How Much Slower Do You Run with Heavy Shoes?

Newswise — Running with heavy shoes costs more energy than running with lightweight shoes. Does this also mean that you run slower with heavier shoes? To answer this question, researchers used three pairs of identical shoes and added small lead pellets to two pairs to make each shoe 100 and 300 grams heavier. (Note: an apple or deck of cards is about 100 grams.) Next, 18 runners ran a 3,000 meter time trial in each of these pairs once a week for three weeks. Unaware of the differences in shoe weight, the runners ran about one percent slower for each 100 grams added lead. Slowing down by one percent agrees well with previous laboratory treadmill studies showing that adding 100 grams of shoe mass costs one percent more energy. Changes in energy costs measured in the lab translate to changes in running performance.

For further information about this research, view the study or contact the investigators.

Posted in Barefoot Running, Fitness: Running | Leave a comment

How Does Fatigue Impact Human Performance?

Newswise — Due to its common usage, the word fatigue has so many meanings that it is essentially meaningless. We propose fatigue be considered a symptom that indicates a decline in work capacity due to actual and perceived reductions in performance capabilities. The level of fatigue reported by an individual person indicates the size of the reduction indicates how much their work capacity has been lowered. The impact of fatigue on performance depends on how long it takes to reach a specific level of fatigue; the longer it takes, the less fatigable the person. Fatigability depends on the rates speed of reduction in performance capabilities and changes in perceptions that challenge the integrity of the performer. As a symptom, fatigue may be thought of as having properties that compare to symptoms of is analogous to pain. Therefore, fatigue and can only be measured by self-report, whereas fatigability can be quantified measured both in terms of performance and perceptions. Much remains to be learned about the functionally relevant mechanisms that underlie fatigue and fatigability.

For further information about this research, view the study or contact the investigators.

Posted in Human Behavior: Fatigue | Leave a comment

Undercooked-meat risks not explained well by restaurant servers

Front-line staff, such as servers in restaurants, are often trusted with providing customers with food safety information regarding their meals. A challenge to the food-service industry is that these positions have high turnover, relatively low wages and servers are focused primarily on providing patrons with a positive experience. And new research shows that this poses a problem.

A recent study finds restaurants don’t do an effective job of communicating with customers when it comes to addressing risks associated with eating undercooked meat – specifically hamburgers. Inaccurate information provided by servers often contradicts science-based information customers need to make informed food safety decisions.

All 50 states in the U.S. have adopted some version of the Food & Drug Administration’s Model Food Code, which requires restaurants to tell customers about risks associated with undercooked meat and poultry products.

“We wanted to know how well restaurant servers and menus communicated with customers about these risks, specifically in the context of beef hamburgers,” says Ben Chapman, co-author of a study on the work and an associate professor at North Carolina State University whose research program is aimed at improving food safety.

The researchers focused on beef hamburgers because consuming undercooked ground beef has been linked to a lot of foodborne illness outbreaks, including outbreaks related primarily to Shiga toxin-producing E. coli.

For this study, the researchers sent trained “secret shoppers” into 265 full-service, sit-down restaurants in seven different regions around the U.S. At each restaurant, the patrons ordered one well-done hamburger and one medium-rare hamburger to go. The shoppers then recorded how, if at all, the restaurant communicated about risk.

This study is the latest in a long line of real-world research that Chapman and his collaborators have conducted.

“We try to actually match what people do versus what they say they do because people will say anything on a survey,” Chapman says. “We’ve looked at cooking shows; observed handwashing and cross-contamination in commercial kitchens; examined hand hygiene during a norovirus outbreaks and others. What people actually do is the difference between an enjoyable meal and a foodborne illness.

“For example,” Chapman says, “did the server mention risks associated with undercooked meat when the shopper ordered? If not, the shopper would ask about the risk of getting sick, and then record whether the wait staff responded with clear, accurate information.”

The shoppers also looked to see whether restaurants included clear, accurate risk information on their menus.

The study found that 25 percent of restaurants wouldn’t even sell an undercooked hamburger to secret shoppers. However, at restaurants that would sell a medium-rare hamburger, the majority of servers – 77 percent – gave customers unreliable information about food safety.

“Servers said that meat was safe because it was cooked until ‘until the juices ran clear’ – which is totally unreliable,” says Ellen Thomas, a food safety scientist at RTI International and lead author of the study who worked on the project while a Ph.D. student at NC State. “Those 77 percent didn’t mention things like cooking meat to the appropriate temperature – either 155°F for 15 seconds, or 160°F for instant kill.

“The indicator of safety most widely reported by servers was the color of the burger, and that’s also not a reliable indicator at all,” Thomas says “Time and temperature are all that matter. An undercooked, unsafe burger can be brown in the middle, and a safely cooked burger can still be red or pink in the center.”

Meanwhile, almost all of the menus complied with FDA guidance. But what servers told customers often contradicted the information on the menu.

“If a menu says something is risky but a server says that it isn’t, that can downplay the risks for consumers and impact a customer’s decisions,” Chapman says. “It’s confusing, leaving the patron to choose which message to believe”

The researchers also found that chain restaurants fared much better than independent restaurants at having servers offer reliable risk information.

“That’s not surprising,” Chapman says. “Large chains implement standardized training across all outlets for servers in order to protect their brand and reduce the likelihood of being implicated in a foodborne illness outbreak. That’s bad for business.

“This study tells us that servers aren’t good risk communicators,” Chapman says. “We encourage consumers to ask food-safety questions, but they should probably ask a manager.

“It also tells us that we need to work on addressing the widespread – and wrong – belief that color is a reliable indicator of food safety in meat,” Chapman adds. “Restaurants are in a position to help us share this information with consumers, but many servers are currently sharing incorrect information.”

The paper, “Assessment of Risk Communication about Undercooked Hamburgers by Restaurant Servers,” is published in the Journal of Food Protection. The paper was co-authored by Andrew Binder, Anne McLaughlin, Lee-Ann Jaykus, and Dana Hanson of NC State; and by Doug Powell of barfblog.com. The research was supported by Agriculture and Food Research Initiative Competitive Grant no. 2012-68003-30155 from the USDA National Institute of Food and Agriculture.

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Posted in Nutrition: Food: Raw, Nutrition: Foodborne Illnesses | Leave a comment

Making Fun Weekend Plans Can Ruin Your Weekend

Have you ever found yourself dreading a leisurely activity you had eagerly scheduled days or weeks in advance?

I first caught myself doing this a few years ago when I was traveling home to Turkey. I had excitedly made plans to meet up with some old friends. But to my surprise, as the date approached, I started to feel reluctant and unenthusiastic about these long-awaited reunions.

“I have to go get lunch with my friend,” I’d grouse to others, making it sound like a chore.

Was I an anomaly? Or do other people feel this way too? We increasingly rely on scheduling to organize our lives: phone calls, appointments, dates – and, yes, fun social activities. But can planning leisure activities also start to feel like work, too? Why might they become a source of dread?

As someone who studies consumer behavior and decision-making, I decided to explore this phenomenon with Gabbie Tonietto, a Ph.D. candidate in marketing. With Tonietto leading the investigation (the results would eventually become a part of her dissertation), we conducted a series of studies to see if filling out our calendars – even with fun activities – can have unexpected side effects.

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Posted in Helicopter Parenting, Human Behavior: Impulse, Human Behavior: Leisure Time | Leave a comment

Highest asthma prevalence, by industry

Workers in the healthcare and social assistance industries had some of the highest asthma rates reported in the first state-specific estimate of current asthma by industry and occupation.

The overall prevalence of workers with current asthma was close to 8% in the analysis of survey data from the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey.

The study, conducted by researchers with the Centers for Disease Control and Prevention, is online in the CDC’s Morbidity and Mortality Weekly Report.

Data from the 2006-2007 BRFSS survey suggested that close to half (48%) of cases of adult asthma in the U.S. may be either caused or exacerbated by workplace exposures, the researchers noted.

In an effort to assess the industry-specific and occupation-specific prevalence of adult asthma by state, the CDC researchers analyzed data from the 2013 BRFSS industry and occupation module, collected from 21 states specific to adults age 18 and older who were employed or had been out of work for less than 12 months.

“Among these respondents, 7.7% had current asthma; based on the Asthma Call-back Survey results, this finding means as many as 2.7 million U.S. workers might have asthma caused by or exacerbated by workplace conditions,” wrote Katelynn Dodd, MPH, and Jacek Mazurek, MD, PhD, of the CDC’s National Institute for Occupational Safety and Health.

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How Narcissistic Individuals Use Social Media to Self-Promote

Newswise — Athens, Ga. – A new statistical review of 62 studies with over 13,000 individuals found that narcissism has a modest but reliable positive relationship with a range of social media behaviors. The largest effects were with the number of friends/followers narcissists had and frequency of status updates, followed by selfie postings, according to University of Georgia psychology researchers.

The two strains of narcissistic behavior—grandiose narcissism and vulnerable narcissism—showed different relationships to social media use. Grandiose narcissism, the more extroverted, callous form, positively related to time spent on social media, the frequency of updates, number of friends/followers, and the frequency of posting selfies. Vulnerable narcissism, the more insecure form, did not show any relationship to social media, but there was relatively little research on this form of narcissism.

“The stories you have heard about grandiose narcissism on social media are probably true,” said the study’s senior author, Keith Campbell, a professor of psychology in the UGA Franklin College of Arts and Sciences.

Campbell, co-author of the best-selling “The Narcissism Epidemic,” notes that “when you engage with social media, you will be engaging with more narcissism than might really exist in the world. This might distort your view of the world as being more narcissistic than it is.”

“It is important to remember that these are only correlations, however,” said the study’s lead author, Jessica McCain, a graduate student in the Behavioral and Brain Sciences Program in the UGA Franklin College of Arts and Sciences department of psychology. “This is not evidence that social media causes narcissism or vice versa. Theoretically, we suspect that individuals with pre-existing narcissism are drawn to social media, but the present evidence only establishes that the two are related.”

“Networks on social media aren’t designed by people in Silicon Valley,” Campbell said. “They are built one link at a time by users. And narcissists seem to be central to this build-out.”

The study, “Narcissism and Social Media Use: A Meta-Analytic Review,” was published in the early online edition of Psychology of Popular Media Culture and is available online.

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Posted in Human Behavior: Narcissism, Human Behavior: Social Media | Leave a comment

Why can’t humans regenerate body parts? We’ve got the genes

Some of our closest invertebrate cousins, like this Acorn worm, have the ability zto perfectly regenerate any part of their body that’s cut off – including the head and nervous system. Humans have most of the same genes, so scientists are trying to work out whether human regeneration is possible, too.

Some of our closest invertebrate cousins, like this Acorn worm, have the ability to perfectly regenerate any part of their body that’s cut off – including the head and nervous system. Humans have most of the same genes, so scientists are trying to work out whether human regeneration is possible, too.ne

Regeneration – that’d be a nice superpower to have. Injure an arm? Chop it off and wait for it to grofw back. Dicky knee? Ingrown toenail? Lop off your leg and get two for one!

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Sports that will save your life revealed: New research

An international research collaboration, led by University of Sydney, has found that cycling, swimming, aerobics and racquet sports offer life saving benefits compared to running and football.

Published today in the British Journal of Sports Medicine, the study also found that death from cardiovascular disease (CVD) was reduced in people who participated in swimming, racquet sports and aerobics.

The study examined 80,000 adults over 30 years of age to investigate the link between participation in six different ‘exercise disciplines’ and death, including cycling, swimming, racquet sports, aerobics, football and running. The researchers drew on responses from 11 nationally representative annual health surveys for England and Scotland, carried out between 1994 and 2008.

Results:

Compared with study participants who did not participate in the corresponding sport, risk of death from any cause was:

  • 47 per cent lower among those who played racquet sports (tennis, squash, badminton)
  • 28 per cent lower among swimmers
  • 27 per cent lower among those who participated in aerobics
  • 15 per cent lower among cyclists.

Compared with study participants who did not participate in the corresponding sport, risk of death from cardiovascular disease was:

  • 56 per cent lower among those who played racquet sports
  • 41 per cent lower among swimmers
  • 36 per cent lower among those who participated in aerobics.

“Our findings indicate that it’s not only how much and how often, but also what type of exercise you do that seems to make the difference,” said senior author Associate Professor Emmanuel Stamatakis from the Charles Perkins Centre, Faculty of Health Sciences and School of Public Health at the University of Sydney.

“Participation in specific sports may have various benefits for health. These observations with the existing evidence should support the sport community together with other sectors to design and implement effective health enhancing exercise programs and physical activity in general,” he said.

Future research should aim to further strengthen the sport-specific evidence base and understanding of how to enable greater sports participation for people from all age groups and walks of life.

This research was a large scale collaboration between University of Sydney, University of Oxford, UKK Institute (Finland), University of Edinburgh, and four other international universities.

Study details:

The researchers drew on responses from eleven nationally representative baseline health examination surveys carried out in the United Kingdom between 1994 and 2006 which looked at the association between participation in six different sport/exercise disciplines and mortality.

In all, the analysis included 80,306 adults with an average age of 52. In each of the surveys, participants were quizzed about how much physical activity they had done in the preceding 4 weeks, and whether it had been enough to make them breathless and sweaty.

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Posted in Exercise: Benefits, Exercise: High Intensity, Exercise: Prescriptions, Sports Medicine: Injuries | Leave a comment

Still Grieving Trump’s Win? You’re Not Alone

Late into the evening of November 8, Amy Wasney sat crying in her home in Merrillville, Indiana.

“I cried for a long time because I got hit hard with the realization that so many people would choose a man who is hateful, anti-Constitution and wholly unfit to head, just to keep a woman from being in charge, and it broke me,” she said. Since then, she has cried multiple times, suffered several panic attacks and felt a general sense of fear. “I’m watching the people Trump is choosing to give power to, and I’m watching the rapid increase in hate crimes, and I’m terrified for my friends and family and the country.”

Her sister, Kimberly Wasney, however, did not cry that night in El Paso, Texas. Instead, she sat staring in shock and fear, unable to do anything other than keep breathing.

“It wasn’t until the next morning, listening to Hillary’s concession speech, that I lost it,” she said. “I have wavered all over the spectrum between grief and anger and disbelief and, honestly, more anger.”

In the midst of a campaign, a candidate, an election and an incoming administration that have been and continue to be anything but normal, it may be comforting to know these experiences, grieving Clinton’s loss or Trump’s win or both, are completely normal, even now weeks later.

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Standing Up May Unmask Cognitive Deficits in Patients with Parkinson’s

Newswise — BOSTON – In a new study published online today in the journal Neurology, a research team led by neurologists at Beth Israel Deaconess Medical Center (BIDMC) and neuropsychologists at Boston University has shown that when patients with Parkinson’s disease experience a drop in blood pressure upon standing up – a condition known as orthostatic hypotension (OH) – they exhibit significant cognitive deficits. These deficits reverse when they lie down and their blood pressure returns to normal.

These cognitive impairments may go unnoticed by physicians assessing patients with Parkinson’s who are lying down or seated, and could lead to difficulty in daily activities performed while standing and walking, such as tracking conversations, counting change and interpreting traffic signals.

“Cognitive impairment is a common symptom of Parkinson’s disease,” said co-senior author Roy Freeman, MD, director of the Center for Autonomic and Peripheral Nerve Disorders at BIDMC and a professor of neurology at Harvard Medical School (HMS). “In this study, we demonstrated that the upright posture in patients with Parkinson’s disease exacerbated cognitive deficits, and that this effect is transient and reversible. Based on these results, we encourage clinicians to include cognitive testing in a variety of postures in their assessments of patients.”

Marked by characteristic tremor, rigidity and slowness of movement, Parkinson’s disease (PD) is a progressive degeneration of parts of the nervous system. It affects many aspects of movement and can cause a masklike, expressionless face, rigid limbs, and problems with walking and posture. PD is also associated with cognitive defects attributed to breakdowns in connectivity between regions of the brain. Up to 50 percent of people with Parkinson’s disease may also have orthostatic hypotension.

In a previous study, Freeman and colleagues demonstrated that orthostatic hypotension is linked to reversible cognitive impairment in patients with a rare neurological disorder called autoimmune autonomic ganglionopathy. In this new study of the far more prevalent Parkinson’s disease, the researchers investigated whether OH is linked to reversible cognitive deficits in patients with PD as well.

Freeman and colleagues including lead author Justin Centi and co-senior author Alice Cronin-Golomb, PhD, director of the Vision and Cognition Laboratory and Center for Clinical Biopsychology and a professor of psychological and brain sciences at Boston University, divided 55 volunteers into three study groups: 18 patients with both PD and OH, 19 patients with PD but without OH, and 18 control participants with neither PD nor OH. All participants were given a series of cognitive tests, with the tests administered while supine and again while tilted to 60 degrees. Researchers measured and recorded the participants’ blood pressure before and during each round of cognitive testing to ensure that participants were never at risk for fainting.

“As we suspected, people with both Parkinson’s disease and orthostatic hypotension showed posture-related impairments when upright relative to supine on nearly all measures of cognition,” said Centi, who noted that study participants with Parkinson’s disease without orthostatic hypotension demonstrated deficits on only two cognitive tests. There was no difference between upright and supine scores for the control group.

When the three groups’ relative performances were compared to each other, postural changes had no significant impact on participants with PD but without OH, compared to the control group. However, Participants with PD and OH were far more susceptible to posture-related impairment on several tests, including those that measured math skills, the ability to produce words easily, keeping information in mind while working on it, paying sufficient attention so that later memory is efficient and searching for items quickly and accurately.

“Essentially all neuropsychological tests are given to patients in the seated position in the clinic as well as during most research studies – with the exception of imaging studies in which the patient is lying down,” said Cronin-Golomb. “The cognitive performance that we see in those patients with Parkinson’s disease who are tested when seated or lying down in fact may underestimate their cognitive problems in real life, when they are standing up and going about their business of daily activities. Also, the patterns of brain activity that we see on imaging when they are lying down may not be the patterns that the brain produces during normal upright activity.”

Cognitive deficits in PD result, at least in part, from neurodegeneration, the authors explained. But transient blood pressure changes when upright may indeed play a contributing role. Clinical providers might miss an important target for intervention when not considering OH as a contributor to cognitive impairment.

In addition to Freeman, Centi, and Cronin-Golomb, study coauthors included Christopher H. Gibbons, MD, of BIDMC and HMS; Sandy Neargarder, PhD, of Boston University and Bridgewater State University; and Alex Canova of Boston University.
This work was funded by grants from the National Institutes of Health, National Institute of Neurological Disorders and Stroke (R01NS067128) and support from a Ruth L. Kirschstein National Research Service Award (F31NS074801).

About Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding.

BIDMC is in the community with Beth Israel Deaconess Hospital-Milton, Beth Israel Deaconess Hospital-Needham, Beth Israel Deaconess Hospital-Plymouth, Anna Jaques Hospital, Cambridge Health Alliance, Lawrence General Hospital, MetroWest Medical Center, Signature Healthcare, Beth Israel Deaconess HealthCare, Community Care Alliance and Atrius Health. BIDMC is also clinically affiliated with the Joslin Diabetes Center, Hebrew Rehabilitation Center and is a research partner of Dana-Farber/Harvard Cancer Center and the Jackson Laboratory. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.org.

Posted in Cognitive Impairment, Parkinson's | Leave a comment

Vitamin D status in newborns and risk of MS in later life

fMINNEAPOLIS – Babies born with low levels of vitamin D may be more likely to develop multiple sclerosis (MS) later in life than babies with higher levels of vitamin D, according to a study published in the November 30, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“More research is needed to confirm these results, but our results may provide important information to the ongoing debate about vitamin D for pregnant women,” said study author Nete Munk Nielsen, MD, MSc, PhD, of the State Serum Institute in Copenhagen, Denmark.

In Denmark, dried blood spots samples from newborn screening tests are stored in the Danish National Biobank. Researchers identified everyone in Denmark who was born since April 30, 1981, had onset of MS by 2012 and whose dried blood spots samples were included in the biobank. The blood from those 521 people was then compared to that of 972 people of the same sex and birthday who did not have MS. In this study, newborns with levels of vitamin D less than 30 nanomoles per liter (nmol/L) were considered born with deficient levels. Levels of 30 to less than 50 nmol/L were considered insufficient and levels higher than or equal to 50 nmol/L were considered sufficient.

The study participants were divided into five groups based on vitamin D level, with the bottom group having levels of less than 21 nmol/L and the top group with levels higher than or equal to 49 nmol/L. There were 136 people with MS and 193 people without MS in the bottom group. In the top group, there were 89 people with MS and 198 people without the disease. Those in the top group appeared to be 47 percent less likely to develop MS later in life than those in the bottom group.

Nielsen emphasizes that the study does not prove that increasing vitamin D levels reduces the risk of MS.

The study has several limitations. Dried blood spots samples were only available for vitamin D analysis for 67 percent of people with MS born during the time period. Vitamin D levels were based on one measurement. Study participants were 30 years old or younger, so the study does not include people who developed MS at an older age. In addition, the Danish population is predominantly white, so the results may not be generalizable to other populations. Furthermore, it cannot be excluded that this apparent beneficial effect could be mediated through other factors in later life such as vitamin D levels, in which case a possible maternal vitamin D supplementation would not reduce the MS risk in the offspring.

Sources of vitamin D are diet, supplements and the sun. Dietary vitamin D is primarily found in fatty fish such as salmon or mackerel. Levels of vitamin D should be within the recommended levels, neither too low nor too high.

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The study was supported by the Danish Society of Multiple Sclerosis, Aase & Ejnar Danielsen’s Foundation, the U.S. National Institutes of Health and U.S. National Multiple Sclerosis Society.

Posted in Multiple Sclerosis, Nutrition: Vitamin D | Leave a comment

Acetaminophen, Supplements and Other Medications May Trigger Drug-Induced Liver Injury

Newswise — More than 1,000 medications, with acetaminophen being the most common, have been associated with drug-induced liver injury (DILI).

Diagnosis can be challenging due to the multitude of contributing factors, and timely recognition and clinical response may mean the difference between recovery and acute liver failure or even death.

DILI affects an estimated fewer than 10 people in every 10,000 exposed persons. The condition is dose-dependent or an adverse reaction to a medication, dietary supplement or other substance.

An article in the current issue of AACN Advanced Critical Care, “Drug-Induced Liver Injury,” discusses the clinical impact of DILI and reviews the medications that most frequently cause it.

The article is co-authored by Leslie Hamilton, PharmD, BCPS, BCCCP, associate professor of clinical pharmacy in the College of Pharmacy at University of Tennessee Health Science Center, Knoxville; Angela Collins-Yoder, RN, PhD, CCNS, ACNS-BC, clinical professor, University of Alabama Capstone College of Nursing, Tuscaloosa, and critical care nurse specialist, Sacred Heart Pensacola Hospital, Pensacola, Florida; and Rachel E. Collins, BA, Auburn University Harrison School of Pharmacy, Auburn, Alabama.

“The liver helps remove toxins, which makes it especially vulnerable to injury from either short-term intake above recommended levels or long-term usage that allows toxins to build up,” Collins-Yoder said. “Recognizing the clinical signs and symptoms is crucial to prompt treatment and effective patient care.”
Depending on the contributing factors and the level of damage to the liver, patients with mild and moderate signs and symptoms may recover normal liver function after the triggering substance is identified and use is discontinued. Other patients may experience more severe damage, progressing to acute liver failure.

About 46 percent of persons with acute liver failure in the United States have liver damage associated with acetaminophen, making it the most common cause of DILI. Since acetaminophen is often an ingredient in over-the-counter and prescription pain medications, patients may take higher doses than needed.

A more infrequent type of DILI is triggered by an adverse reaction to prescription medications, herbal dietary supplements or other substances, including:
• Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen and others
• Antibiotics and antiviral agencies, such as amoxicillin-clavulanate, sulfamethoxazole-trimethoprim and nitrofurantoin
• Antileptic agents, such as volproic acid and carbamazepine
• Statins
• Novel anticoagulants
• Proton pump inhibitors
• Methotrexate
• Azathioprine
• Sulfasalazine
• Herbal and dietary supplements

The article follows a presentation by the authors at the National Teaching Institute and Critical Care Exposition, the annual conference of the American Association of Critical-Care Nurses (AACN), which publishes the journal.

The article about DILI is part of a symposium collection of articles focusing on gastrointestinal and liver disease in the October-December 2016 issue of the peer-reviewed journal. Other articles in the series:
• “Sepsis in Patients With Cirrhosis”
• “Acute Liver Failure”
• “Cholestatic Liver Injury: Care of Patient With Primary Biliary Cholangitis or Primary Sclerosing Cholangitis”

Symposium editor Amanda Chaney, MSN, ARNP, FNP-BC, is a liver transplant nurse practitioner at Mayo Clinic and assistant professor of medicine at Mayo Clinic College of Medicine, Jacksonville, Florida.

“Clinical management of patients with gastrointestinal and liver disease has advanced significantly in the past 10 years,” she said. “By presenting four different but related disease processes, this series aims to expand the knowledge of critical care nurses and other healthcare providers so they can continue to give excellent patient care.”

AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles and columns of interest to critical and progressive care clinicians.

Access the issue by visiting the AACN Advanced Critical Care website at
www.aacnadvancedcriticalcare.com.

About AACN Advanced Critical Care: AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. An official publication of the American Association of Critical-Care Nurses, the journal has a circulation of 4,845 and can be accessed at http://journals.lww.com/aacnadvancedcriticalcare/pages/default.aspx.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 225 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. www.aacn.org; facebook.com/aacnface; twitter.com/aacnme

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