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Objectives: Men show higher rates of cardiovascular morbidity and mortality than pre-menopausal women and this sexual dimorphism may be related to sex-specific effects of sex steroids on cardiovascular risk factors. Unlike androgens, estrogens were not extensively investigated in relation to cardiovascular phenotypes in men.
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Introduction: Adequate amount of proteins from foods are normally needed to maintain muscle mass of the human body. Although protein intakes of Papua New Guinea (PNG) highlanders are less than biologically adequate, protein deficiency related disorders have rarely been reported. It has been postulated that gut microbiota play a role in such low-protein-adaptation. Objective: To explore underlying biological mechanisms of low-protein adaptation among PNG highlanders by investigating metabolomic profiles of faecal water and urine. Methods: We performed metabolome analysis using faecal water extracted from faecal samples of PNG highlanders, PNG non-highlanders and Japanese subjects. We paid special attention to amino acids and other metabolites produced by gut microbiota, as well as to metabolites involved in nitrogen recycling in the human gut. Results: Our results indicated that amino acid levels were higher in faecal water from PNG highlanders than PNG non-highlanders, but amino acid levels did not differ between PNG highlanders and Japanese subjects. Among PNG highlander samples, amino acid levels tended to be higher in those who consumed less protein. Conclusion: We speculated that a greater proportion of urea was excreted to the intestine among the PNG highlanders than other groups, and that the urea was used for nitrogen salvage. Intestinal bacteria are essential for producing ammonia from urea and also for producing amino acids from ammonia, which is a key process in low-protein adaptation. Profiling the gut microbiota of PNG highlanders is an important avenue for further research into the mechanisms of low-protein adaptation.
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Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
Description:
Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
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Background: Many health care organizations use social media to support a variety of activities. To ensure continuous improvement in social media performance, health care organizations must measure their social media. Objective: The purpose of this study is to explore how health care organizations approach social media measurement and to elucidate the tools they employ. Methods: In this exploratory qualitative research, Australian health care organizations that use social media, varying in size and locality, were invited to participate in the study. Data were collected through semistructured interviews, and the transcripts were analyzed using thematic analysis. Results: The study identified health care organizations' approaches to social media measurement. While some measured their social media frequently, others used infrequent measurements, and a few did not measure theirs at all. Those that measured their social media used one or a combination of the following yardsticks: personal benchmarking, peer benchmarking, and metric benchmarking. The metrics tracked included one or more of the following: reach, engagement, and conversion rates. The tools employed to measure social media were either inbuilt or add-on analytics tools. Although many participants showed great interest in measuring their social media, they still had some unanswered questions. Conclusions: The lack of a consensus approach to measurement suggests that, unlike other industries, social media measurement in health care settings is at a nascent stage. There is a need to improve knowledge, sophistication, and integration of social media strategy through the application of theoretical and analytical knowledge to help resolve the current challenge of effective social media measurement. This study calls for social media training in health care organizations. Such training must focus on how to use relevant tools and how to measure their use effectively.
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Objectives The aim of this study was to investigate the effects of a 4-wk in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by ultrasound tissue characterization (UTC). Design This was a randomized clinical trial. Volleyball and basketball players (16-31 yrs, n = 29) with clinically diagnosed patellar tendinopathy were randomized to a 4-wk isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-wk UTC scan was used to evaluate change in tendon structure. Results No significant change in tendon structure or dimensions on UTC was detected after the exercise program despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area of aligned fibrillar structure (echo types I + II) (Z = -0.414, P = 0.679) as well as disorganized structure (echo types III + IV) (Z = -0.370, P = 0.711) did not change over the 4-wk exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. Conclusion Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-wk isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement in symptoms. It seems that structural improvements are not required for a positive clinical outcome.
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Background: Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods: We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results: More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions: The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by future studies. Our findings have particular relevance for falls prevention strategies, clinical practice and planning of follow-up services for these patients.
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Background: Community-dwelling older people aged 65+ years sustain falls frequently; these can result in physical injuries necessitating medical attention including emergency department care and hospitalisation. Certain health conditions and impairments have been shown to contribute independently to the risk of falling or experiencing a fall injury, suggesting that individuals with these conditions or impairments should be the focus of falls prevention. Since older people commonly have multiple conditions/impairments, knowledge about which conditions/impairments coexist in at-risk individuals would be valuable in the implementation of a targeted prevention approach. The objective of this study was therefore to examine the prevalence and patterns of comorbidity in this population group. Methods: We analysed hospitalisation data from Victoria, Australia's second most populous state, to estimate the prevalence of comorbidity in patients hospitalised at least once between 2005-6 and 2007-8 for treatment of acute fall-related injuries. In patients with two or more comorbid conditions (multicomorbidity) we used an agglomerative hierarchical clustering method to cluster comorbidity variables and identify constellations of conditions. Results: More than one in four patients had at least one comorbid condition and among patients with comorbidity one in three had multicomorbidity (range 2-7). The prevalence of comorbidity varied by gender, age group, ethnicity and injury type; it was also associated with a significant increase in the average cumulative length of stay per patient. The cluster analysis identified five distinct, biologically plausible clusters of comorbidity: cardiopulmonary/metabolic, neurological, sensory, stroke and cancer. The cardiopulmonary/metabolic cluster was the largest cluster among the clusters identified. Conclusions: The consequences of comorbidity clustering in terms of falls and/or injury outcomes of hospitalised patients should be investigated by future studies. Our findings have particular relevance for falls prevention strategies, clinical practice and planning of follow-up services for these patients.
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Summary Background: Patients with advanced liver disease may develop portal hypertensionthat can result in variceal haemorrhage. Beta-blockers reduce portal pressure andminimise haemorrhage risk. These medications may attenuate measures of car-diopulmonary performance, such as the ventilatory threshold and peak oxygenuptake measured via cardiopulmonary exercise testing. Aim: To determine the effect of beta-blockers on cardiopulmonary exercise testingvariables in patients with advanced liver disease. Methods: This was a cross-sectional analysis of 72 participants who completed acardiopulmonary exercise test before liver transplantation. All participants remainedon their usual beta-blocker dose and timing prior to the test. Variables measuredduring cardiopulmonary exercise testing included the ventilatory threshold, peakoxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and theventilatory equivalents for carbon dioxide slope. Results: Participants taking beta-blockers (n = 28) had a lower ventilatory threshold(P <.01) and peak oxygen uptake (P = .02), compared to participants not takingbeta-blockers. After adjusting for age, the model of end-stage liver-disease score,liver-disease aetiology, presence of refractory ascites and ventilatory thresholdremained significantly lower in the beta-blocker group (P = .04). The oxygen uptakeefficiency slope was not impacted by beta-blocker use. Conclusions: Ventilatory threshold is reduced in patients with advanced liver dis-ease taking beta-blockers compared to those not taking the medication. This mayincorrectly risk stratify patients on beta-blockers and has implications for patientmanagement before and after liver transplantation. The oxygen uptake efficiencyslope was not influenced by beta-blockers and may therefore be a better measureof cardiopulmonary performance in this patient population.
Condom use consistency and associated factors among college student men who have sex with men from seven colleges in Changsha city : a cross-sectional survey
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Ewen et al. recently reported in the journal Hypertension that they investigated, for the first time, the effect of renal denerva tion on blood pressure in 63 patients with isolated systolic hypertension (Ewen et al., 2014). The authors concluded that renal denervation reduced office and ambula- tory blood pressure in patients with iso- lated systolic hypertension (Ewen et al., 2014). However, this conclusion may not be drawn, as renal denervation may not decrease ambulatory blood pressure in these patients. The potential risk of renal denervation may overweigh its benefit in patients with isolated systolic hypertension. Therefore, adjusted drug treatment may be recommended to these patients before renal denervation.
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Ewen et al. recently reported in the journal Hypertension that they investigated, for the first time, the effect of renal denerva tion on blood pressure in 63 patients with isolated systolic hypertension (Ewen et al., 2014). The authors concluded that renal denervation reduced office and ambula- tory blood pressure in patients with iso- lated systolic hypertension (Ewen et al., 2014). However, this conclusion may not be drawn, as renal denervation may not decrease ambulatory blood pressure in these patients. The potential risk of renal denervation may overweigh its benefit in patients with isolated systolic hypertension. Therefore, adjusted drug treatment may be recommended to these patients before renal denervation.