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41.
Shannon Mendez Jamie Kubota Adrianne M. Widaman John Gieng 《Journal of nutrition education and behavior》2021,53(7):608-613
ObjectiveTo evaluate the effects of a group-based Advance Quantity Meal Preparation (AQMP) program on the consumption of home-cooked meals, cooking attitudes, and self-efficacy in healthy adults.MethodsParticipants (n = 10) in a group setting prepared healthy meals weekly consisting of 10 entrees and 5 snacks for 6 weeks. A survey assessing cooking attitudes, cooking self-efficacy, and cooking behavior and consumption at 3 time points: preprogram, postprogram (T2), and 3 months postprogram (T3).ResultsThe AQMP program increased the proportion of overall home-cooked meal consumption (T2, P = 0.03), home-cooked dinner consumption (T2, P = 0.04), cooking attitudes (T3, P = 0.01), and cooking self-efficacy (T2, P = 0.002).Conclusions and ImplicationsThis pilot study indicates that AQMP may increase home-cooked meal consumption, cooking attitudes, and cooking self-efficacy. 相似文献
42.
Surgeons are privileged to offer treatments that often cure disease. Optimizing comfort for those who cannot be cured is also a core part of every clinician's duty: surveys repeatedly tell us that when death is approaching, people value quality of life above length of survival. Recognizing when someone is dying can be difficult. Tools exist to help; it is worth noting that emergency presentation with life-threatening symptoms can be a marker of poor prognosis. Clear, effective communication is crucial: understanding the patient's perspective and expectations is vital before attempting to offer information that allows future care planning. Judicious use of surgery combined with careful prescribing will optimize comfort, allowing the patient to live as well as possible for as long as possible. Anticipatory prescribing includes opioid, anti-emetic, anti-secretory and sedative medication. Attention should also be given to care of the bereaved. Generalists should understand when to refer to specialist palliative care and remember that reflecting on care when someone has died can be beneficial for professional wellbeing. 相似文献
43.
Ana I. Ribau Jamie E. Collins Antonia F. Chen Ricardo J. Sousa 《The Journal of arthroplasty》2021,36(2):752-766.e6
BackgroundStaphylococcus aureus is a major pathogen implicated in orthopedic infections worldwide. Preoperative decolonization has been promoted but different strategies present mixed results. Thus, the goals of this study are to determine (1) whether S aureus screening and/or decolonization is effective at reducing surgical site infection in orthopedic surgery, (2) with a special focus on elective total joint arthroplasty (TJA), and (3) which preoperative S aureus screening/treatment strategy is most cost-effective for TJA.MethodsPubMed, Ovid MEDLINE, and Cochrane databases were searched on January 1, 2020, using a systematic strategy. We included papers with data comparing surgical site infection and periprosthetic joint infection rate in orthopedic surgery and/or elective total hip and knee arthroplasty patients before/after S aureus screening and/or decolonization protocol and papers evaluating the cost-effectiveness of different S aureus screening/treatment strategies.ResultsA total of 1260 papers were screened, and 32 papers were ultimately included. Results showed an increased risk of developing any infection (relative risk [RR] = 1.71 ± 0.16) and S aureus infection (RR = 2.79 ± 0.45) after orthopedic surgery without previous nares and whole-body decolonization. Focusing exclusively on elective TJA, there was an increased risk of developing any infection (RR = 1.70 ± 0.17) and S aureus infection (RR = 2.18 ± 0.41) if no decolonization is performed. All strategies appeared to be cost-effective, although universal decolonization without screening seemed to be the most advantageous.ConclusionPreoperative S aureus screening/decolonization protocol lowered the risk of infection after elective orthopedic and TJA surgeries. However, further studies are needed to determine optimal clinical and cost-effective methodologies. 相似文献
44.
Raoud Marayati Laura V. Bownes Colin H. Quinn Nikita Wadhwani Adele P. Williams Hooper R. Markert Venkatram Atigadda Jamie M. Aye Jerry E. Stewart Karina J. Yoon Elizabeth A. Beierle 《Journal of pediatric surgery》2021,56(6):1165-1173
IntroductionThe poor therapeutic efficacy seen with current treatments for neuroblastoma may be attributed to stem cell-like cancer cells (SCLCCs), a subpopulation of cancer cells associated with poor prognosis and disease recurrence. Retinoic acid (RA) is a differentiating agent used as maintenance therapy for high-risk neuroblastoma but nearly half of children treated with RA relapse. We hypothesized that 6-Methyl-UAB30 (6-Me), a second-generation rexinoid recently developed with a favorable toxicity profile compared to RA, would reduce cancer cell stemness in human neuroblastoma patient-derived xenografts (PDXs).MethodsCells from three neuroblastoma PDXs were treated with 6-Me and proliferation, viability, motility, and cell-cycle progression were assessed. CD133 expression, sphere formation, and mRNA abundance of stemness and differentiation markers were evaluated using flow cytometry, in vitro extreme limiting dilution analysis, and real-time PCR, respectively.ResultsTreatment with 6-Me decreased proliferation, viability, and motility, and induced cell-cycle arrest and differentiation in all three neuroblastoma PDXs. In addition, 6-Me treatment led to decreased CD133 expression, decreased sphere-forming ability, and decreased mRNA abundance of Oct4, Nanog, and Sox2, indicating decreased cancer cell stemness.Conclusions6-Me decreased oncogenicity and reduced cancer cell stemness of neuroblastoma PDXs, warranting further exploration of 6-Me as potential novel therapy for neuroblastoma. 相似文献
45.
Ryan Schutt Jamie Case Sunil M. Kurian Samantha R. Spierling Bagsic Bethany L. Barrick Alice E. Toll Qiuheng Zhang Elaine F. Reed Michael M. Quigley Randolph Schaffer Jonathan S. Fisher James C. Rice Christopher L. Marsh 《Transplantation proceedings》2021,53(3):950-961
Although interest in the role of donor-specific antibodies (DSAs) in kidney transplant rejection, graft survival, and histopathological outcomes is increasing, their impact on steroid avoidance or minimization in renal transplant populations is poorly understood. Primary outcomes of graft survival, rejection, and histopathological findings were assessed in 188 patients who received transplants between 2012 and 2015 at the Scripps Center for Organ Transplantation, which follows a steroid avoidance protocol. Analyses were performed using data from the United Network for Organ Sharing. Cohorts included kidney transplant recipients with de novo DSAs (dnDSAs; n = 27), preformed DSAs (pfDSAs; n = 15), and no DSAs (nDSAs; n = 146). Median time to dnDSA development (classes I and II) was shorter (102 days) than in previous studies. Rejection of any type was associated with DSAs to class I HLA (P < .05) and class II HLA (P < .01) but not with graft loss. Although mean fluorescence intensity (MFI) independently showed no association with rejection, an MFI >5000 showed a trend toward more antibody-mediated rejection (P < .06), though graft loss was not independently associated. Banff chronic allograft nephropathy scores and a modified chronic injury score were increased in the dnDSA cohort at 6 months, but not at 2 years (P < .001 and P < .08, respectively). Our data suggest that dnDSAs and pfDSAs impact short-term rejection rates but do not negatively impact graft survival or histopathological outcomes at 2 years. Periodic protocol post-transplant DSA monitoring may preemptively identify patients who develop dnDSAs who are at a higher risk for rejection. 相似文献
46.
47.
D. Scott Kreiner Paul Matz Christopher M. Bono Charles H. Cho John E. Easa Gary Ghiselli Zoher Ghogawala Charles A. Reitman Daniel K. Resnick William C. Watters Thiru M. Annaswamy Jamie Baisden Walter S. Bartynski Shay Bess Randall P. Brewer R. Carter Cassidy David S. Cheng Sean D. Christie Amy M. Yahiro 《The spine journal》2021,21(4):726-727
48.
Kristina H. Lewis Katherine Callaway Stephanie Argetsinger Jamie Wallace David E. Arterburn Fang Zhang Adolfo Fernandez Dennis Ross-Degnan Justin B. Dimick J. Frank Wharam 《Surgery for obesity and related diseases》2021,17(1):72-80
BackgroundHiatal hernias are often repaired concurrently with bariatric surgery to reduce risk of gastroesophageal reflux disease–related complications.ObjectivesTo examine the association between concurrent hiatal hernia repair (HHR) and bariatric outcomes.SettingA 2010–2017 U.S. commercial insurance claims data set.MethodsWe conducted a retrospective cohort study. We identified adults who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) alone or had bariatric surgery concurrently with HHR. We matched patients with and without HHR and followed patients up to 3 years for incident abdominal operative interventions, bariatric revisions/conversions, and endoscopy. Time to first event for each outcome was compared using multivariable Cox proportional hazards modeling.ResultsWe matched 1546 SG patients with HHR to 3170 SG patients without HHR, and we matched 457 RYGB patients with HHR to 1156 RYGB patients without HHR. A total of 73% had a full year of postoperative enrollment. Patients who underwent concurrent SG and HHR were more likely to have additional abdominal operations (adjusted hazard ratio [aHR], 2.1; 95% CI, 1.5–3.1) and endoscopies (aHR, 1.5; 95% CI, 1.2–1.8) but not bariatric revisions/conversions (aHR, 1.7; 95% CI, .6–4.6) by 1 year after surgery, a pattern maintained at 3 years of follow-up. Among RYGB patients, concurrent HHR was associated only with an increased risk of endoscopy (aHR, 1.4; 95% CI, 1.1–1.8)) at 1 year of follow-up, persisting at 3 years.ConclusionsConcurrent SG/HHR was associated with increased risk of some subsequent operative and nonoperative interventions, a pattern that was not consistently observed for RYGB. Additional studies could examine whether changes to concurrent HHR technique could reduce risk. 相似文献
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50.
Gina Martin Drew D. Bowman Megan Graat Andrew F. Clark Alexander J. Wray Zoe Askwith Jamie A. Seabrook Jason A. Gilliland 《Canadian journal of public health. Revue canadienne de santé publique》2021,112(3):440
ObjectivesOn January 1, 2020, the Government of Ontario passed a regulation banning vaping advertisements by retailers, apart from specialty shops. A motivation for this ban was to limit youth exposure to vaping advertisements. The primary goal of this research was to evaluate the impact of this ban on the number and density of vaping advertisements surrounding secondary schools. Additionally, we examined whether the number of vaping advertisements varied by school socio-demographic characteristics.MethodsThis study used a pre-post design. Audits were conducted December 2019 (pre-ban) and again January to February 2020 (post-ban), to identify vaping advertisements within 800 m surrounding secondary schools (n = 18) in London, Ontario.ResultsPrior to the ban, there were 266 vaping advertisements within 800 m of secondary schools. After the ban, this was reduced to 58, a 78.2% reduction. The mean number of vaping advertisements surrounding schools significantly decreased from 18.1 before the ban to 3.6 after the ban (p < 0.001). A significant positive correlation was found, prior to the ban, between the number of vaping advertisements surrounding schools and school-level residential instability (r = 0.42, p = 0.02). After the ban, no significant correlations were found between the number of vaping advertisements and school socio-demographic characteristics.ConclusionThe provincial ban of vaping advertisements in select retail settings significantly reduced the number of vaping advertisements in the areas surrounding secondary schools in London, Ontario. The ban also reduced socio-demographic inequities in youths’ potential exposure to marketing of vaping products. Continued monitoring of the geographic accessibility and promotion of vaping products is warranted. 相似文献