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https://www.readbyqxmd.com/read/28739638/undue-inducement-or-unfair-exclusion-considering-a-case-study-of-pregnancy-in-an-hiv-prevention-trial
#1
Bridget G Haire, Morenike Oluwatoyin Folayan
In their recent paper' Undue inducement: a case study in CAPRISA 008', Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not'unduly induced' to participate by the offer of an experimental product. This paper argues that while the authors' conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy (regardless of whether those risks may be willingly assumed by pregnant women themselves)...
July 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28739474/traumatic-subaxial-cervical-facet-subluxation-and-dislocation-epidemiology-radiographic-analyses-and-risk-factors-for-spinal-cord-injury
#2
Ryan D Quarrington, Claire F Jones, Petar Tcherveniakov, Jillian M Clark, Simon J I Sandler, Yu Chao Lee, Shabnam Torabiardakani, John J Costi, Brian J C Freeman
BACKGROUND CONTEXT: Distractive-flexion injuries (DFIs) of the subaxial cervical spine are major contributors to spinal cord injury (SCI). Prompt assessment and early intervention of DFIs associated with SCI is crucial to optimize patient outcome; however, neurological examination of patients with subaxial cervical injury is often difficult, as patients commonly present with reduced levels of consciousness. Therefore, it is important to establish potential associations between injury epidemiology and radiographic features, and neurological involvement...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739416/comparison-of-non-invasive-assessments-of-strength-of-the-proximal-femur
#3
Fjola Johannesdottir, Erica Thrall, John Muller, Tony M Keaveny, David L Kopperdahl, Mary L Bouxsein
It is not clear which non-invasive method is most effective for predicting strength of the proximal femur in those at highest risk of fracture. The primary aim of this study was to compare the abilities of dual energy X-ray absorptiometry (DXA)-derived aBMD, quantitative computed tomography (QCT)-derived density and volume measures, and finite element analysis (FEA)-estimated strength to predict femoral failure load. We also evaluated the contribution of cortical and trabecular bone measurements to proximal femur strength...
July 21, 2017: Bone
https://www.readbyqxmd.com/read/28738987/evaluation-of-sensor-technology-to-detect-fall-risk-and-prevent-falls-in-acute-care
#4
Patricia Potter, Kelly Allen, Eileen Costantinou, William Dean Klinkenberg, Jill Malen, Traci Norris, Elizabeth O'Connor, Wilhemina Roney, Heidi Hahn Tymkew, Laurie Wolf
BACKGROUND: Sensor technology that dynamically identifies hospitalized patients' fall risk and detects and alerts nurses of high-risk patients' early exits out of bed has potential for reducing fall rates and preventing patient harm. During Phase 1 (August 2014-January 2015) of a previously reported performance improvement project, an innovative depth sensor was evaluated on two inpatient medical units to study fall characteristics. In Phase 2 (April 2015-January 2016), a combined depth and bed sensor system designed to assign patient fall probability, detect patient bed exits, and subsequently prevent falls was evaluated...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738986/pilot-testing-fall-tips-tailoring-interventions-for-patient-safety-a-patient-centered-fall-prevention-toolkit
#5
Patricia C Dykes, Megan Duckworth, Stephanie Cunningham, Sasha Dubois, Melissa Driscoll, Zinnia Feliciano, Michael Ferrazzi, Farah E Fevrin, Stephanie Lyons, Mary Ellen Lindros, Allison Monahan, Matthew M Paley, Saby Jean-Pierre, Maureen Scanlan
BACKGROUND: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. METHODS: The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York)...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738667/toe-grip-strength-in-middle-aged-individuals-as-a-risk-factor-for-falls
#6
Ryota Tsuyuguchi, Satoshi Kurose, Takayuki Seto, Nana Takao, Satoshi Tagashira, Hiromi Tsutsumi, Shingo Otsuki, Yutaka Kimura
BACKGROUND: Toe grip strength is the force of a toe on a surface. The objective of this study was to investigate the relationship between falls in middle-aged individuals and physical strength factors such as toe grip strength and knee extension strength. METHODS: The subjects were 194 middle-aged individuals (388 feet) who were independent in daily life, received no nursing care, and participated in a health sports event organized by a sports club. We evaluated the body composition, blood pressure, vascular age, systemic response, bone density, knee extension strength, and toe grip strength, and examined their relationship using a self-administered questionnaire survey...
July 24, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28738139/association-of-history-of-dizziness-and-long-term-adverse-outcomes-with-early-vs-later-orthostatic-hypotension-assessment-times-in-middle-aged-adults
#7
Stephen P Juraschek, Natalie Daya, Andreea M Rawlings, Lawrence J Appel, Edgar R Miller, B Gwen Windham, Michael E Griswold, Gerardo Heiss, Elizabeth Selvin
Importance: Guidelines recommend assessing orthostatic hypotension (OH) 3 minutes after rising from supine to standing positions. It is not known whether measurements performed immediately after standing predict adverse events as strongly as measurements performed closer to 3 minutes. Objective: To compare early vs later OH measurements and their association with history of dizziness and longitudinal adverse outcomes. Design, Setting, and Participants: This was a prospective cohort study of middle-aged (range, 44-66 years) participants in the Atherosclerosis Risk in Communities Study (1987-1989)...
July 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28737646/crp-albumin-ratio-an-early-predictor-of-steroid-responsiveness-in-acute-severe-ulcerative-colitis
#8
David J Gibson, Karen Hartery, Jayne Doherty, Jack Nolan, Denise Keegan, Kathryn Byrne, Sean T Martin, Maire Buckley, Juliette Sheridan, Gareth Horgan, Hugh E Mulcahy, Garret Cullen, Glen A Doherty
INTRODUCTION: Identifying hospitalized patients with acute severe ulcerative colitis (ASUC) who will be refractory to corticosteroid therapy and require rescue therapy remains difficult. Hypoalbuminemia worsens with time during hospitalization and is associated with rapid clearance of and reduced response to infliximab (IFX) rescue. Early use of rescue therapy may therefore be more effective. Simple clinical and laboratory predictors of corticosteroid responsiveness would facilitate earlier use of rescue therapy...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737117/prevalence-and-correlates-of-traumatic-brain-injury-tbi-in-older-adults-results-from-the-well-being-of-the-singapore-elderly-wise-study
#9
Laxman Cetty, Edimansyah Abdin, Janhavi Ajit Vaingankar, Anitha Jeyagurunathan, Boon Yiang Chua, Louisa Picco, Martin Prince, Siow Ann Chong, Mythily Subramaniam
BACKGROUND: Older adults are among the most susceptible to sustain traumatic brain injury (TBI). The study aimed to determine the (1) prevalence of TBI among older adults in Singapore, and (2) socio-demographic, lifestyle, and clinical correlates of TBI. METHODS: Data were extracted from the cross-sectional, Well-being of the Singapore Elderly (WiSE) study. The study included 2,565 participants aged 60 years and above (Mean = 72.75, SD = 9.54). Information on TBI, socio-demographic, and lifestyle factors were collected using participant self-report and verified with the informant report where necessary...
July 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28737101/intervention-to-prevent-falls-community-based-clinics
#10
Dorothy I Baker, Linda Leo-Summers, Terrence E Murphy, Barbara Katz, Beth A Capobianco
PURPOSE: The purpose of this study was to document results of State funded fall prevention clinics on rates of self-reported falls and fall-related use of health services. METHODS: Older adults participated in community-based fall prevention clinics providing individual assessments, interventions, and referrals to collaborating community providers. A pre-post design compares self-reported 6-month fall history and fall-related use of health care before and after clinic attendance...
July 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28736899/trajectories-of-depressive-and-anxiety-symptoms-in-older-adults-a-6-year-prospective-cohort-study
#11
Sophie E Holmes, Irina Esterlis, Carolyn M Mazure, Yen Ying Lim, David Ames, Stephanie Rainey-Smith, Chris Fowler, Kathryn Ellis, Ralph N Martins, Olivier Salvado, Vincent Doré, Victor L Villemagne, Christopher C Rowe, Simon M Laws, Colin L Masters, Robert H Pietrzak, Paul Maruff
OBJECTIVE: Depressive and anxiety symptoms are common in older adults, significantly affect quality of life, and are risk factors for Alzheimer's disease. We sought to identify the determinants of predominant trajectories of depressive and anxiety symptoms in cognitively normal older adults. METHOD: Four hundred twenty-three older adults recruited from the general community underwent Aβ positron emission tomography imaging, apolipoprotein and brain-derived neurotrophic factor genotyping, and cognitive testing at baseline and had follow-up assessments...
July 24, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28736853/tai-chi-for-risk-of-falls-a-meta-analysis
#12
Rafael Lomas-Vega, Esteban Obrero-Gaitán, Francisco J Molina-Ortega, Rafael Del-Pino-Casado
OBJECTIVES: To analyze the effectiveness of tai chi for falls prevention. DESIGN: Systematic review and meta-analysis. SETTING: Pubmed, Scopus, CINHAL, and Physiotherapy Evidence Database (PEDro) were searched to May 26, 2016. PARTICIPANTS: Older adult population and at-risk adults. INTERVENTION: Randomized controlled trials analyzing the effect of tai chi versus other treatments on risk of falls...
July 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28736795/identifying-characteristics-and-outcomes-that-are-associated-with-fall-related-fatalities-multi-year-retrospective-summary-of-fall-deaths-in-older-adults-from-2005-2012
#13
Sara M Deprey, Lynda Biedrzycki, Kristine Klenz
BACKGROUND: Fall-related deaths continue to be the leading cause of accidental deaths in the older adult (65+ year) population. However, many fall-related fatalities are unspecified and little is known about the fall characteristics and personal demographics at the time of the fall. Therefore, this report describes the characteristics, circumstances and injuries of falls that resulted in older adult deaths in one U.S. County and explores the variables associated with fatal injuries from falls...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28736353/sport-related-structural-brain-injury-three-cases-of-subdural-hemorrhage-in-american-high-school-football
#14
Aaron M Yengo-Kahn, Ryan M Gardner, Andrew W Kuhn, Gary S Solomon, Christopher M Bonfield, Scott L Zuckerman
BACKGROUND: The risk of sport-related concussion (SRC) has emerged as a major public health concern. In rare instances, sport-related head injuries can be even more severe, such as subdural hemorrhage, epidural hemorrhage, or malignant cerebral edema. Unlike SRCs, sport-related structural brain injury (SRSBI) is rare, may require neurosurgical intervention, and can lead to permanent neurologic deficit or death. Data characterizing SRSBI is limited and many have recognized the need to better understand these catastrophic brain injuries...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28736201/text-message-reminders-for-vaccination-of-adolescents-with-chronic-medical-conditions-a-randomized-clinical-trial
#15
Annika M Hofstetter, Angela Barrett, Stewin Camargo, Susan L Rosenthal, Melissa S Stockwell
BACKGROUND: Many adolescents with chronic medical conditions (CMCs) are at risk of vaccine-preventable infection, yet are frequently under-vaccinated. Text message reminders, particularly those with embedded educational information, have been shown to increase general pediatric vaccination. Their use has not been studied specifically among adolescents with CMCs. METHODS: Eligible parents of adolescents with CMCs receiving care at one of 4 academically-affiliated pediatric clinics and requiring human papillomavirus (first dose), influenza, and/or pneumococcal polysaccharide vaccines were randomized in 4 consecutive cohorts to receive text message vaccine reminders with or without embedded educational information ("educational" vs...
July 20, 2017: Vaccine
https://www.readbyqxmd.com/read/28735766/risk-factor-analysis-for-predicting-vertebral-body-re-collapse-after-posterior-instrumented-fusion-in-thoracolumbar-burst-fracture
#16
Hae-Dong Jang, Jae Chul Lee, Jae-Wan Soh, Sung-Woo Choi, Hyeung-Kyu Cho, Byung-Joon Shin
BACKGROUND CONTEXT: In the posterior instrumented fusion surgery for thoracolumbar (T-L) burst fracture, early postoperative re-collapse of well-reduced vertebral body fracture could induces critical complications such as correction loss, post-traumatic kyphosis, metal failure, often lead to revision surgery. Furthermore, re-collapse is quite difficult to predict because of the variety of risk factors and no widely accepted accurate prediction systems existed. Although load sharing classification (LSC) has been known to help to decide the need for additional anterior column support, this radiographic scoring system has several critical limitations...
July 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28734941/sleep-chronic-pain-and-opioid-risk-for-apnea
#17
REVIEW
Serguei Marshansky, Pierre Mayer, Dorrie Rizzo, Marc Baltzan, Ronald Denis, Gilles J Lavigne
Pain is an unwelcome sleep partner. Pain tends to erode sleep quality and alter the sleep restorative process in vulnerable patients. It can contribute to next-day sleepiness and fatigue, affecting cognitive function. Chronic pain and the use of opioid medications can also complicate the management of sleep disorders such as insomnia (difficulty falling and/or staying asleep) and sleep-disordered breathing (sleep apnea). Sleep problems can be related to various types of pain, including sleep headache (hypnic headache, cluster headache, migraine) and morning headache (transient tension type secondary to sleep apnea or to sleep bruxism or tooth grinding) as well as periodic limb movements (leg and arm dysesthesia with pain)...
July 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28734909/prognostic-value-of-exercise-stress-echocardiography-in-asymptomatic-patients-with-aortic-valve-stenosis
#18
Coppelia Goublaire, Maria Melissopoulou, David Lobo, Naozumi Kubota, Constance Verdonk, Claire Cimadevilla, Isabelle Codogno, Eric Brochet, Alec Vahanian, David Messika-Zeitoun
OBJECTIVES: This study sought to evaluate the prognostic value of mean pressure gradient (MPG) increase and peak systolic pulmonary artery pressure (SPAP) measured during exercise stress echocardiography in asymptomatic patients with aortic stenosis (AS). BACKGROUND: Exercise testing is recommended in asymptomatic AS patients, but the additional value of exercise-stress echocardiography, especially the prognostic value of MPG increase and peak SPAP, is still debated...
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28733891/consequences-of-bisphenol-a-perinatal-exposure-on-immune-responses-and-gut-barrier-function-in-mice
#19
Yann Malaisé, Sandrine Ménard, Christel Cartier, Corinne Lencina, Caroline Sommer, Eric Gaultier, Eric Houdeau, Laurence Guzylack-Piriou
The potent immunomodulatory effect of the endocrine disruptor bisphenol A during development and consequences during life span are of increasing concern. Particular interests have been raised from animal studies regarding the risk of developing food intolerance and infection. We aimed to identify immune disorders in mice triggered by perinatal exposure to bisphenol A. Gravid mice were orally exposed to bisphenol (50 μg/kg body weight/day) from day 15 of pregnancy until weaning. Gut barrier function, local and systemic immunity were assessed in adult female offspring...
July 21, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28733759/management-of-gait-changes-and-fall-risk-in-mci-and-dementia
#20
REVIEW
Gilles Allali, Joe Verghese
Gait disorders and falls are very prevalent in aging, especially in older adults with cognitive impairment: older adults with dementia are 2-3 times more likely to fall than their non-demented counterparts. The management of gait disorders and falls in older adults with mild cognitive impairment (MCI) or dementia begins by their identification with the use of specific screening tools, such as measuring gait speed, use of dual-task gait tests, or diagnosing motoric cognitive risk syndrome, a newly described pre-dementia syndrome...
September 2017: Current Treatment Options in Neurology
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