This qualitative descriptive study described the prodromal symptoms of older individuals, age 65 and above, experiencing acute coronary syndrome (ACS). Review of the literature establishes that older adults experiencing precursor symptoms of ACS are a high-risk group, one that experiences disparities in hospital emergency departments (EDs) and decreased ACS survival. Identification of early symptoms predictive of ACS may influence a patient's willingness to seek medical treatment and necessitate early, accurate diagnosis and treatment. The purpose of this study was to describe older individual's prodromal symptoms patterns and symptom experiences including perceptions, interpretations, and treatment seeking decisions. This study compared and contrasted symptom patterns of ACS among groups of older adult participants, age 65+ based upon age, gender, and other demographic characteristics (previous myocardial infarction, race, ethnicity, regular exercise, insurance, and comorbidity). Three specific aims were addressed in this study. Specific Aim 1 Explore the prodromal symptom patterns as perceived by the older individual encountering ACS. Specific Aim 2 Explore the older individual's interpretation of the prodromal symptom patterns encountering ACS. Specific Aim 3 Explore the treatment decision making processes used by older individuals when experiencing and interpreting prodromal symptom patterns in ACS. Participants included patients newly diagnosed with ACS and ≥ 65 years of age. For the qualitative description, participants (n=20) were recruited and a chart audit was conducted. Demographic information and data were obtained from the admitting ED history and physical, and discharge summary. Additionally, face-to-face semi-structured interviews were conducted with each participant. Content and matrix analyses were used to address the study aims. Research findings from this study elucidated early symptom indicators of myocardial ischemia/infarction (MI), which may be used for screening or developing ACS assessment guidelines specific to geriatric patients.

Everyone gets frustrated over lack of motivation or focus sometimes, but people with ADHD have struggles of related character every single day in their lives. This struggle may be difficult for people to understand. Another factor not well understood is the large discrepancyin the ADHD prevalence between males and females. The most obvious way to study this sex biased male to female ratio of ADHD is by looking at the correlation between sex hormones and ADHD. Moreover, the biggest difference in hormonal profiles between the sexes is the menstrual cycle. Some research exists on testosterone and ADHD but research is limited on more female associated sex hormones such as estradiol. A systematic literature review is now conducted with search words relating to ADHD and estrogen. The results from this review imply that estrogen may mediate ADHD symptom presentation by interacting with other sex hormones. It is further indicated that estrogen receptors may affect ADHD symptom presentation, but this finding needs to be supported by replicating research.

Although Lyme disease is the most frequently reported vector-borne illness in the United States, recent evidence from the CDC suggests that Lyme disease incidence in the United States may be much higher than reported. Lyme disease symptoms can be mistaken for a wide variety of diseases, which can complicate the diagnosis. To date, no diagnostic criteria analysis has been conducted examining the association between sociodemographic variables (sex and age) and seasonality of infection with the severity and symptomology found in Lyme disease cases. Using the CDC's outbreak investigation model, a primary case/control study was conducted using the ROSS Scale to collect data. Comparisons were made between a Lyme disease-diagnosed group (n = 203) and a convenience sample of non-Lyme disease patients (n = 388). Novel symptom patterns were found to significantly predict a diagnosis of Lyme disease. Odds ratio results revealed a positive association between musculoskeletal (OR = 11; 95% CI), neurological (OR = 12; 95% CI), cognitive (OR = 10; 95% CI), and cutaneous (OR = 144; 95% CI) symptoms frequency and severity and the diagnosis of Lyme disease. In addition, overall symptom frequency and severity scores displayed significant differences between cases and controls, between males and females, and among certain age groups. No correlation was found between symptom frequency and severity with the seasonality of infection. Current diagnostic tools search for antibodies to the Borrelia bacteria, but antibody production takes a few weeks. The results of this study help identify at-risk patients based on the presentation and severity of Lyme disease symptoms when antibodies are not present in measureable quantities in the blood stream, allowing for earlier diagnosis.