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CSA Is Not Beneficial Long Term in Heart Failure Patients with Reduced Ejection Fraction.

Central sleep apnea (CSA) affects many patients, with heart failure and results in hypoxia and nor-epinephrine release and is associated with high morbidity and mortality. Recent trials in the treatment of CSA using positive airway pressure therapies have failed to demonstrate improvement in mortality and as a result, the compensatory nature of CSA has been questioned. The detrimental effects from CSA are clear. While there may be a short term compensatory effect, the long term effects cause chronic insult to the cardiovascular system indicating that CSA should be treated, but alternative trea

Hidradenitis suppurativa: Epidemiology and scope of the problem.

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving painful, deep abscesses and chronic, draining sinus tracts. Because of the variable signs and symptoms displayed by patients, it remains widely unrecognized and difficult to treat, resulting in significant diagnostic delay and inconsistent treatment process. No medical specialty has successfully designated a criterion standard of treatment, resulting in variable care and unmet patient needs. Widespread causes and effects of HS are difficult to determine because the prevalence is dependent on a variety of things, includin

Current Status of the Management of Hereditary Breast and Ovarian Cancer in Asia: First Report by the Asian BRCA Consortium.

BACKGROUND: BRCA1/BRCA2 mutations are associated with an increased lifetime risk for hereditary breast and ovarian cancer (HBOC). Compared with the Western developed countries, genetic testing and risk assessment for HBOC in Asia are less available, thus prohibiting the appropriate surveillance, clinical strategies and cancer management. METHODS: The current status of HBOC management in 14 Asian countries, including genetic counselling/testing uptakes and clinical management options, was reviewed. We analysed how economic factors, healthcare and legal frameworks, and cultural issues affect th

The mental and physical health difficulties of children held within a British immigration detention center: a pilot study.

OBJECTIVE: The present study aimed to assess the mental and physical health of children held within a British immigration detention center. METHOD: A total of 24 detained children (aged 3 months to 17 years) were assessed with their parents or carer after being referred by a registered legal charity. Thirteen were seen by a pediatrician alone, 4 by a psychologist alone, and 7 by both professions using semi-structured clinical interviews. The psychologist also used standardized self-report questionnaires to measure psychopathology. RESULTS: During the psychological assessment of 11 children,

Health professionals need to be able to identify depression in older people.

Healthcare literature shows that depression in older people, as a mental health problem, is often under-recognized and under-managed. This may partly be the result of multiple pathology, a common feature in later life, masking the features of depressive illness. It may also be the consequence of inadequate use of mental health specialists' skills. As the population is ageing rapidly, healthcare professionals will encounter more cases of depression among the older population. Some therapeutic approaches have been suggested for nurses to adopt. More importantly, nurses and other care workers hav

Supportive care needs of adults living with a peripherally inserted central catheter (PICC) at home: a qualitative content analysis.

BackgroundPeripherally inserted central catheters (PICCs) are common vascular access devices inserted for adults undergoing intravenous treatment in the community setting. Individuals with a PICC report challenges understanding information and adapting to the device both practically and psychologically at home. There is a lack of research investigating the supportive care needs of individuals with a PICC to inform nursing assessment and the provision of additional supports they may require to successfully adapt to life with a PICC. The aim of this study was to identify the supportive care need

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… Yet there are no supportive care needs assessment tools that are specific for individuals with a PICC. The assessment of supportive care needs is common in the treatment and management of solid tumours and haematological malignancies. … Both participants with cancer and infection in the present study identified needs across the supportive care needs domains, which indicates that a single PICC associated supportive care needs assessment tool may be appropriate. …

Translation, Adaptation, and Preliminary Validation of Dacakis and Davies' "Transsexual Voice Questionnaire (Male to Female)" in French.

UNLABELLED: Transgender MtF people (trans women) consult otorhinolaryngologists and vocologists with the aim of feminizing their voice and being consistently perceived as women. Treatment of these trans women always begins with a vocal assessment that is relatively unspecific as it was originally constructed for individuals with dysphonia. OBJECTIVES: This study examines the subjective portion of the assessment and specifically the self-assessment questionnaire. There is no French-language questionnaire designed to identify the issues facing people who want voice feminization and quantify the

Current unmet needs of cancer survivors: analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II.

BACKGROUND: Cancer survivors may continue to experience psychosocial and physical needs related to their cancer experience for many years after treatment. The specification of these needs across cancer types and by survivor characteristics may lead to better prevention approaches and clinical responses. Mixed methods were used to examine responses to an open-ended question about current unmet needs from a survey of 2-, 5-, and 10-year cancer survivors. METHODS: Qualitative techniques were used to code themes of unmet needs from open-ended responses. These themes were then examined with quanti

Occupational therapy needs of patients with thoracic cancer at the time of diagnosis: findings of a dedicated rehabilitation service.

PURPOSE: Guidelines recommend screening patients with cancer to identify their rehabilitation needs. To help quantify this area of need and associated workload from an occupational therapy perspective in patients with thoracic cancer, we report the experiences of a dedicated rehabilitation service. METHODS: Consecutive patients were screened soon after diagnosis using items associated with occupational performance in the Sheffield Profile for Assessment and Referral for Care questionnaire. Those reporting predetermined levels of distress underwent a full occupational therapy evaluation; this

Relationship between gingivitis severity, caries experience and orthodontic anomalies in 13-15 year-old adolescents in Brno, Czech Republic.

OBJECTIVES: The aim of the present cross-sectional study was to assess oral health in adolescents selected from the ELSPAC (European Longitudinal Study of Pregnancy and Childhood) Bmo group and complete thus the ELSPAC series of studies on child general health. MATERIAL AND METHODS: Randomly selected children from the ELSPAC group (n=780) were examined clinically for dental and periodontal status, dental plaque, dental calculus and orthodontic anomalies. The following clinical parameters were assessed: DMFT score and its components, gingival index (GI), plaque index (PI) and calculus index (C

People with dementia living alone: what are their needs and what kind of support are they receiving?

BACKGROUND: In the U.K. about 141,460 people with dementia (PWD) live alone. They are at risk of social isolation and inadequate social and medical supervision. The aims of this study were to identify the needs of PWD living alone and to compare the needs of PWD living alone versus those living with others. It was predicted that PWD living alone would have significantly more unmet needs than those living with others. METHODS: 152 PWD were interviewed about their cognitive status and quality of life (QoL); and 128 informal carers were interviewed about the PWD's QoL, social networks, behaviora

Digital Health Literacy and Supportive Care Needs After Curative Esophagectomy: A Cross-Sectional Study.

PURPOSE: Recovery after esophagectomy may involve physical, informational, and psychosocial demands. This study examined whether total Digit … ortive care needs. Together, these findings support considering digital capability in postoperative needs assessment, but the association should not be interpreted causally because the sample was digitally selected and cross-sectional. Longitudinal studies should include patients with limited digital access and collect relevant clinical and psychosocial covariates …

Network visualization to interpret which healthcare services are central to people living with HIV.

AIM: To employ network analysis to identify the central healthcare service needs of people living with HIV (PLWH) for integrated care. DESIGN: Cross-sectional survey. METHODS: A list of healthcare services was identified through literature reviews, expert workshops and validity evaluations by PLWH. A total of 243 PLWH participated at five hospitals and self-reported their need for healthcare services on a four-point Likert scale. Centrality of healthcare service needs was analysed using network analysis. RESULTS: The mean score for 20 healthcare service needs was 3.53 out of 4. The highest

Unmet clinical needs in women with polycystic ovary syndrome regarding chronic non-communicable diseases: A cross‑sectional study.

PURPOSE: Polycystic ovary syndrome (PCOS) is recognised as a potential risk factor for chronic non communicable diseases (NCD). Although international guidelines recommend proactive NCD risk prevention, actual practice may be suboptimal. This study aimed to identify unmet clinical needs regarding information, risk assessment and satisfaction with care related to NCD risk factors among women with PCOS. METHODS: An eight-domain questionnaire was developed based on the 2018 ESHRE guideline, covering demographics, PCOS diagnostic criteria, aesthetics, metabolism, reproduction, mental health and N

Prescription opioid medication misuse among university students.

BACKGROUND AND OBJECTIVES: Prescription opioid misuse is an established problem in the United States. Less information is known regarding the clinical and cognitive characteristics of prescription opioid misusers, specifically in a college age population. This study sought to characterize individuals who misuse prescription opioids and the differences between current, past and non-misusers. METHODS: A 156-item survey was administered to over 9,449 university students at a large, public Midwestern university. Survey questions obtained demographic information, self-reported grade point average,

Environmental Risks and Children's Health in a Mayan Community from Southeast of Mexico.

BACKGROUND: The World Health Organization (WHO) estimates that 25% of global morbidity and one-third of childhood morbidity may be attributable to environment. Low and high-income countries displayed different environmental risks. Mexico demonstrates the necessity for creating a national environmental health program. In southeastern Mexico, Tixméhuac, is a Mayan community with a high marginalization degree and social backwardness. The main childhood morbidities are acute and chronic diseases. OBJECTIVE: The aim of the study was to recognize environmental risks for children's health in Tixméha

Validating the UNICEF/Washington Group Child Functioning Module for Fijian schools to identify seeing, hearing and walking difficulties.

PURPOSE: This study investigated the seeing, hearing and walking questions of the UNICEF/Washington Group Child Functioning Module and the inter-rater reliability between teachers and parents as proxy respondents. METHODS: Cross-sectional diagnostic accuracy study, two-gate design with representative sampling, comparing Module responses to reference standard assessments for 472 primary aged students in Fiji. Receiver operating characteristic curves were constructed to determine the area under the curve and optimal cut-off points. RESULTS: Areas under the curves ranged from 0.823 to 0.889 ind

Challenges Faced in Translating the Benefits of Surfactant Replacement Therapy to a Resource-Limited Setting.

Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indies during the period 2001 to 2011. Descriptive analyses were performed. Statistical significance was taken at the level p < 0.05. Results Only 13% of neonates with respiratory distress syndrome received surfactant therapy. The median time of surfactant administration was 16.5 hour

Effects of needs-based patient education on self-efficacy and health outcomes in people with rheumatoid arthritis: a multicentre, single blind, randomised controlled trial.

OBJECTIVES: The Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects of needs-based patient education on self-efficacy, health outcomes and patient knowledge in people with rheumatoid arthritis (RA). METHODS: Patients with RA were enrolled into this multicentre, single-blind, parallel-group, pragmatic randomised controlled trial. Patients were randomised to either the intervention group (IG) where patients completed ENAT, responses of which were …

Universal screening of newborns to detect hearing impairment--is it necessary?

BACKGROUND: In contrast to the recommendations of the Joint Committee on Infant Hearing, neonatal hearing screening programs are still not universally available. OBJECTIVES: To prospectively evaluate the presence of hearing loss in all newborn babies delivered in our hospital during study period using the transient evoked otoactoustic emission as the primary screening tool followed by confirmation with brainstem evoked response audiometry before six months of age and to determine risk factors responsible for hearing loss. DESIGN: A prospective study of nonrandomized cohort. SETTING: Nursery