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https://www.readbyqxmd.com/read/29458056/alcohol-and-cv-health-jekyll-and-hyde-j-curves
#1
REVIEW
Evan L O'Keefe, James J Di Nicolantonio, James H O'Keefe, Carl J Lavie
A routine of light or moderate alcohol consumption (≤1 drink/day for women and 1 to 2 drinks/day for men) were associated with a lower risk for all-cause mortality, coronary artery disease (CAD), type 2 diabetes mellitus (T2D), heart failure (HF), and stroke. Conversely, heavy drinking, (>4 drinks/day) is associated with an increased risk for death and cardiovascular (CV) disease (CVD). Excessive alcohol intake trails behind only smoking and obesity among the 3 leading causes of premature deaths in the United States (US)...
February 16, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29457923/flipping-social-determinants-on-its-head-medical-student-perspectives-on-the-flipped-classroom-and-simulated-patients-to-teach-social-determinants-of-health
#2
N Gostelow, J Barber, F Gishen, A Berlin
BACKGROUND: Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students. INNOVATION: A flipped learning session was piloted for year 4 medical students combining an online lesson followed by a tutorial with a simulated patient. METHODS: A mixed-methods approach collected questionnaire data using 4-point Likert scales and free text answers...
February 19, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29457837/improved-wound-remodeling-correlates-with-modulated-tgf-beta-expression-in-skin-diabetic-wounds-following-combined-red-and-infrared-photobiomodulation-treatments
#3
Reza Fekrazad, Arash Sarrafzadeh, Katayoun Am Kalhori, Imran Khan, Praveen R Arany, Alessio Giubellino
Diabetic wounds are a major cause of morbidity among patients with poorly controlled blood glucose levels. Conventional empirical wound care strategies have shown limited efficacy and there is an urgent need to develop novel therapeutic strategies. Photobiomodulation treatments have shown a positive therapeutic effects in several cell culture and animal models. In this study, we examined wound healing in diabetic rats following treatments with two laser wavelengths, namely red (660nm) and infrared (808nm) individually and in combination as compared to routine wound dressings...
February 19, 2018: Photochemistry and Photobiology
https://www.readbyqxmd.com/read/29457743/a-framework-for-complexity-in-palliative-care-a-qualitative-study-with-patients-family-carers-and-professionals
#4
Sophie Pask, Cathryn Pinto, Katherine Bristowe, Liesbeth van Vliet, Caroline Nicholson, Catherine J Evans, Rob George, Katharine Bailey, Joanna M Davies, Ping Guo, Barbara A Daveson, Irene J Higginson, Fliss Em Murtagh
BACKGROUND: Palliative care patients are often described as complex but evidence on complexity is limited. We need to understand complexity, including at individual patient-level, to define specialist palliative care, characterise palliative care populations and meaningfully compare interventions/outcomes. AIM: To explore palliative care stakeholders' views on what makes a patient more or less complex and insights on capturing complexity at patient-level. DESIGN: In-depth qualitative interviews, analysed using Framework analysis...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29457704/comparability-and-repeatability-of-three-commonly-used-methods-for-measuring-endurance-capacity
#5
James Baxter-Gilbert, Max Mühlenhaupt, Martin J Whiting
Measures of endurance (time to exhaustion) have been used to address a wide range of questions in ecomorphological and physiological research, as well as being used as a proxy for survival and fitness. Swimming, stationary (circular) track running, and treadmill running are all commonly used methods for measuring endurance. Despite the use of these methods across a broad range of taxa, how comparable these methods are to one another, and whether they are biologically relevant, is rarely examined. We used Australian water dragons (Intellagama lesueurii), a species that is morphologically adept at climbing, swimming, and running, to compare these three methods of endurance and examined if there is repeatability within and between trial methods...
February 19, 2018: Journal of Experimental Zoology. Part A, Ecological and Integrative Physiology
https://www.readbyqxmd.com/read/29457585/training-nurses-in-a-competency-framework-to-support-adults-with-epilepsy-and-intellectual-disability-the-epaid-cluster-rct
#6
Howard Ring, James Howlett, Mark Pennington, Christopher Smith, Marcus Redley, Caroline Murphy, Roxanne Hook, Adam Platt, Nakita Gilbert, Elizabeth Jones, Joanna Kelly, Angela Pullen, Adrian Mander, Cam Donaldson, Simon Rowe, James Wason, Fiona Irvine
BACKGROUND: People with an intellectual (learning) disability (ID) and epilepsy have an increased seizure frequency, higher frequencies of multiple antiepileptic drug (AED) use and side effects, higher treatment costs, higher mortality rates and more behavioural problems than the rest of the population with epilepsy. The introduction of nurse-led care may lead to improvements in outcome for those with an ID and epilepsy; however, this has not been tested in a definitive clinical trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29457521/relationships-between-race-ethnicity-and-health-care-utilization-among-older-post-acute-home-health-care-patients
#7
Jo-Ana D Chase, David Russell, Liming Huang, Alexandra Hanlon, Melissa O'Connor, Kathryn H Bowles
Few studies have explored racial/ethnic differences in health care outcomes among patients receiving home health care (HHC), despite known differences in other care settings. We conducted a retrospective cohort study examining racial/ethnic disparities in rehospitalization and emergency room (ER) use among post-acute patients served by a large northeastern HHC agency between 2013 and 2014 ( N = 22,722). We used multivariable binomial logistic regression to describe the relationship between race/ethnicity and health care utilization outcomes, adjusting for individual-level factors that are conceptually related to health service use...
February 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29457318/equity-dimensions-of-the-availability-and-quality-of-reproductive-maternal-and-neonatal-health-services-in-zambia
#8
Lily D Yan, Jonas Mwale, Samantha Straitz, Godfrey Biemba, Zulfiqar Bhutta, Julia F Ross, Lawrence Myananyanda, Mary Nambao, Paul Ngwakum, Eleonora Genovese, Bowen Banda, Nadia Akseer, Kojo Yeboah-Antwi, Peter Rockers, Davidson H Hamer
OBJECTIVE: To assess how quality and availability of reproductive, maternal, neonatal (RMNH) services vary by district wealth and urban/rural status in Zambia. METHODS: We conducted a retrospective analysis of data from the Millennium Development Goal Acceleration Initiative baseline assessment of 117 health facilities in 9 districts. Quality was assessed through a composite score of 23 individual RMNH indicators, ranging from 0 to 1. Availability was evaluated by density of providers and facilities...
February 19, 2018: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29457241/can-rationing-through-inconvenience-be-ethical
#9
Nir Eyal, Paul L Romain, Christopher Robertson
In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By "rationing through inconvenience" in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29456905/a-comprehensive-review-of-the-sternal-foramina-and-its-clinical-significance
#10
REVIEW
Paul J Choi, Joe Iwanaga, R Shane Tubbs
A sternal foramen (SF), which arises from the incomplete fusion of the cartilaginous neonatal sternum, is a relatively common anatomical variation found in 2.5% to 13.8 % of all individuals. SFs are usually located at the lower third of the sternal body and their average diameter is 6.5 mm. An SF is subclinical; however, its close proximity to the thoracic organs, i.e., the heart and lungs, entails a risk of serious complications from blinded sternal interventions. Moreover, its presence can lead to misinterpretation of radiological and postmortem findings...
December 8, 2017: Curēus
https://www.readbyqxmd.com/read/29456895/calibration-adjustments-to-address-bias-in-mortality-analyses-due-to-informative-sampling-a-census-linked-survey-analysis-in-switzerland
#11
André Moser, Matthias Bopp, Marcel Zwahlen
Background: Sampling bias, like survey participants' nonresponse, needs to be adequately addressed in the analysis of sampling designs. Often survey weights will be calibrated on specific covariates related to the probability of selection and nonresponse to get representative population estimates. However, such calibrated survey (CS) weights are usually constructed for cross-sectional results, but not for longitudinal analyses. For example, when the outcome of interest is time to death, and sampling selection is related to time to death and censoring, sampling is informative...
2018: PeerJ
https://www.readbyqxmd.com/read/29456871/gestational-obesity-weight-management-implementation-of-national-guidelines-glowing-a-pilot-cluster-randomised-controlled-trial-of-a-guideline-implementation-intervention-for-the-management-of-maternal-obesity-by-midwives
#12
Nicola Heslehurst, Judith Rankin, Catherine McParlin, Falko F Sniehotta, Denise Howel, Stephen Rice, Elaine McColl
Background: Weight management in pregnancy guidelines exist, although dissemination alone is an ineffective means of implementation. Midwives identify the need for support to overcome complex barriers to practice. An evaluation of an intervention to support midwives' guideline implementation would require a large-scale cluster randomised controlled trial. A pilot study is necessary to explore the feasibility of delivery and evaluation prior to a definitive trial. The GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING) trial aims to test whether it is feasible and acceptable to deliver a behaviour change intervention to support midwives' implementation of weight management guidelines...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29456430/effect-of-medical-nutrition-therapy-for-patients-with-type-2-diabetes-in-a-low-no-cost-clinic-a-propensity-score-matched-cohort-study
#13
Mark D Agee, Zane Gates, Patrick M Irwin
Background: Although many studies have been conducted regarding the effectiveness of medical nutrition therapy (MNT) for type 2 diabetes management, less is known about the effectiveness of MNT for low-income adults. This study evaluated the contribution of MNT in improving A1C and blood pressure in a population of low-income adults with type 2 diabetes. Methods: This was a population-based, propensity score-matched cohort study using provincial health data from Altoona, Blair County, Pa...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29456427/the-experience-of-diabetes-related-language-in-diabetes-care
#14
Jane K Dickinson
Objective: The goal of this study was to understand how adults with diabetes experience the words used in diabetes care. Methods: This qualitative study guided by Critical Theory used two virtual and two in-person focus groups conducted by the same facilitator. A total of 68 focus group members participated. The facilitator transcribed and coded focus group data using individual responses as the unit of analysis. The facilitator used constant comparison to analyze responses and developed a research summary of themes that emerged...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29456425/reasons-for-open-and-closed-attitudes-regarding-type-1-diabetes
#15
Jamie K Easler, Helena M Haueter, Susanne Olsen Roper, Donna Freeborn, Tina Dyches
Thirty-one adults with type 1 diabetes participated in this qualitative study to explore reasons why they were willing (had an open attitude) or unwilling (had a closed attitude) to disclose diabetes-related information to others. Participants (61.3% female, mean age 38.48 years, mean duration of diabetes 21.94 years, 100% white) answered open-ended questions about living with type 1 diabetes. Interviews were transcribed verbatim and coded to identify major patterns that emerged in the data. Reasons for open attitudes included support from others, confidence and feeling comfortable, feeling normal despite diabetes, seeking to educate, and feeling that it was not a major concern to share information with others...
February 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29456075/qualitative-analysis-of-a-cultural-dexterity-program-for-surgeons-feasible-impactful-and-necessary
#16
Rhea Udyavar, Douglas S Smink, John T Mullen, Tara S Kent, A Green, Alyssa F Harlow, Manuel Castillo-Angeles, Alexandra B Columbus, Adil H Haider
OBJECTIVES: Ineffective cross-cultural communication contributes to adverse outcomes for minority patients. To address this, the authors developed a novel curriculum for surgical residents built on the principle of cultural dexterity, emphasizing adaptability to clinical and sociocultural circumstances to tailor care to the needs of the individual patient. This study's objective was to evaluate the feasibility, acceptability, and perception of this program upon conclusion of its first year...
February 15, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29455911/trauma-theatre-productivity-does-the-individual-surgeon-anaesthetist-or-consultant-presence-matter
#17
Gareth S Turnbull, Mounir Hakimi, George J McLauchlan
INTRODUCTION: With rising NHS clinical and financial demands, improving theatre efficiency is essential to maintain quality of patient care. Consistent teams and consultant presence have been shown to improve outcomes and productivity in elective orthopaedic surgery. The aim of this study was to investigate the impact on trauma theatre productivity of different surgeons and anaesthetists working together in a Major Trauma Centre. The influence of consultant presence and weekend operating on productivity was also considered...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29455893/cognitive-behavioural-therapy-for-insomnia-cbt-i-to-treat-depression-a-systematic-review
#18
REVIEW
Jasmyn E A Cunningham, Colin M Shapiro
INTRODUCTION: Major depressive disorder is one of the most commonly diagnosed psychiatric illnesses, and it has a profound negative impact on an individual's ability to function. Up to 90% of individuals suffering from depression also report sleep and circadian disruptions. If these disruptions are not effectively resolved over the course of treatment, the likelihood of relapse into depression is greatly increased. Cognitive Behavioural Therapy for Insomnia (CBT-I) has shown promise in treating these sleep and circadian disturbances associated with depression, and may be effective as a stand-alone treatment for depression...
March 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29455777/palliative-treatment-of-coronary-atherosclerotic-cancer-by-drug-eluting-or-bare-metal-stents-from-oculo-stenotic-reflex-period-to-age-of-precision-medicine
#19
Elif Hande Ozcan Cetin, Ozcan Ozeke, Erdogan Ilkay, Dursun Aras, Serkan Topaloglu, Zehra Golbasi, Sinan Aydogdu, Can Ozer
Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease such as atherosclerosis or cancer. Some authors speculated that atherosclerotic coronary artery disease (CAD) could be considered a "cancer of the coronary arterial wall". Although the percutaneous coronary intervention (PCI) has proven to be effective in decreasing mortality rates among patients with acute coronary syndromes, the previous meta-analyses of PCI versus optimal medical therapy for stable CAD have not been able to demonstrate a reduction in major adverse cardiac outcomes...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455690/effect-of-cerebral-perfusion-pressure-on-acute-respiratory-distress-syndrome
#20
Sonny Thiara, Donald E Griesdale, William R Henderson, Mypinder S Sekhon
BACKGROUND: Increased cerebral perfusion pressure (CPP)>70 mmHg has been associated with acute respiratory distress syndrome (ARDS) after traumatic brain injury (TBI). Since this reported association, significant changes in ventilation strategies and fluid management have been accepted as routine critical care. Recently, individualized perfusion targets using autoregulation monitoring suggest CPP titration>70 mmHg. Given these clinical advances, the association between ARDS and increased CPP requires further delineation...
February 19, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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