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1.
Charlotte Baker Jill Powell Dominic Le Melissa S. Creary Lori-Ann Daley Mary Anne McDonald Charmaine DM. Royal 《Journal of the National Medical Association》2018,110(6):564-573
Objective
To describe the perspectives and experiences of athletic trainers, coaches, and student-athletes approximately three years post-implementation of the NCAA sickle cell trait (SCT) screening policy.Participants
Two-hundred and eight student-athletes, 32 athletic trainers, and 43 coaches from 10 NCAA Division I (DI) institutions in North Carolina from January to June 2014.Methods
Two online surveys were used to assess knowledge, perspectives, and experiences.Results
Athletic staff were more supportive than student-athletes of the need for the policy. Noted challenges included variation in implementation and follow-up for SCT-positive athletes, financial costs to institutions and athletes, and timing of the screening.Conclusions
More education about SCT is needed for student-athletes and athletic staff in order to help make the implementation more successful. All parties need to be in agreement regarding the importance of knowing which student-athletes have SCT and how that information will be utilized. 相似文献2.
Patrick M. Brunner Donald Y.M. Leung Emma Guttman-Yassky 《Annals of allergy, asthma & immunology》2018,120(1):34-41
Objective
To provide an overview of studies contributing to the understanding of immunologic, microbial, and epithelial interactions in atopic dermatitis.Data Sources
PubMed literature review (2000–2017) and meeting abstracts from recent international dermatology conferences.Study Selections
Articles discussing primarily human disease.Results
Clinical studies showed that atopic dermatitis is a type 2 immune-centered disease with a systemic inflammatory component but with heterogeneous treatment responses. This suggests that other factors are likely involved in shaping the skin disease phenotype, including microbial dysbiosis and epidermal barrier dysfunction.Conclusion
Recent clinical investigation has significantly expanded our knowledge on disease pathogenesis in atopic dermatitis, and current and future clinical trials will most likely further help to elucidate this complex, heterogeneous skin disease. 相似文献3.
Peng Li Miao Ge Congxia Wang Jinwei He Shaofang Yang Jing Jing Dezhi Wei 《Journal of the National Medical Association》2018,110(4):334-342
Objectives
This study aims to explore the spatial characteristics of the alpha-fetoprotein (AFP) reference value in healthy Chinese adults, and its relationship to geographical location.Methods
A total of 9396 AFP reference values were collected from patients in 96 administrative units. A correlation analysis and support vector machine (SVM) were employed to extract dependent geographical factors and predict the reference values in the entire country, respectively. A geostatistics analysis was developed to reveal the spatial characteristics of the value.Results
Under the long-term influence of geographical environment, AFP reference values show spatial autocorrelation and regional variation. The values are higher in western and northern areas than in eastern and southern areas of China.Conclusions
The AFP reference values show regional differences, and this difference should be considered in clinical practice. 相似文献4.
Kamal Shigli Sushma S. Nayak Sivaranjani Gali Banashree Sankeshwari Deepti Fulari K. Shyam Kishore Nagaraja Upadhya P. Vasanti Jirge 《Journal of the National Medical Association》2018,110(5):455-458
Background
Construction of appropriate test items is a challenge in preparing quality multiple choice questions. Item analysis provides valuable feedback data on validity of multiple choice questions. The present study was conducted to evaluate the difficulty index, discrimination index and distracter efficiency of the items present in the multiple choice questions of post graduate dental entrance examinations.Methods
A list consisting of 20 MCQs was taken from the entrance exam books of MCQs on an introductory topic and administered to 104 undergraduate students.Results
In the present study 15% of the MCQs related to impression making procedure were difficult with difficulty index (p) less than 30%, 15% were poor discriminators and 55% had at least one non-functional distracter.Conclusion
Item analysis of MCQs in post graduate entrance examinations demonstrated low difficulty index, discrimination index and distracter efficiency. Hence, we propose a strong need for faculty training in test constructors and their post validation. 相似文献5.
Charles P. Mouton Janet H. Southerland 《Journal of the National Medical Association》2017,109(4):262-271
Background
As with many other populations, abuse of older adults is a growing problem across the Africa Diaspora. Modernization and urbanization are eroding the traditional values of respect for older adults. Also, older adults living in environments with limited social and economic resources, and having no means of economic support create a recipe for elder abuse and neglect.Methods
This article reviews the current literature on the epidemiology, risk factors, and interventions used for elder abuse across the African Diaspora.Results
Reports of elder abuse range from 24.9% to 81.1% across the Diaspora. Risk factors include cognitive and physical impairment, social isolation, lack of resources and widowhood.Conclusion
Community-based programs using the unique social networks of older populations of African descent can provide a venue to improve caregiver training and support, reinforce traditional filial and informal caregiving practices, increase the utilization of available governmental and institutional. 相似文献6.
Kuang-Yao Chen Chuan-Min Yen Kao-Pin Hwang Lian-Chen Wang 《Journal of microbiology, immunology, and infection》2018,51(4):559-564
Background
The prevalence of pinworm infection is extremely low in Taipei, Taiwan. This population study was designed to determine the current status and the associated risk factors of this infection among pre-school children.Methods
Perianal swab specimens were obtained from the parents or guardians using a two-consecutive-day adhesive cellophane perianal swab kit. Information of family background, personal hygiene, and household sanitary conditions were collected by asking the parents or guardians to complete a questionnaire.Results
Of 44,163 children, 0.21% was found to infect with pinworm. The positive rate was highest in Datong (0.59%) and Nangang (0.58%) Districts and lowest in Neihu District (0.02%). There was no significant difference in the rates by gender (boys 0.24% and girls 0.19%) or school (kindergartens 0.25% and nurseries 0.17%). Significantly higher positive rates were found in children having parent with lower educational level and elder brother(s)/sister(s). Children taking bath by themselves and those sleeping in bed with matting had significantly higher positive rates. Five significant independent predictors of pinworm infection were determined by multivariate analysis: having elder brother(s), having elder sister(s), infrequent washing hands after using toilet facilities, bathing without the help of family members, and sleeping on bed with matting.Conclusion
The prevalence of pinworm infection in the pre-school children of Taipei is extremely low and decreasing. Good hand washing habit should be an important preventive measure. Transmission of this infection in pre-school children may occur in the family through their school-age siblings. 相似文献7.
Linda Jones Herbert Priya Mehta Hemant Sharma 《Annals of allergy, asthma & immunology》2017,118(3):345-350
Background
Food allergies are increasingly prevalent in the pediatric population. Balancing allergen avoidance with the promotion of healthy eating behaviors can be challenging for families.Objective
To characterize mealtime behaviors among parents of young children with food allergy.Methods
Seventy-four parents of young children with food allergies (≤7 years of age) completed measures of mealtime behavior, perceptions of food allergy risk and severity, pediatric parenting stress, and food allergy–related quality of life. Mealtime behavior reports were compared with published data regarding typically developing children, young children with type 1 diabetes, and children with diagnosed feeding disorders (with or without related medical factors).Results
Parents of young children with food allergies reported frequent mealtime concerns. Specifically, they reported significantly more mealtime behavioral concerns than typically developing peers, comparable mealtime behavioral concerns to young children with type 1 diabetes, and significantly fewer mealtime behavioral concerns than children with diagnosed feeding disorders. Parental mealtime concerns were positively correlated with other parent perceptions of food allergy, such as risk of allergen exposure, illness-related parenting stress, and food allergy–related quality of life.Conclusion
Young children with food allergy and their parents are more likely to exhibit mealtime behavioral concerns than typically developing peers and their parents. Future research should investigate the effect of food allergies and maladaptive mealtime behaviors on children's nutrition to provide clinical guidelines for parents who may benefit from psychosocial and/or nutritional support. 相似文献8.
Oh Samuel Jacqueise M. Unonu Kierra Dotson Soon Park Richard Parker Anthony K. Wutoh Euni Lee 《Journal of the National Medical Association》2018,110(4):378-383
Background
Human immunodeficiency virus (HIV) infection presents a significant burden, especially in the Washington, DC area. Literature is limited in describing the role of pharmacists in the outpatient clinic setting to provide patient-centered pharmaceutical care for patients with HIV.Objective
Our study aims to describe an interdisciplinary HIV care model including a clinical pharmacist at a community-based transcultural clinic in the Washington, DC area, and to describe the role of the pharmacist as indicated by an association between non-adherence to antiretroviral therapy (ART) and an ART regimen change.Methods
Using the electronic health record at the clinic from May 2011 through July 2013, 53 patients were identified who were referred to the clinical pharmacist.Results
The average age of the patients with HIV was 46.57 years in the clinic. About 28% of patients had documented non-adherence to ART and 30% of patients had one or more ART regimen changes during the study period. Medication non-adherence was a significant predictor of ART regimen change (ORadj 8.44; 95% CI 1.91–37.29). Substance use was a strong predictor of ART regimen change (ORunadj 3.47; 95% CI 1.02–11.81), but the relationship disappeared in the multivariate analysis.Conclusions
A strong association between pharmacist's evaluation of non-adherence to ART and a regimen change was demonstrated and the role of the pharmacist as the interdisciplinary team member was described. A follow-up study should be made to assess the services provided by the pharmacist on clinical, economic, and humanistic outcomes in the community-based clinical setting. 相似文献9.
Tohru Daikoku Mineyuki Mizuguchi Takayuki Obita Takeshi Yokoyama Yoshihiro Yoshida Masaya Takemoto Kimiyasu Shiraki 《Journal of microbiology, immunology, and infection》2018,51(5):581-586
Background
T-705 (favipiravir) is a potent inhibitor of RNA-dependent RNA polymerases of influenza viruses and no favipiravir-resistant virus has been isolated. Poliovirus RNA polymerase has been well characterized and isolation of resistant virus was examined in poliovirus.Methods
Susceptibility variants of poliovirus I (Sabin strain) were isolated during passages in the presence of favipiravir and characterized for their susceptibility and the sequence of RNA polymerase.Results
Five variants with 0.47–1.88 times the 50% inhibitory concentration for plaque formation of the parent poliovirus had amino acid variations in the 3D gene of the RNA polymerase. The distribution of amino acid variations was not related to ribavirin resistance, and two amino acid variation sites were found near the finger domain.Conclusion
Favipiravir as a chain terminator would not be incorporated and replicate to cause lethal mutagenesis as a mutagen like ribavirin, and resistant mutants were not isolated. A high replication level would generate mutations leading to favipiravir resistance as ribavirin resistance was generated, but generated mutations would be lethal to the RNA polymerase function. 相似文献10.
Ilgim Seval Kurt Erden Erol Unluer Togay Evrin Burak Katipoglu Utku Eser 《Journal of the National Medical Association》2018,110(6):579-582
Introduction
Community acquired pneumonia (CAP) is responsible for an important part of treatment costs across the world. Even though posterior-anterior lung radiography (PALG) and direct sputum smear microscopy are required or routine diagnoses. The purpose of this study is to determine the diagnostic value of the bedside urine strip tests in CAP.Methods
Patients who attended the emergency department (ED) between from February 2016 to September 2016 with expectoration complaints and suspicion of pneumonia. The sensitivity, specificity, and accuracy rate of the urine strip tests, direct sputum smear microscopy, and PALG were calculated and analyzed using SPSS 15.0.Results
During the study period, 100 patients with pneumonia suspicion were evaluated in the ED. The sample was divided into two groups: negative and positive diagnosis of CAP. The leukocytes detecting by urine strip tests are statistical differences between the two groups (p: 0.003). The results show that the sensitivity, specificity, and accuracy rate of leukocytes detected in sputum with urine strip tests in the pneumonia diagnosis were 83.3%, 44.2% and 63% respectively.Conclusion
According to the study, it is believed that the method of determination of leukocytes with urine strip tests in sputum combined with more detailed results. They can become part of CAP diagnosis methods. 相似文献11.
Xin Hu Qian Zhang Jia Ning Wenmeng Wu Changyi Li 《Journal of the National Medical Association》2018,110(3):250-255
Introduction
The purpose of this study was to evaluate the two-body wear resistances of natural enamel and four dental materials in vitro.Methods
The testing machine was modified to form a type of pin-on-disk wear test apparatus. Four dental material specimens (Au-Pd alloy, Ag-Pd alloy, FiltekTMP60 and FiltekTMZ350 composite resins) and enamel were used as the pins, and a steatite ceramic grinding wheel was used as the abrasive counter face. The wear volume loss and the rigidity value was measured. The worn surface and the element analysis of the debris were analyzed.Result
The wear volume loss of Au-Pd alloy and its steatite antagonists were the nearest to those of the dental enamel. SEM microphotographs showed that, the main wear mechanism of the dental materials was abrasive and adhesive wear.Conclusions
Au-Pd alloy had good wear resistance and was more suitable for dental applications than other three dental materials. 相似文献12.
Yolanda N. Evans Sarah A. Rafton Eriberto Michel Beth E. Ebel 《Journal of the National Medical Association》2018,110(3):212-218
Objective
To examine associations between self-assessed language ability and provision of clinical care without professional interpretation.Methods
We conducted an anonymous web-based survey of pediatric residents at a large pediatric training program. Respondents self-rated their language ability, and then reported on their willingness to deliver clinical care without professional interpretation in standardized clinical scenarios.Results
All pediatric residents completed the survey (n=81; 100%). Many residents (58 of the total sample) indicated at least rudimentary skills in a second language, and seven (9%) indicated they were proficient in Spanish. Eight-five percent had sometimes relied upon friends or family to communicate with parents. Most (69%) reported occasional use of Spanish-language skills to take a history or provide medical advice without the use of a professional interpreter. In contrast, in clinical scenarios where a child was believed to have a complex medical history, few residents (2.5%) felt comfortable using their language skills in the clinical encounter. Residents were willing to have their language ability assessed.Conclusions
Residents still face circumstances in which care proceeds without an interpreter. Discomfort with providing care in a second language grows with the perceived complexity of care, and yet a complex condition may not be apparent when communication barriers exist. Overcoming barriers to the use of professional interpretation may improve care for LEP children. 相似文献13.
Johanna P.M. van der Valk Irene Berends Roy Gerth van Wijk Nicolette. J.T. Arends Maurits S. van Maaren Hans de Groot Harry J. Wichers Joyce A.M. Emons Anthony E.J. Dubois Nicolette W. de Jong 《Annals of allergy, asthma & immunology》2018,120(3):300-303
Background
Severe allergic reactions, including anaphylaxis, occur during oral food challenges (OFCs) and the first-line treatment of anaphylaxis is epinephrine.Objective
To evaluate the percentage of anaphylactic reactions treated with epinephrine during OFCs and to identify associated factors for the administration of epinephrine.Methods
Children who underwent an OFC with peanut, hazelnut, cow's milk, hen's egg, or cashew nut from 2005 through 2015 in the Netherlands were evaluated. Children with reactions meeting the criteria for anaphylaxis according to the European Academy of Allergy and Clinical Immunology guidelines for food allergy and anaphylaxis were included. Children with an anaphylactic reaction treated with vs without epinephrine were compared. Possible factors associated with the administration of epinephrine, such as age, sex, symptoms consistent with asthma, history of an allergic reaction to the tested allergen, and symptom types during the anaphylactic reaction, were evaluated using logistic regression analysis.Results
Eighty-three children in clinical and research settings (43% boys; median age, 7 years; range, 1–17) who met the criteria for anaphylaxis were included in this study. Thirty-two of 83 children (39%) with anaphylaxis were treated with epinephrine. Respiratory symptoms during the OFC were treated significantly more often with epinephrine than gastrointestinal symptoms (P = .01).Conclusion
Only 39% of children with anaphylaxis, according to the guideline criteria, were treated with epinephrine during the OFC and most of these children had respiratory symptoms. There is need for an easy-to-use international guideline for the treatment of allergic symptoms during OFCs. 相似文献14.
Faith A. Birnbaum 《Journal of the National Medical Association》2018,110(5):473-479
Purpose
The purpose of this review is to describe the demographics (age, gender, race and iris color) of subjects enrolled in clinical trials supportive of approved New Molecular Entities (NMEs) in ophthalmology over the last 10 years (2006–2016).Methods
Publicly available data on Drugs@FDA were reviewed for all 9 approved NMEs, including biologics, from 2006 to 2016.Results
All NMEs have publicly available data on the race, gender and age of clinical trial participants. Women and white subjects comprise a majority of clinical trial participants (68% and 92%, respectively). FDA analyses on all 9 NMEs did not find any differences across age, gender, race, or iris color subgroups. 相似文献15.
Kenneth D. Royal 《Journal of the National Medical Association》2018,110(2):157-162
Background
Social and cultural outcomes are critically important in medical education. A large medical school located in the United States implemented a learning community model intended to promote social and cultural growth among its medical students. The purpose of this study was to evaluate the degree to which medical students from the same peer cohort were socially connected across racial and sex groups.Methods
Because most assessments involving social and cultural outcomes involve self-reported data of a personal nature, the possibility of social desirability bias is increased. To mitigate this threat, this study utilized a novel method for measuring medical students social connectedness by having peers in one's advisory college provide social connectedness ratings about one another.Results
While surface level results did not reveal any significant differences, a closer inspection of data revealed Black females were less socially connected with medical student peers from their cohort than other peer groups.Discussion
Possible explanations for this are discussed. Future research should continue to investigate the experiences of Black females in medical schools so as to better understand the needs of this important and valuable subpopulation of students. 相似文献16.
17.
Background
The reported associations of blood lipid profiles with asthma are ambiguous.Objective
To explore the association between asthma and the serum levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).Methods
A systematic search was performed in the PubMed, MEDLINE, Cochrane Library, and Chinese Biomedical Literature databases. Ten studies were identified. We divided these studies into 2 subgroups according to age: children (<18 years old) and adults (≥18 years old).Results
In children, the asthma group had lower HDL-C levels (weighted mean difference, ?3.44; 95% confidence interval [CI], ?5.83 to ?1.04; P = .005) compared with the nonasthma group, whereas the serum levels of LDL-C in these 2 groups were not statistically different. In contrary, in adults, the asthma group had higher LDL-C levels (weighted mean difference, 8.95; 95% confidence interval, 3.55–14.35; P = .001) compared with the nonasthma group, whereas the HDL-C levels were not statistically different.Conclusion
There is a significant association between asthma and the serum levels of HDL-C and LDL-C. Moreover, this association differs in children and adults. 相似文献18.
Eun Lee Si Hyeon Lee Young-Ho Kim Hyun-Ju Cho Jisun Yoon Song-I. Yang Young-Ho Jung Hyung Young Kim Ju-Hee Seo Ji-Won Kwon Hyo-Bin Kim So Yeon Lee Ho-Jang Kwon Soo-Jong Hong 《Annals of allergy, asthma & immunology》2017,118(5):542-550.e1
Background
Although previous studies have investigated the association between atopy phenotypes and allergic diseases, atopy characterizations in association with the development of allergic diseases remain poorly understood.Objective
To identify atopy phenotypes in school-age children and to evaluate the association between atopy phenotypes and allergic diseases.Methods
We enrolled 616 children with atopy defined as 1 or more positive allergen responses on skin prick tests and 665 children without atopy from the Children's Health and Environmental Research (CHEER) study. All children were followed up for 4 years at 2-year intervals. Atopy phenotypes were classified using latent class analysis.Results
Four atopy phenotypes were characterized: later sensitization to indoor allergens (cluster 1); multiple early sensitization (cluster 2); early sensitization to outdoor allergens, especially Alternaria, and later sensitization to indoor allergens, including Aspergillus (cluster 3); and early sensitization to indoor allergens and later sensitization to outdoor allergens (cluster 4). New cases of asthma during follow-up were increased in clusters 2 and 3 (adjusted odds ratio [aOR], 2.76 and 4.25, respectively). The risk of new-onset bronchial hyperresponsiveness was highest in cluster 3 (aOR, 5.03). Clusters 2 and 4 had an increased risk of allergic rhinitis (aOR, 7.21 and 2.37, respectively).Conclusion
Identification of atopy phenotypes facilitates prediction of the development of asthma and bronchial hyperresponsiveness in school-age children. Our study suggests prevention of additional sensitization is required to modify the progression of allergic diseases. 相似文献19.
Steven S. Coughlin Lovoria B. Williams Gina M. Besenyi Lorraine W. Jackson Judith Anglin 《Journal of the National Medical Association》2018,110(4):391-395
Background
Few studies have examined health behavior interventions for African American women who are uterine cancer survivors. Black-white differences in uterine cancer survival suggest that there are unmet needs among these survivors.Methods
This article identifies opportunities to address disparities in uterine corpus cancer survival and quality of life, and thereby to increase uterine cancer survivorship among African American women.Results
For cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, lymphedema, and difficulty sleeping. A variety of interventions have been evaluated to address physical and mental health concerns, including exercise and dietary interventions. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among cancer survivors, but few studies have focused specifically on African American women with a uterine corpus cancer diagnosis. Research-tested culturally tailored lifestyle interventions are lacking.Conclusions
There is a need for a better understanding of uterine cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American uterine cancer survivors are needed. 相似文献20.
Chih-Yu Chi Li-Na Liao Cheng-Mao Ho Chia-Huei Chou Mao-Wang Ho Jen-Hsein Wang 《Journal of microbiology, immunology, and infection》2018,51(4):527-534