Complexes of 2,4,6-trihydroxybenzoic acid: effects of intramolecular hydrogen bonding on ligand geometry and metal binding modes.

This article describes a series of more than 20 new compounds formed by the combination of 2,4,6-trihydroxybenzoic acid (H4thba) with metal ions in the presence of a base, with structures that include discrete molecular units, chains, and two- and three-dimensional networks. As a result of the presence of two ortho-hydroxy groups, H4thba is a relatively strong acid (pKa1 = 1.68). The carboxylate group in H3thba- is therefore considerably less basic than most carboxylates with intramolecular hydrogen bonds, conferring a rigid planar geometry upon the anion. These characteristics of H3thba- significantly impact upon the way it interacts with metal ions. In s-block metal compounds, where the interaction of the metal centres with the carboxylate O atoms is essentially ionic, the anion bonds to up to three metal centres via a variety of binding modes. In cases where the metal ion is able to form directional coordinate bonds, however, the carboxylate group tends to bond in a monodentate mode, interacting with just one metal centre in the syn mode. A dominant influence on the structures of the complexes seems to be the face-to-face stacking of the aromatic rings, which creates networks containing layers of metal-oxygen polyhedra that participate in hydrogen bonding. This investigation was undertaken, in part, by a group of secondary school students as an educational exercise designed to introduce school students to the technique of single-crystal X-ray diffraction and enhance their understanding of primary and secondary bonding.

Changes in psychosocial well-being after mindfulness-based stress reduction: a prospective cohort study.

Objectives: The primary purpose of the current study was to assess the effects of a mindfulness-based stress reduction (MBSR) program, facilitated by non-psychologist clinicians, for improving psychosocial well-being. A secondary purpose of the current study was to explore the role of self-compassion as a potential underlying factor for improvements in emotional distress. Application of these findings to a physical therapy setting is provided. Methods: One hundred and thirty participants with a variety of medical complaints completed an eight-week MBSR program at Vanderbilt University's Osher Center for Integrative Medicine. Prior to the intervention and at the eight-week time point, participants completed measures for emotional distress (Brief Symptom Inventory), stress (Perceived Stress Scale-10), mindfulness (Mindfulness Attention and Awareness Scale), and self-compassion (Self-Compassion Scale). Wilcoxon signed-rank test was used to evaluate changes in outcomes after MBSR. Linear model estimation using ordinary least squares was used to evaluate the association between changes in self-compassion with changes in emotional distress. Results: Following MBSR, participants reported significant reductions in emotional distress (p < 0.001). Additionally, participants reported improvements in mindfulness and self-compassion (p < 0.001). Linear regression model revealed that changes in self-compassion were significantly associated with changes in emotional distress (p < 0.001). Discussion: An MBSR program conducted by non-psychologist clinicians was associated with improvements in emotional distress, stress, and self-compassion. MBSR is a promising adjunct intervention in which principles can be integrated within a physical therapy approach for chronic conditions. Level of Evidence: 3B.

The Influence of Patient and Provider Communication on Diabetes Care Delivery.

PURPOSE: To elicit the perspective of patients with type 2 diabetes, specific to communication with providers and health care teams. METHODS: We conducted 21 focus groups with 115 adults in Midwestern primary care, endocrinology, and bariatric surgery clinics. Facilitators analyzed the transcripts using an iterative coding method. RESULTS: The themes of encouragement and motivation, relationship building, compassion, and communication preferences highlighted effective strategies consistent with the core components of patient-centered care. CONCLUSIONS: Patients and providers benefit from systems in which patients are efficiently and compassionately supported in self-management within their abilities and in partnership with their support networks.

Dedicated Education Unit Model for a Transition Into Practice Course.

A dedicated education unit (DEU) model involves a collaborative partnership between a clinical agency and a school of nursing. This article describes the development of a DEU for a transition to practice course. No differences were noted in the satisfaction of students, staff nurses, and the clinical agency between the DEU and traditional preceptor models, but the DEU design enabled the school of nursing to place more students in the unit, compared with a preceptorship model.

Rethinking the psychogenic model of complex regional pain syndrome: somatoform disorders and complex regional pain syndrome.

ABSTRACT: Explaining the etiology of Complex Regional Pain Syndrome (CRPS) from the psychogenic model is exceedingly unsophisticated, because neurocognitive deficits, neuroanatomical abnormalities, and distortions in cognitive mapping are features of CRPS pathology. More importantly, many people who have developed CRPS have no history of mental illness. The psychogenic model offers comfort to physicians and mental health practitioners (MHPs) who have difficulty understanding pain maintained by newly uncovered neuro inflammatory processes. With increased education about CRPS through a biopsychosocial perspective, both physicians and MHPs can better diagnose, treat, and manage CRPS symptomatology.

The formulation of consensus on nutrition policy: policy actors' perspectives on good process.

Food security and nutrition are ascendant issues on global and national policy agendas in recent years, as a result of the global food crisis and growing recognition of the magnitude and consequences of these problems for human and economic development. The translation of this attention into effective action at the country level will require multistakeholder agreements concerning priority problems, interventions, delivery strategies, roles and responsibilities, and other matters, but this has proven to be a difficult and contentious process in many countries. This study explores stakeholders' perspectives on the characteristics of a good process in Guatemala, a country that has encountered difficulties deciding such matters in recent years, as well as their views on decision acceptance and the feasibility of implementing a good process. Semistructured interviews were conducted with 20 participants in earlier policy deliberations who were identified through snowball sampling. The constant comparative method was used for analysis. These participants attach great importance to the quality of decision processes, have strong support for decision principles derived from theory and experience elsewhere, would be willing to participate in such a process and accept the resulting decisions, and feel such a process would be challenging but feasible in the Guatemalan context. These findings, together with experiences elsewhere, suggest that countries would do well to seek agreement on the design of a multistakeholder decision-making process before they seek agreement on priority nutrition problems, target groups, interventions, delivery strategies, and other matters that have proven contentious in many settings.

Ethical and legal issues in antiaging medicine.

The development of specific antiaging treatments and the emergence of the practice of antiaging medicine have created new ethical and legal issues. The ultimate desirability of treatments designed to alter human aging is currently an actively debated issue that needs to emerge as an issue of public dialogue, given the potentially dramatic effect these therapies could have on both individual health and societal structure. Current therapies carry many doubts about their safety and effectiveness, which makes the practice of antiaging medicine with the prescription of these therapies a challenging issue from both a legal and ethical perspective. Finally, although the practice of antiaging medicine is not directly recognized and regulated by legislation, both anti-aging treatments and practice are regulated by emerging state and federal legislation that is evolving to address the emerging area of complementary and alternative medicine.