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661.
Suryavanshi N Erande A Pisal H Shankar AV Bhosale RA Bollinger RC Phadke M Sastry J 《AIDS care》2008,20(9):1111-1118
HIV-positive women of reproductive age face challenges in decision making related to pregnancy. Understanding factors influencing repeat pregnancies in women with known HIV status are necessary to guide interventions and counseling strategies to better inform and support them. We compared three groups of women attending a large antenatal clinic in Pune, India. They include: Group A--63 HIV-positive women coming for care for a repeat pregnancy after being diagnosed in a previous pregnancy; Group B--64 HIV-negative (repeat) pregnant women attending this antenatal clinic; and Group C--63 HIV-positive non-pregnant women currently enrolled in an ongoing clinical trial. Comparisons of Group A and B indicate that the likelihood of unplanned repeat pregnancies was significantly higher in HIV-positive (70%) than HIV-negative (36%) women (OR=4.1, CI: 2.0-8.7). Inability to terminate the pregnancy (31%) and familial obligations (40%) appear to be important for continuing the unplanned repeat pregnancy. Despite high reported contraceptive use by HIV-positive women, pregnancies still occurred. Death of their youngest child is an important factor as 21% of HIV-positive pregnant women lost their youngest child compared with 3% of HIV-negative women and 3% of HIV-positive non-pregnant women (p<0.001). Repeat pregnancies were more likely to occur for women who did not disclose their HIV status to their spouse. Thus the majority of the repeat pregnancies for HIV-positive women were both unplanned and unwanted. 相似文献
662.
J. Daryl Thornton Catherine Sullivan Jeffrey M. Albert Maria Cedeño Bridget Patrick Julie Pencak Kristine A. Wong Margaret D. Allen Linda Kimble Heather Mekesa Gordon Bowen Ashwini R. Sehgal 《Journal of general internal medicine》2016,31(8):832-839
BACKGROUND
Low organ donation rates remain a major barrier to organ transplantation.OBJECTIVE
We aimed to determine the effect of a video and patient cueing on organ donation consent among patients meeting with their primary care provider.DESIGN
This was a randomized controlled trial between February 2013 and May 2014.SETTING
The waiting rooms of 18 primary care clinics of a medical system in Cuyahoga County, Ohio.PATIENTS
The study included 915 patients over 15.5 years of age who had not previously consented to organ donation.INTERVENTIONS
Just prior to their clinical encounter, intervention patients (n?=?456) watched a 5-minute organ donation video on iPads and then choose a question regarding organ donation to ask their provider. Control patients (n?=?459) visited their provider per usual routine.MAIN MEASURES
The primary outcome was the proportion of patients who consented for organ donation. Secondary outcomes included the proportion of patients who discussed organ donation with their provider and the proportion who were satisfied with the time spent with their provider during the clinical encounter.KEY RESULTS
Intervention patients were more likely than control patients to consent to donate organs (22 % vs. 15 %, OR 1.50, 95%CI 1.10–2.13). Intervention patients were also more likely to have donation discussions with their provider (77 % vs. 18 %, OR 15.1, 95%CI 11.1–20.6). Intervention and control patients were similarly satisfied with the time they spent with their provider (83 % vs. 86 %, OR 0.87, 95%CI 0.61–1.25).LIMITATION
How the observed increases in organ donation consent might translate into a greater organ supply is unclear.CONCLUSION
Watching a brief video regarding organ donation and being cued to ask a primary care provider a question about donation resulted in more organ donation discussions and an increase in organ donation consent. Satisfaction with the time spent during the clinical encounter was not affected.TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT01697137663.
Darpan Bhargava Rajkumar Ahirwal Nupur Chakravorty Ashwini Deshpande 《Journal of maxillofacial and oral surgery》2015,14(1):13-16
Purpose
It remains vital for the trauma management team including the anaesthetist and the operating surgeon to assess and evaluate the anticipated difficulty in intubation to secure airway and for administration of anaesthesia. This study assesses the difficulty in intubating patients with vertically unstable mandibular parasymphysis fracture with attached genial tubercles and associated musculature to the fractured segment.Methods
Randomized sampling was done from the cases with maxillofacial trauma planned for a surgical procedure under general anaesthesia. The inclusion criteria was to prospectively identify ten patients each of unilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment, with bilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment and with unilateral favourable mandibular parasymphysis fracture with genial tubercle attached to the un-displaced segment. All the patients were intubated by a single anaesthetist, who documented the difficulty in nasoendotracheal intubation using Intubation Difficulty Scale.Results
Nasoendotracheal intubation was found relatively easy in the study group with unilateral favourable mandibular parasymphysis fracture with genial tubercle attached to the un-displaced segment. Clinical difficulty in intubating the patients was maximum in the study group with bilateral unfavourable mandibular parasymphysis fracture with genial tubercle attached to the displaced segment.Conclusion
Displacement of fractured mandible and resultant displacement of the genial musculature should be considered as a vital parameter for assessing difficulty during intubation. 相似文献664.
665.
Pauli TW Gangaputra S Hubbard LD Thayer DW Chandler CS Peng Q Narkar A Ferrier NJ Danis RP 《Investigative ophthalmology & visual science》2012,53(9):5117-5123
Purpose. Changes in retinal vascular caliber measured from digital color fundus photographs have been independently associated with systemic outcomes in epidemiologic studies, but the effect of image resolution and compression on vascular measurements has not been previously evaluated. Methods. To explore image compression, 40 natively digital fundus images were selected with good photo quality, high spatial resolution, and no previous image compression. Using Adobe Photoshop, these images were compressed at progressively higher levels up to 147:1, and then retinal vascular caliber was measured at each level using semiautomated software. To examine resolution, 40 fundus photographs acquired on high-resolution film were scanned with settings corresponding to 10, 7, 5, 3, and 1 megapixel fundus cameras. After adjusting for scale factor, vascular caliber was measured at each level of resolution. Data were analyzed by comparing the calculated central retinal arteriole equivalent (CRAE) and the central retinal venular equivalent (CRVE) of the original and altered images, using repeated measures ANOVA. Results. CRAE became significantly wider with increasing levels of compression at the 25:1 threshold (~1 μm wider, P < 0.001) and was ~5 μm wider with 147:1 compression. CRVE also increased, but less than CRAE. Using 7 (megapixel)-MP resolution as the standard, CRVE was significantly narrower at the 5-MP simulation (~2 μm, P < 0.001) and was ~12 μm narrower at the 1-MP simulation. CRAE also decreased, but less than CRVE. Conclusions. Increasing digital image file compression and decreasing fundus image spatial resolution led to skewed measurements of the retinal vascular caliber. 相似文献
666.
Pande A Krishnamoorthy G Moulick ND 《International journal of food sciences and nutrition》2012,63(6):649-658
This prospective study reports significant hypoglycaemic and hypolipidaemic effects in type 2 diabetic subjects who were provided the complete diet plan to be on low glycaemic index (GI) and low-medium glycaemic load (GL) Indian vegetarian snacks and mixed meals for 4 continuous weeks. Five millilitres of fasting blood sample drawn at weekly intervals for 4 weeks were analysed for blood glucose, HbA1c and lipid profile. Four weeks later mean blood glucose level of 173.6?mg% decreased to 137.8?mg%, HbA1c of 8% also decreased to 7.1% which reflected the blood glucose level during the study period and hence correlated well with the fall in blood glucose level. Triglyceride level of 244.5?mg% decreased to 164.7?mg% (p?0.0001) and total cholesterol of 173.5?mg% decreased to 134.6?mg% (p?0.0001). High-density lipoprotein cholesterol of 33?mg% increased to 39.8?mg% (p?0.003), very low density lipoprotein (VLDL) cholesterol of 48.9?mg% decreased to 32.9?mg% (p?0.0001) and low-density lipoprotein cholesterol of 90.1?mg% decreased to 64.3 (p?0.009). This significant outcome can be improved further if compliance to low GI and low-to-medium GL diet is continued. This may achieve desired glycaemic control and that's limit oxidative stress. 相似文献
667.
Katrice D. Cain Jacqueline R. Theurer Ashwini R. Sehgal 《CTS Clinical and Translational Science》2014,7(2):141-144
Objectives
To determine how grant funds are shared between academic institutions and community partners in community‐based participatory research (CBPR).Methods
Review of all 62 investigator‐initiated R01 CBPR grants funded by the National Institutes of Health from January 2005 to August 2012. Using prespecified criteria, two reviewers independently categorized each budget item as being for an academic institution or a community partner. A third reviewer helped resolve any discrepancies.Results
Among 49 evaluable grants, 68% of all grant funds were for academic institutions and 30% were for community partners. For 2% of funds, it was unclear whether they were for academic institutions or for community partners. Community partners’ share of funds was highest in the categories of other direct costs (62%) and other personnel (48%) and lowest in the categories of equipment (1%) and indirect costs (7%).Conclusions
A majority of CBPR grant funds are allocated to academic institutions. In order to enhance the share that community partners receive, funders may wish to specify a minimum proportion of grant funds that should be allocated to community partners in CBPR projects. 相似文献668.
Mary C. White ScD Ashwini Soman MBBS MPH Clarice R. Weinberg PhD Juan L. Rodriguez MPH MS Susan A. Sabatino MD MPH Lucy A. Peipins PhD Lisa DeRoo PhD Hazel B. Nichols PhD M. Elizabeth Hodgson PhD MSPH Dale P. Sandler PhD 《The breast journal》2018,24(5):764-771
Although annual breast magnetic resonance imaging (MRI) is recommended for women at high risk for breast cancer as an adjunct to screening mammography, breast MRI use remains low. We examined factors associated with breast MRI use in a cohort of women with a family history of breast cancer but no personal cancer history. Study participants came from the Sister Study cohort, a nationwide, prospective study of women with at least 1 sister who had been diagnosed with breast cancer but who themselves had not ever had breast cancer (n = 17 894). Participants were surveyed on breast cancer beliefs, cancer worry, breast MRI use, provider communication, and genetic counseling and testing. Logistic regression was used to assess factors associated with having a breast MRI overall and for those at high risk. Breast MRI was reported by 16.1% and was more common among younger women and those with higher incomes. After adjustment for demographics, ever use of breast MRI was associated with actual and perceived risk. Odds ratios (OR) were 12.29 (95% CI, 8.85‐17.06), 2.48 (95% CI, 2.27‐2.71), and 2.50 (95% CI, 2.09‐2.99) for positive BRCA1/2 test, lifetime breast cancer risk ≥ 20%, and being told by a health care provider of higher risk, respectively. Women who believed they had much higher risk than others or had higher level of worry were twice as likely to have had breast MRI; OR = 2.23 (95% CI, 1.82‐2.75) and OR = 1.76 (95% CI, 1.52‐2.04). Patterns were similar among women at high risk. Breast cancer risk, provider communication, and personal beliefs were determinants of breast MRI use. To support shared decisions about the use of breast MRI, women could benefit from improved understanding of the chances of getting breast cancer and increased quality of provider communications. 相似文献
669.
670.
Anat Mirelman PhD Hagar Bernad‐Elazari BSc Avner Thaler MD PhD Eytan Giladi‐Yacobi MD Tanya Gurevich MD Mali Gana‐Weisz PhD Rachel Saunders‐Pullman MD Deborah Raymond MSc Nancy Doan MD Susan B. Bressman MD Karen S. Marder MD Roy N. Alcalay MD Ashwini K. Rao PhD Daniela Berg MD Kathrin Brockmann MD Jan Aasly MD Bjørg Johanne Waro MD Eduardo Tolosa MD Dolores Vilas MD Claustre Pont‐Sunyer MD Avi Orr‐Urtreger MD PhD Jeffrey M. Hausdorff PhD Nir Giladi MD 《Movement disorders》2016,31(10):1527-1534