.48 (p < 0.001) and confidence level pre to post test increased from 2.89 ± 0.60 to 3.30 ± 0.68 (p < 0.001). Conclusions: Further research is needed in evaluating the feasibility and effectiveness of IPV prevention programs that uses mobile devices to create the best optimal health outcomes.

关键词： Disruptive Innovations (DI) Intimate Partner Violence (IPV) Primary Prevention Strategy Text Messaging Intervention (TMI) Violence Prevention

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Assessing the Readability and Usability of Online H-E-L-P Intervention for IPV Survivors

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Open Journal of Nursing 2014年第3期4卷 150-157页

作者： Rose E. Constantino Ayman M. Hamdan-Mansour Amanda Henderson Bonnie Noll-Nelson Willa Doswell betty braxter Department of Community and Health Systems University of Pitts-burgh School of Nursing Pittsburgh USA Department of Health Promotion and Development University of Pittsburgh School of Nursing Pittsburgh USA Mental Health Nursing Community Health Department Faculty of Nursing The University of Jordan Amman Jordan RN-BSN Department Mount Aloysius College of Nursing Cresson USA University of Pittsburgh School of Nursing Pittsburgh USA

Purpose: The purpose of this study was to assess the readability and usability of an online HELP (Health, Education, and Legal Program) intervention for women experiencing IPV (Intimate Partner Violence) by asking graduate nursing students to review in class nine online HELP intervention modules. Design: A descriptive online survey administered to 15 graduate nursing students was used to assess the readability and usability of an online HELP intervention. Methods: Participants were asked to perform the following activities: 1) reading the nine HELP modules on PowerPoint as posted on Blackboard (a web-based course management program), 2) filling in five blank lines under each heading (HEALTH, EDUCATION, LEGAL, and PROGRAM), by writing words or terms on the line after each heading, 3) ranking the words within each heading (with #1 as the highest and #5 as the lowest), 4) engaging in a class discussion of the rationale for the ranking, 5) re-ranking, and 6) voting on the ranking. The results were compiled to yield a master rank and vote order for each heading between 12 (received 12 votes) and 15 (received 15 votes) of the words that were ranked #1. Results: The words that were ranked #1 under each heading and the number of votes received were: Under HEALTH: Depression (15), Anger (14), Anxiety (13), and Pain (12);EDUCATION: Safety (15), Injury (14), Social Support (13) and Parenting/Child Care (12);LEGAL: Protection from Abuse (15), Attorney (14), Court/Hearing (13), and Rights (12);PROGRAM: Internet (15), Online (14), Intervention (13) and Resources (12). Conclusions: HELP intervention is readable and usable however, HELP needs to be piloted to ensure that survivors of IPV participants can access and benefit from HELP intervention.

关键词： Intimate Partner Abuse HELP

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Clinical Judgment Development: Six Steps to Establish Professional Identity and Role-Specific Competencies in Caring for a Sexual Assault Survivor

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Health 2022年第1期14卷 23-37页

作者： Rose Eva Constantino Larissa C. Allen Vivian Hui Kelly M. Nitowski Brayden Kameg Amy S. Bowser Rebecca Burkart betty braxter Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA School of Nursing University of Pittsburgh Pittsburgh Pennsylvania USA

Background: Clinical judgment is a specific role that establishes a professional identity. The purpose of this paper is to prepare nursing students to make better judgments in the clinical setting and realign learning and teaching. Methods: We used six steps to arrive at a competent clinical judgment suggested by the National Council State Board of Nursing (NSCBN) as a clinical judgment model 1) recognizing cues, 2) analyzing cues, 3) prioritizing hypotheses, 4) generating solutions, 5) taking an action, and 6) evaluating outcomes during the head-to-toe examination of the patient. Results: The primary outcomes are stabilization of the hemodynamics of the patient and prevention of further blood loss. Fluids are being given to help keep the vascular volume from being depleted, but they cannot solve the underlying problem. Continued assessment, intervention, and monitoring of vital signs through the course of the hospital stay ending with the patient’s discharge. Discussion: Survivors of sexual assault are unique for a nurse to provide care. The nurse needs to assess, intervene, monitor, and pay attention to detail of the 6 steps to clinical judgment, resulting in positive outcomes for their patient. Conclusions: Forensic nursing is a field of nursing that focuses on sexual assault survivor care and works to make the aftermath of their tragic situation easier to cope with. Strengthening clinical judgment skills could remedy significant mistakes made by novice forensic nurses. Critical thinking and clinical ethical reasoning are the building blocks of clinical judgment.

关键词： Analyze Cues Clinical Judgment Evaluate Outcomes Generate Solutions Prioritize Hypotheses Recognize Cues

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Targeting calcium signaling in Alzheimer’s disease: challenges and promising therapeutic avenues

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Neural Regeneration Research 2024年第3期19卷 501-502页

作者： LinLin Song YongPei Tang betty Yuen Kwan Law Neher’s Biophysics Laboratory for Innovative Drug Discovery State Key Laboratory of Quality Research in Chinese MedicineMacao University of Science and TechnologyMacao Special Administration RegionChina

The critical role of calcium dyshomeostasis in the pathogenesis of Alzheimer’s disease(AD):AD is a progressive neurodegenerative disease characterized by cognitive decline,memory impairment,and behavioral *** an estimated 50 million people being affected worldwide,the incidence of AD is constantly increasing *** hallmark of AD is the accumulation of amyloid-beta protein(Aβ)in the form of amyloid plaques and hyperphosphorylated tau protein in the form of neurofibrillary ***,increasing evidence suggests that calcium ion(Ca2+)dysregulation also plays a crucial role in the pathogenesis of AD(Calvo-Rodriguez and Bacskai,2021).As a key second messenger,Ca2+regulates a wide range of cellular processes,including the release of neurotransmitters,gene expression,and cell ***^(2+)also regulates the activity of Calcium/calmodulin-dependent protein kinase II,which is critical for synaptic plasticity,learning,and memory(Kaushik et al.,2022).Alternation in the Ca^(2+)signal is an early event in the pathogenesis of AD,which can lead to synaptic dysfunction,neuronal loss,and cognitive impairment.

关键词： Alzheimer homeostasis globally

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Imaging and endoscopic tools in pediatric inflammatory bowel disease: What’s new?

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World Journal of Clinical Pediatrics 2024年第1期13卷 7-13页

作者： Alexandra S Hudson Ghassan T Wahbeh Hengqi betty Zheng Department of Pediatrics University of WashingtonSeattleWA 98109United States

Pediatric inflammatory bowel disease(IBD)is a chronic inflammatory disorder,with increasing incidence and prevalence *** have been recent advances in imaging and endoscopic technology for disease diagnosis,treatment,and *** ultrasound,including transabdominal,transperineal,and endoscopic,has been emerging for the assessment of transmural bowel inflammation and disease complications(e.g.,fistula,abscess).Aside from surgery,IBD-related intestinal strictures now have endoscopic treatment options including through-the-scope balloon dilatation,injection,and needle knife stricturotomy and new evaluation tools such as endoscopic functional lumen imaging *** transnasal endoscopy may have a role in patients with upper gastrointestinal Crohn’s disease or those with IBD with new upper gastrointestinal *** to dysplasia screening in pediatric patients with longstanding colonic disease or primary sclerosing cholangitis hold promise with the addition of virtual chromoendoscopy and ongoing research in the field of artificial intelligence-assisted endoscopic *** intelligence and machine learning is a rapidly evolving field,with goals of further personalizing IBD diagnosis and treatment selection as well as *** review summarized these advancements,focusing on pediatric patients with IBD.

关键词： Intestinal ultrasound Endoscopy Inflammatory bowel disease Pediatrics Imaging

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Mitophagy and cGAS-STING crosstalk in neuroinflammation

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Acta Pharmaceutica Sinica B 2024年第8期14卷 3327-3361页

作者： Xiaogang Zhou Jing Wang Lu Yu Gan Qiao Dalian Qin betty Yuen-Kwan Law Fang Ren Jianming Wu Anguo Wu Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia MedicaKey Laboratory of Medical Electrophysiology of Ministry of EducationSchool of PharmacySouthwest Medical UniversityLuzhou 646000China State Key Laboratory of Quality Research in Chinese Medicine Macao University of Science and TechnologyMacao SAR 999078China Chongqing Key Laboratory of Sichuan-Chongqing Co-construction for Diagnosis and Treatment of Infectious Diseases Integrated Traditional Chinese and Western Medicine Chongqing Traditional Chinese Medicine HospitalChongqing 400021China

Mitophagy,essential for mitochondrial health,selectively degrades damaged *** is intricately linked to the cGAS-STING pathway,which is crucial for innate *** pathway responds to mitochondrial DNA and is associated with cellular stress *** review explores the molecular details and regulatory mechanisms of mitophagy and the cGAS-STING *** critically evaluate the literature demonstrating how dysfunctional mitophagy leads to neuroinflammatory conditions,primarily through the accumulation of damaged mitochondria,which activates the cGAS-STING *** activation prompts the production of pro-inflammatory cytokines,exacerbating *** review emphasizes the interaction between mitophagy and the cGAS-STING *** mitophagy may suppress the cGAS-STING pathway,offering protection against ***,impaired mitophagy may activate the cGAS-STING pathway,leading to chronic ***,we explored how this interaction influences neurodegenerative disorders,suggesting a common mechanism underlying these *** conclusion,there is a need for additional targeted research to unravel the complexities of mitophagy-cGAS-STING interactions and their role in *** review highlights potential therapies targeting these pathways,potentially leading to new treatments for neuroinflammatory and neurodegenerative *** synthesis enhances our understanding of the cellular and molecular foundations of neuroinflammation and opens new therapeutic avenues for neurodegenerative disease research.

关键词： Neuroinflammation Mitophagy cGAS-STING Innate immunity Mitochondrial DNA Crosstalk Therapeutic avenues Neurodegenerative diseases

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Activation of autophagy by Citri Reticulatae Semen extract ameliorates amyloid-beta-induced cell death and cognition deficits in Alzheimer’s disease

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Neural Regeneration Research 2024年第11期19卷 2467-2479页

作者： Yong Tang Jing Wei Xiao-Fang Wang Tao Long Xiaohong Xiang Liqun Qu Xingxia Wang Chonglin Yu Xingli Xiao Xueyuan Hu Jing Zeng Qin Xu Anguo Wu Jianming Wu Dalian Qin Xiaogang Zhou betty Yuen-Kwan Law Dr.Neher’s Biophysics Laboratory for Innovative Drug Discovery State Key Laboratory of Quality Research in Chinese MedicineMacao University of Science and TechnologyMacao Special Administrative RegionChina Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica Southwest Medical UniversityLuzhouSichuan ProvinceChina Eye School and Key Laboratory of Sichuan Province Ophthalmopathy Prevention&Cure and Visual Function Protection of Chengdu University of TCM ChengduSichuan ProvinceChina School of Basic Medical Sciences Southwest Medical UniversityLuzhouSichuan ProvinceChina Department of Ophthalmology The Affiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina Department of Neurology The First People’s Hospital of NeijiangNeijiangSichuan ProvinceChina

Amyloid-beta-induced neuronal cell death contributes to cognitive decline in Alzheimer’s *** Reticulatae Semen has diverse beneficial effects on neurodegenerative diseases,including Parkinson’s and Huntington’s diseases,however,the effect of Citri Reticulatae Semen on Alzheimer’s disease remains *** the current study,the anti-apoptotic and autophagic roles of Citri Reticulatae Semen extract on amyloid-beta-induced apoptosis in PC12 cells were first *** Reticulatae Semen extract protected PC12 cells from amyloid-beta-induced apoptosis by attenuating the Bax/Bcl-2 ratio via activation of *** addition,Citri Reticulatae Semen extract was confirmed to bind amyloid-beta as revealed by biolayer interferometry in vitro,and suppress amyloid-beta-induced pathology such as paralysis,in a transgenic Caenorhabditis elegans in vivo ***,genetically defective Caenorhabditis elegans further confirmed that the neuroprotective effect of Citri Reticulatae Semen extract was *** importantly,Citri Reticulatae Semen extract was confirmed to improve cognitive impairment,neuronal injury and amyloid-beta burden in 3×Tg Alzheimer’s disease *** revealed by both in vitro and in vivo models,these results suggest that Citri Reticulatae Semen extract is a potential natural therapeutic agent for Alzheimer’s disease via its neuroprotective autophagic effects.

关键词： Alzheimer’s disease amyloid-beta apoptosis autophagy Caenorhabditis elegans Citri Reticulatae Semen

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Trial characteristics and treatment effect estimates in randomized controlled trials of Chinese herbal medicine: A meta-epidemiological study

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Journal of Integrative Medicine 2024年第3期22卷 223-234页

作者： betty H.Wang Ya-li Lin Yin-yan Gao Jin-lu Song Lang Qin Ling-qi Li Wen-qi Liu Claire C.W.Zhong Mary Y.Jiang Chen Mao Xiao-bo Yang Vincent C.H.Chung Irene X.Y.Wu Jockey Club School of Public Health and Primary Care the Chinese University of Hong KongHong Kong 999077China Xiangya School of Public Health Central South UniversityChangsha 410006Hunan ProvinceChina School of Chinese Medicine the Chinese University of Hong KongHong Kong 999077China School of Public Health Southern Medical UniversityGuangzhou 510080Guangdong ProvinceChina State Key Laboratory of Dampness Syndrome of Chinese Medicine the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120Guangdong ProvinceChina Chinese Medicine Syndrome Research Team the Second Affiliated HospitalGuangzhou University of Chinese MedicineGuangzhou 510120Guangdong ProvinceChina Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome Guangzhou 510120Guangdong ProvinceChina Hunan Provincial Key Laboratory of Clinical Epidemiology Central South UniversityChangsha 410006Hunan ProvinceChina

Background:Previously published meta-epidemiological studies focused on Western medicine have identified some trial characteristics that impact the treatment effect of randomized controlled trials(RCTs).Nevertheless,it remains unclear if similar associations exist in RCTs on Chinese herbal medicine(CHM).Further,Chinese medicine-related characteristics have not been explored ***:To investigate trial characteristics related to treatment effect estimates on CHM *** strategy:This meta-epidemiological study searched 5 databases for systematic reviews on CHM treatment published between January 2011 and July *** criteria:An eligible systematic review should only include RCTs of CHM and conduct at least one *** extraction and analysis:Two reviewers independently conducted data extraction on general characteristics of systematic reviews,meta-analyses and included *** also assessed the risk of bias of RCTs using the Cochrane risk of bias tool.A two-step approach was used for data *** ratio of odds ratios(ROR) and difference in standardized mean differences (dSMD) with 95%confidence interval (CI) were applied to present the difference in effect estimates for binary and continuous outcomes,***:Ninety-one systematic reviews,comprising 1338 RCTs were *** binary outcomes,RCTs incorporated with syndrome differentiation (ROR:1.23;95%CI:[1.07,1.39]),adopting Chinese medicine formula (ROR:1.19;95%CI:[1.03,1.34]),with low risk of bias on incomplete outcome data (ROR:1.29;95%CI:[1.06,1.52]) and selective outcome reporting (ROR:1.12;95%CI:[1.01,1.24]),as well as a trial size≥100 (ROR:1.23;95%CI:[1.04,1.42]) preferred to show larger effect *** for continuous outcomes,RCTs with Chinese medicine diagnostic criteria (dSMD:0.23;95%CI:[0.06,0.41]),judged as high/unclear risk of bias on allocation concealment (dSMD:-0.70;95%CI:[-0.99,-0.42]),with low risk of bias on incomplete outcome data (dSMD:0.30

关键词： Chinese herbal medicine Randomized controlled trial Risk of bias Meta-epidemiological study Effect estimates

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