Publication date: Available online 6 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jasper D. Bier, Steven J. Kamper, Arianne P. Verhagen, Christopher G. Maher, Christopher M. Williams
ObjectiveTo describe the magnitude of patient reported non-adherence with guideline-recommended care for acute low back pain.DesignSecondary analysis of data from participants enrolled in the PACE trial, a randomised controlled trial evaluating the effectiveness of paracetamol for acute low back pain.ParticipantsData from 1643 participants with acute low back pain.InterventionsGuideline recommendend care including; reassurance, simple analgesia, and the advice to stay active and avoid bed rest. Also advice against additional treatments and referral for imaging.Main Outcome MeasuresProportion of non-adherence with guideline-recommended care. Non-adherence was defined as 1) failure to consume the advised paracetamol dose, or 2) receipt of additional healthcare, tests, or medication during the trial treatment period (4 weeks). Multivariable logistic regression analysis was preformed to determine the factors associated with non-adherence.ResultsIn the first week of treatment, 39.7% of the participants were classified as non-adherent. Over the 4-week treatment period 70.0% were non-adherent, 57.5% did not consume the advised paracetamol dose. Higher perceived risk of persistent pain, lower level of disability and not claiming workers' compensation were associated with non-adherence with odds ratios ranging from 0.46 to 1.05.ConclusionsAdherence to guideline-recommended care for acute low back pain was poor. Most participants do not take the advised paracetamol dose. Higher perceived risk of persistence of complaints, lower baseline disability and participants not claiming workers' compensation were independently associated with non-adherence.
http://ift.tt/2uSuw2N
Παρασκευή 7 Ιουλίου 2017
Patient non-adherence to guideline-recommended care in acute low back pain
Using the Systems-Practice Framework to Understand Food Allergen Management Practices at College Catering Operations: A Qualitative Study
Publication date: Available online 6 July 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jennie Verstappen, Miranda Mirosa, Carla Thomson
BackgroundThe number of individuals with food allergies or intolerances attending catered university residential colleges is increasing, and safe dining options are required to minimize the risk of allergic reactions and food-induced death.ObjectiveThis qualitative research study sought to advance professional knowledge of the factors affecting allergen management practices, particularly pertaining to college foodservices.DesignThree catered residential colleges affiliated with a major university in New Zealand were selected as research sites. The study used an ethnographic approach and systems-practice theory as a framework for data collection and organizing results. Data collection techniques included document analyses (3 hours per site), observations (6 to 8 hours per site), focus groups with foodservice workers (30 to 45 minutes per site, n=16), and interviews with foodservice managers (45 to 90 minutes per interview, n=5). Notes and transcripts were coded through the process of thematic analysis using NVivo for Mac software, version 11.1.1, to identify factors affecting allergen management practices.ResultsThe main factors affecting allergen management practices at college foodservices included information provided by residents about dietary requirements; communication between residents and foodservice staff; systems for allergen management; attitude of foodservice staff; and college size.ConclusionsDetailed dietary information, effective communication with residents, sufficient resources, clarification of responsibilities, and thorough systems are required for staff to perform safe allergen management practices. Ultimately, successful implementation was predominantly determined by staff attitude. Foodservice managers are advised to identify motivators and address barriers of staff attitudes toward allergen management practices to promote successful implementation.
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Nutrition Screening: Coding after Discharge Underestimates the Prevalence of Undernutrition
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jessie M. Hulst, Koen F.M. Joosten
http://ift.tt/2sxLvXi
Validity and Interrater Reliability of the Visual Quarter-Waste Method for Assessing Food Waste in Middle School and High School Cafeteria Settings
Publication date: Available online 6 July 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Katherine M. Getts, Emilee L. Quinn, Donna B. Johnson, Jennifer J. Otten
BackgroundMeasuring food waste (ie, plate waste) in school cafeterias is an important tool to evaluate the effectiveness of school nutrition policies and interventions aimed at increasing consumption of healthier meals. Visual assessment methods are frequently applied in plate waste studies because they are more convenient than weighing. The visual quarter-waste method has become a common tool in studies of school meal waste and consumption, but previous studies of its validity and reliability have used correlation coefficients, which measure association but not necessarily agreement.ObjectiveThe aims of this study were to determine, using a statistic measuring interrater agreement, whether the visual quarter-waste method is valid and reliable for assessing food waste in a school cafeteria setting when compared with the gold standard of weighed plate waste.MethodsTo evaluate validity, researchers used the visual quarter-waste method and weighed food waste from 748 trays at four middle schools and five high schools in one school district in Washington State during May 2014. To assess interrater reliability, researcher pairs independently assessed 59 of the same trays using the visual quarter-waste method. Both validity and reliability were assessed using a weighted κ coefficient.ResultsFor validity, as compared with the measured weight, 45% of foods assessed using the visual quarter-waste method were in almost perfect agreement, 42% of foods were in substantial agreement, 10% were in moderate agreement, and 3% were in slight agreement. For interrater reliability between pairs of visual assessors, 46% of foods were in perfect agreement, 31% were in almost perfect agreement, 15% were in substantial agreement, and 8% were in moderate agreement.ConclusionsThese results suggest that the visual quarter-waste method is a valid and reliable tool for measuring plate waste in school cafeteria settings.
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Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies.
Community hospitals can provide a wide range of potentially integrative services, suggesting that a more strategic role for community hospitals in England may be timely
http://ift.tt/2uSAjVQ
Seclusion and Psychiatric Intensive Care Evaluation Study (SPICES): combined qualitative and quantitative approaches to the uses and outcomes of coercive practices in mental health services.
The availability of seclusion and psychiatric intensive care influences how disturbed behaviour is managed, and there were clear predictors of their use when available; however, it remains unclear whether they reduce or worsen violence.
http://ift.tt/2tUyCKf
Clinical effectiveness, cost-effectiveness and acceptability of low-intensity interventions in the management of obsessive–compulsive disorder: the Obsessive–Compulsive Treatment Efficacy randomised controlled Trial (OCTET).
Low-intensity interventions led to no clinically significant improvements in obsessive–compulsive disorder symptoms, but they may be cost-effective at 12 months.
http://ift.tt/2tUwsKY
Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study.
Women who smoke beyond early pregnancy can find quitting very difficult, and smoking cessation interventions need to consider the interplay between the individual, interpersonal and environmental aspects of women's lives
http://ift.tt/2tUaHLa
Is primary hyperparathyroidism a cause of endothelial dysfunction?
Summary
Objective
Symptomatic primary hyperparathyroidism (PHPT) is thought to be related to increased cardiovascular morbidity and mortality. In our study, we aimed to investigate endothelial dysfunction and markers of subclinical atherosclerosis in PHPT patients. Also we aimed to demonstrate the effect of vitamin D supplementation on these parameters.
Materials and methods
Twenty-nine patients followed by medical treatment (A), 25 preoperative (B) and 23 postoperative patients with PHPT (C), and 26 normocalcemic subjects (D) were included. Groups were assessed by measurements of flow-mediated dilation (FMD), carotid intima-media thickness (CIMT), serum levels of sCD40L, high-sensitivity CRP (hs-CRP), and interleukin-8 (IL-8). Thirteen patients with low levels of 25-hydroxy-vitamin D (25OHD) in the medical treatment group were assessed before and 3 months after vitamin D replacement.
Results
The median FMD was 5% in group A, 5.1% in group B, 7.6% in group C, and 7.7% in group D. The FMD measurement in group A was significantly lower than groups C and D (P = 0.02) and was similar to the FMD measurement in group B. FMD measurements of group B were not significantly lower than groups C and D. In 13 patients with low 25OHD in group A, the median FMD increased to 7.07% from 4.71% after vitamin D replacement (P = 0.02).
Conclusion
FMD was impaired in PHPT patients, particularly in the medically observed group. Vitamin D supplementation seems to provide improvements in FMD in medically observed PHPT patients with low 25OHD levels and this was the novel observation of our study.
This article is protected by copyright. All rights reserved.
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Deviated septum: Causes, symptoms, and treatment
It is quite common for people to not have a straight septum. What is a deviated septum, what causes it, and how is a deviated septum diagnosed?
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Context for Practice: Clinical Challenges Related to Rare and Uncommon Skin Conditions.
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Does Incremental Positioning (Weight Shifts) Reduce Pressure Injuries in Critical Care Patients?.
http://ift.tt/2tQaiJU
Does Incremental Positioning (Weight Shifts) Reduce Pressure Injuries in Critical Care Patients?.
http://ift.tt/2sxrY9q
Medical Device-Related Pressure Injuries in Long-term Acute Care Hospital Setting.
http://ift.tt/2tPZk7u
Pressure Injuries in Inpatient Care Facilities in the Czech Republic: Analysis of a National Electronic Database.
http://ift.tt/2sxCC03
Use of Noncontact Low-Frequency Ultrasound in Deep Tissue Pressure Injury: A Retrospective Analysis.
http://ift.tt/2tQel9p
Expression of MMP-8 in Pressure Injuries in Spinal Cord Injury Patients Managed by Negative Pressure Wound Therapy or Conventional Wound Care: A Randomized Controlled Trial.
http://ift.tt/2sxfDlJ
Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies.
http://ift.tt/2tQ8e4J
Health-Related Quality of Life and Sleep Disorders in Patients With a Urostomy: Is There a Relationship?.
http://ift.tt/2sx9Psb
Institution of a Preoperative Stoma Education Group Class Decreases Rate of Peristomal Complications in New Stoma Patients.
http://ift.tt/2tPXa7z
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Ειδοποίηση Μελετητή:[ ωτα ] [HTML] Gender, identity and material: Film screening C Brand - 2017 ftypM4V *M4V M4A mp42isom*a┌moovlmvhd...
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Publication date: September 2017 Source: Free Radical Biology and Medicine, Volume 110 Author(s): Lucía Fernández-del-Río, Anish Nag, Elen...
