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Clinical Trajectories of Comorbidity Associated With Military-Sustained Mild Traumatic Brain Injury: Pre- and Post-Injury.

BACKGROUND AND OBJECTIVE: In the US military, traumatic brain injury (TBI) is of distinct importance, at home and in the deployed setting, and is considered a "signature injury of the wars in Afghanistan and Iraq." Since 2000, an estimated 468 424 service members (SMs) have been diagnosed with at least one TBI. We examined the clinical trajectories of a group of 18 comorbidities before and after a military-sustained mild TBI (mTBI). METHODS: Without making assumptions on causality, a group of 18 conditions often co-occurring with mTBI were identified through literature review and TBI subject

Effects of Meditation Training and Non-Native Language Training on Cognition in Older Adults: A Secondary Analysis of a Randomized Clinical Trial.

IMPORTANCE: Nonpharmacological interventions are a potential strategy to maintain or promote cognitive functioning in older adults. OBJECTIVE: To investigate the effects of 18 months' meditation training and 18 months' non-native language training on cognition in older adults. DESIGN, SETTING, AND PARTICIPANTS: This study was a secondary analysis of the Age-Well trial, an 18-month, observer-masked, randomized clinical trial with 3 parallel arms. Eligible participants were community-dwelling adults aged 65 years and older residing in Caen, France. Participants were enrolled from November 24,

Feasibility of a yoga, aerobic and stretching-toning exercise program for adult cancer survivors: the STAYFit trial.

BackgroundThe use of yoga as a mind-body practice has become increasingly popular among clinical populations and older adults who use this practice to manage age and chronic disease-related symptoms. Although yoga continues to gain popularity among practitioners and researchers, pilot studies that examine its feasibility and acceptability, especially among cancer survivors, are limited. Feasibility studies play a critical role in determining whether the target population is likely to engage with larger scale efficacy and effectiveness trials. In this paper we present feasibility and acceptabil

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… The yoga group practiced Hatha yoga , which focused on physical poses, breathing, and meditation and were led by a certified yoga instructor. …

Effectiveness of self-managed continuous monitoring for maintaining high-quality early essential newborn care compared to supervision visit in Lao PDR: a cluster randomised controlled trial.

BACKGROUND: Thousands of neonatal deaths are expected to be averted by introducing the Early Essential Newborn Care (EENC) in the Western Pacific Region. In Lao People's Democratic Republic (Lao PDR), the government adopted the EENC programme and expanded it to district hospitals. With the expansion, maintaining the quality of EENC has become difficult for the government. METHODS: A cluster randomised controlled trial with four strata based on province and history of EENC coaching was implemented to evaluate the effectiveness of self-managed continuous monitoring compared with supervisory vis

Study protocol: a core outcome set for perinatal interventions for congenital diaphragmatic hernia.

BACKGROUND: Congenital diaphragmatic hernia (CDH) is, depending of the severity, a birth defect associated with significant mortality and morbidity. Prenatal screening by ultrasound may detect this condition and comprehensive assessment of severity is possible, allowing for in utero referral to an experienced centre for planned delivery. In an effort to improve outcomes, prenatal interventions to stimulate lung development were proposed. Along the same lines, new postnatal management strategies are being developed. In order to enable proper comparison of novel perinatal interventions as well a

Nonconvulsive status epilepticus in adults: electroclinical differences between proper and comatose forms.

OBJECTIVE: Nonconvulsive status epilepticus (NCSE) represents an important percentage of status epilepticus in adults, but detailed studies of both NCSE proper and comatose NCSE are lacking. We retrospectively analyzed a prospectively collected series of 50 adult patients with a diagnosis of NCSE whose electroencephalograms (EEGs) have been interpreted for a period of 10 years by the same investigator. METHODS: Two groups, NCSE proper and comatose NCSE were considered. All clinical, EEGs, neuroimaging data, antiepileptic treatment and outcome were analyzed. RESULTS: Thirty-two patients (64%)

Cervico-thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome.

BACKGROUND: This review is an update on 'Sympathectomy for neuropathic pain' originally published in Issue 2, 2003. The concept that many neuropathic pain syndromes (traditionally this definition would include complex regional pain syndromes (CRPS)) are "sympathetically maintained pains" has historically led to treatments that interrupt the sympathetic nervous system. Chemical sympathectomies use alcohol or phenol injections to destroy ganglia of the sympathetic chain, while surgical ablation is performed by open removal or electrocoagulation of the sympathetic chain, or minimally invasive pro

[ProSeal-laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic laparoscopy].

BACKGROUND: The aim of this study was to assess the practicality of the ProSeal laryngeal mask (PS-LMA) airway during laparoscopic surgery with capnoperitoneum compared to endotracheal intubation (ET). METHODS: Prospective, randomized study. 104 patients undergoing gynaecologic, laparoscopic surgery were allocated randomly to two groups: 1. ET-group (n = 50). 2. PS-LMA-group (n = 54). Total intravenous anaesthesia was performed by the same anaesthesiologist. MEASUREMENTS: Mean arterial pressure, heart rate, at 4 and circuit pressure at 2 measurement points, and the incidences of coughing and

Implementation of multisectoral interventions to improve nutrition in Uganda: stakeholder perceptions and experiences.

BACKGROUND: Malnutrition in sub-Saharan Africa remains a persistent public health challenge driven by food insecurity, inadequate health services, suboptimal caregiving practices, and weak livelihoods. Addressing these complex determinants requires multisectoral interventions that integrate nutrition, health, agriculture, and community development. The Uganda Community Connector (UCC) programme was designed to address these challenges through integrated, community-based approaches. This study explored stakeholder perceptions of UCC implementation strategies using the RE-AIM framework. METHODS

Antiracist Practices Across the Stages of a Research Project: A Narrative Review.

OBJECTIVES: There is a need for formal guidance around antiracist research practices to dismantle structural racism, which has been embedded into the design and conduct of health sciences research. Our objective is to review and summarize recommendations from published literature published on antiracist research practices applicable to all health sciences research studies. METHOD: In 2022, we systematically reviewed PubMed, SCOPUS, Excerpta Medica Database, British Nursing Index, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Sociological Abstracts using search terms

Healthcare professionals' attitudes towards digital health interventions and perspectives on digital health inequalities in cardiometabolic care: a qualitative study.

BACKGROUND: The ue of digital health interventions (DHIs) for the management of cardiometabolic diseases has increased but may exacerbate existing health inequalities. Healthcare professionals (HCPs) play a vital role in recommending and supporting healthcare users to use these tools. There is a need to understand the role of HCPs in managing the implementation of digital health in communities at risk of health inequalities. OBJECTIVE: To explore the views of HCPs regarding digital health and its impact on health inequalities, focusing on cardiometabolic diseases and the South Asian populatio

Antibiotic use among young, hospitalized children in Jordan, 2010-2023.

UNLABELLED: Inappropriate antibiotic use drives antimicrobial resistance, a global health threat causing increased morbidity and mortality. Understanding antibiotic practices in low-resource settings is essential to identify intervention targets. This study investigates antibiotic prescription practices in Amman, Jordan. We conducted three prospective viral surveillance studies at the largest public hospital in Amman, Jordan (2010-2013, 2020, and 2023) and included children <2 years old hospitalized with fever or respiratory symptoms. The data collected included antibiotic use and the results

What do physiotherapists find useful in e-learning interventions to improve their knowledge, attitudes and beliefs on low back pain management: a nested qualitative study from an educational randomized clinical trial.

BACKGROUND: Physiotherapists encounter many barriers in their management of low back pain (LBP). However, little attention has been paid to what content physiotherapists find useful to improve their LBP management. We aimed to: (1) explore the experiences of physiotherapists regarding the educational content after completing either an "experimental" or "traditional" e-learning intervention, (2) identify in both interventions which content physiotherapists reported beneficial or lacking in order to enhance their management of LBP. METHODS: A purposive, criterion-based sampling strategy was emp

Physiotherapists' barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice in patients at risk of recurrence of low back pain: a qualitative study.

BACKGROUND: Recurrences of low back pain (LBP) are frequent and associated with high levels of disability and medical costs. Regular exercise practice may be an effective strategy to prevent recurrences of LBP, however, the promotion of this behaviour by physiotherapists seems to be challenging. This study aims to explore physiotherapists' perceived barriers and facilitators to the implementation of a behaviour change-informed exercise intervention to promote the adoption of regular exercise practice by patients at risk of recurrence of low back pain. METHODS: Two focus groups with primary he

Evaluating Adequacy of VTE Prophylaxis Dosing with Enoxaparin for Overweight and Obese Patients on an Orthopedic-Medical Trauma Comanagement Service.

OBJECTIVES: Venous thromboembolism (VTE) is a common nosocomial condition, developing frequently in overweight and obese patients. VTE prophylaxis with weight-based enoxaparin dosing may be more effective than the standard dosing regimen for overweight and obese patients; however, weight-based dosing is not practiced routinely. In this pilot study we sought to evaluate prophylactic anticoagulation regimens used for VTE prevention in overweight and obese patients on the Orthopedic-Medical Trauma (OMT) service to inform the need for modification of dosing practices. METHODS: This prospective, o

Spinal anesthesia in contemporary and complex lumbar spine surgery: experience with 343 cases.

OBJECTIVE: Spinal anesthesia (SA) is an alternative to general anesthesia (GA) for lumbar spine surgery, including complex instrumented fusion, although there are relatively few outcome data available. The authors discuss their experience using SA in a modern complex lumbar spine surgery practice to describe its utility and implementation. METHODS: Data from patients receiving SA for lumbar spine surgery by one surgeon from March 2017 to December 2020 were collected via a retrospective chart review. Cases were divided into nonfusion and fusion procedure categories and analyzed for demographic

Differences in infant feeding practices between Chinese-born and Australian-born mothers living in Australia: a cross-sectional study.

BACKGROUND: Chinese immigrants are the third largest immigrant group in Australia. Recent qualitative evidence from Victorian Maternal and Child Health nurses indicate that infants of Chinese parents commonly have rapid growth trajectories and that high value is placed on rapid growth and having a fatter child; with low breastfeeding rates and overfeeding of infant formula. The aim of this study was to compare infant feeding practices (breastfeeding, infant formula, other liquids, solids) of Chinese-born and Australian-born mothers living in Australia. METHODS: Using the Australian National I

[Early detection of prostate cancer by PSA testing: the results of a qualitative study on barriers caused by physicians in Austria implementing informed decision making].

OBJECTIVES: In the context of the Austrian Periodic Health Examination and on the basis of current evidence based medicine a systematic screening for prostate-specific antigen (PSA) is inadvisable. General practitioners (GPs) are expected to inform their patients about risks and benefits of screening before undergoing a PSA test. Ideally, this information corresponds to the model of informed decision making (IDM).The aim of this qualitative pilot-study is to explore factors, which gain insight into GPs' practice of counselling about the PSA test. METHODS: This qualitative pilot study involves

Health Education Campaign to Improve Malaria Knowledge, Prevention, and Treatment Behaviors in Rural East Nusa Tenggara Province, Indonesia: Protocol for a Cluster-Assigned Quasi-Experimental Study.

BACKGROUND: Malaria is a major health issue that is distributed across 85 countries globally including Indonesia. Indonesia is in the process of achieving malaria elimination. Currently, a high burden of malaria exists in the rural eastern part of the nation, including East Nusa Tenggara Province where the number of malaria cases increased significantly during COVID-19. To achieve malaria elimination, malaria awareness must be measurable and integrated into malaria policy. Currently, malaria awareness among rural communities in the region is low, and interventional studies aiming at improving

Effectiveness of a Conversational Chatbot (Dejal@bot) for the Adult Population to Quit Smoking: Pragmatic, Multicenter, Controlled, Randomized Clinical Trial in Primary Care.

BACKGROUND: Tobacco addiction is the leading cause of preventable morbidity and mortality worldwide, but only 1 in 20 cessation attempts is supervised by a health professional. The potential advantages of mobile health (mHealth) can circumvent this problem and facilitate tobacco cessation interventions for public health systems. Given its easy scalability to large populations and great potential, chatbots are a potentially useful complement to usual treatment. OBJECTIVE: This study aims to assess the effectiveness of an evidence-based intervention to quit smoking via a chatbot in smartphones