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Find video protocols related to scientific articles indexed in Pubmed.
Evaluation of an online program to teach microbiology to internal medicine residents.
J. Clin. Microbiol.
PUBLISHED: 11-14-2014
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Background: Microbiology rounds are an integral part of infectious disease consultation service. During microbiology rounds we highlight microbiology principles using vignettes. We created case-based, interactive, microbiology online modules similar to the vignettes presented during microbiology rounds since internal medicine residents rotating on our infectious disease elective have limited time to participate in rounds and learn microbiology. Objective: Evaluate the use of the microbiology online modules by internal medicine residents. Design: We asked residents to complete 10 of 25 online modules during their infectious disease elective. We evaluated which modules they chose and the change in their knowledge level. Results: Forty-six internal medicine residents completed assessments given before and after accessing the modules with an average of 11/20 (range 6-19) and 16/20 (range 9-20) correct questions, respectively (average improvement 5; p=0.0001). The modules accessed by more than 30 residents included those related to Clostridium difficile, anaerobes, Candida spp., Streptococcus pneumoniae, influenza, Mycobacterium tuberculosis, and Neisseria meningitidis. Summary: We demonstrated improved microbiology knowledge after completion of the online modules. This improvement may not be solely attributed to completing the online modules as fellows and faculty may have provided additional microbiology education during the rotation.
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Tracheal palpation to assess endotracheal tube depth: an exploratory study.
Can J Anaesth
PUBLISHED: 11-05-2014
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Correct placement of the endotracheal tube (ETT) occurs when the distal tip is in mid-trachea. This study compares two techniques used to place the ETT at the correct depth during intubation: tracheal palpation vs placement at a fixed depth at the patient's teeth.
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Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations.
Health Educ Res
PUBLISHED: 11-02-2014
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In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC.
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Multidisciplinary handoffs improve perceptions of communication.
Hosp Pediatr
PUBLISHED: 10-16-2014
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Communication errors during handoffs are a leading cause of sentinel events. The Accreditation Council for Graduate Medical Education 2011 duty hour standards (DHS) increase the frequency of handoffs.
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Bupropion, smoking cessation, and health-related quality of life following an acute myocardial infarction.
J Popul Ther Clin Pharmacol
PUBLISHED: 10-08-2014
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BackgroundThe use of bupropion, a smoking cessation aid, has been associated with improved health-related quality of life (HRQOL) in the general population of smokers; but, its effect on HRQOL in post-myocardial infarction (MI) patients remains unknown.  ObjectivesTo examine the effect of bupropion on HRQOL in post-MI patients who are attempting to quit smoking. MethodsTo accomplish this objective, we used data from a randomized, double-blind, placebo-controlled trial in 392 hospitalized post-MI patients. Treatment duration was 9 weeks, and follow-up was 12 months. HRQOL was assessed via the EuroQol-5D (EQ-5D) questionnaire, which includes 5 dimensions (mobility, self-care, daily activities, pain/discomfort, and anxiety/depression). Analyses were restricted to patients (n=225) who completed the EQ-5D at baseline, 6 months, and 12 months.  ResultsPatients randomized to bupropion (n=109) and those randomized to placebo (n=116) experienced similar improvements in HRQOL during follow-up (difference in change in EQ-5D index from baseline to 6 months = 0.02, 95% confidence interval [CI] = -0.04, 0.08; from baseline to 12 months = 0.02, 95% CI = -0.04, 0.08). No between-group differences were observed in any of the 5 dimensions. Similar improvements in HRQOL were observed between patients who remained abstinent and those who relapsed. Lower baseline HRQOL, defined as having a HRQOL that was less than the median value, was associated with decreased smoking abstinence at 12 months follow-up (odds ratio ?OR? =0.39, 95% CI = 0.22, 0.68).   ConclusionsBupropion does not improve HRQOL among patients attempting to quit smoking post-MI. 
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Brain derived Neurotropic Factor (BDNF) is associated with childhood abuse but not cognitive domains in first episode psychosis.
Schizophr. Res.
PUBLISHED: 09-22-2014
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The Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome.
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Addressing perinatal depression in a group of underserved urban women: a focus group study.
BMC Pregnancy Childbirth
PUBLISHED: 09-18-2014
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Perinatal mental health problems are common complications of pregnancy that can go undetected and untreated. Research indicated that mental health complications are more prevalent in women from disadvantaged communities, yet women from these communities often experience barriers to accessing treatments and interventions. Untreated depression during pregnancy can lead to poor self-care, increased substance abuse, poor obstetrical outcomes, developmental delay in children, and increased risk of postpartum depression. In this study we investigated the perceived perinatal mental health needs of our participants and they wanted to address their perceived needs.
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Prevalence of obesity, overweight and thinness in Australian children and adolescents by socioeconomic status and ethnic/cultural group in 2006 and 2012.
Int J Public Health
PUBLISHED: 09-05-2014
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To study the prevalence of obesity, overweight and thinness, by sex, SES and ethnic background in 2006 and 2012.
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The Association Between Exergaming and Physical Activity in Young Adults.
J Phys Act Health
PUBLISHED: 08-15-2014
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Compared to traditional non-active video games, exergaming contributes significantly to overall daily physical activity (PA) in experimental studies but the association in observational studies is not clear.
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Perceived parental social support and moderate-to-vigorous physical activity in children at risk of obesity.
Res Q Exerc Sport
PUBLISHED: 08-08-2014
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Identification of factors that relate to physical activity behavior in children at higher risk for weight problems--namely, children with obese parents--is key to informing the development of effective interventions to promote physical activity and reduce obesity. The purpose of our study was to examine children's perceptions of parental social support for physical activity and the associations between these perceptions and health-enhancing physical activity behavior. Our specific objectives were to: (a) compare perceptions of parental support in children across gender and weight status; (b) compare perceptions of support across source (mother, father) and type (tangible, intangible) in normal-weight and overweight girls and boys; and (c) examine the associations between perceptions of parental support and moderate-to-vigorous physical activity (MVPA) behavior.
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Association Between Childhood Sleep-Disordered Breathing and Disruptive Behavior Disorders in Childhood and Adolescence.
Behav Sleep Med
PUBLISHED: 08-07-2014
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We examined the association between sleep-disordered breathing (SDB) and disruptive behavior disorders in 605 children participating in a population-based cohort study. Nineteen percent of children snored (sometimes or often) and 10% had obstructive sleep apnea (OSA) symptoms. Thirteen percent had an ADHD diagnosis or symptoms and 5-9% had behavioral problems or a conduct disorder. Snoring or OSA symptoms were associated with a twofold difference in the odds of ADHD diagnosis or symptoms. OSA symptoms were associated with a threefold to fourfold difference in the odds of behavioral problems or conduct disorder. Clinicians should consider inquiring about SDB in children with disruptive behavior disorders and should also consider disruptive behavior disorders as potential sequelae of SDB.
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Recalled first reactions to inhaling nicotine predict the level of physical dependence.
Drug Alcohol Depend
PUBLISHED: 07-29-2014
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The level of physical dependence is a measure of addiction that correlates highly with addiction-associated changes in brain structure. We sought to determine whether age at first inhalation and initial reactions to inhaling nicotine are related to level of physical dependence in early adulthood.
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Cohort Profile: The Nicotine Dependence in Teens (NDIT) Study.
Int J Epidemiol
PUBLISHED: 07-16-2014
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The Nicotine Dependence in Teens (NDIT) study is a prospective cohort investigation of 1294 students recruited in 1999-2000 from all grade 7 classes in a convenience sample of 10 high schools in Montreal, Canada. Its primary objectives were to study the natural course and determinants of cigarette smoking and nicotine dependence in novice smokers. The main source of data was self-report questionnaires administered in class at school every 3 months from grade 7 to grade 11 (1999-2005), for a total of 20 survey cycles during high school education. Questionnaires were also completed after graduation from high school in 2007-08 and 2011-12 (survey cycles 21 and 22, respectively) when participants were aged 20 and 24 years on average, respectively. In addition to its primary objectives, NDIT has embedded studies on obesity, blood pressure, physical activity, team sports, sedentary behaviour, diet, genetics, alcohol use, use of illicit drugs, second-hand smoke, gambling, sleep and mental health. Results to date are described in 58 publications, 20 manuscripts in preparation, 13 MSc and PhD theses and 111 conference presentations. Access to NDIT data is open to university-appointed or affiliated investigators and to masters, doctoral and postdoctoral students, through their primary supervisor (www.nditstudy.ca).
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Cochlin in Normal Middle Ear and Abnormal Middle Ear Deposits in DFNA9 and Coch (G88E/G88E) Mice.
J. Assoc. Res. Otolaryngol.
PUBLISHED: 07-01-2014
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DFNA9 sensorineural hearing loss and vestibular disorder, caused by mutations in COCH, has a unique identifying histopathology including prominent acellular deposits in cochlear and vestibular labyrinths. A recent study has shown presence of deposits also in middle ear structures of DFNA9-affected individuals (McCall et al., J Assoc Res Otolaryngol 12:141-149, 2004). To investigate the possible role of cochlin in the middle ear and in relation to aggregate formation, we evaluated middle ear histopathology in our Coch knock-in (Coch (G88E/G88E) ) mouse model, which harbors one of the DFNA9-causative mutations. Our findings reveal accumulation of acellular deposits in the incudomalleal and incudostapedial joints in Coch (G88E/G88E) mice, similar to those found in human DFNA9-affected temporal bones. Aggregates are absent in negative control Coch (+/+) and Coch (-/-) mice. Thickening of the tympanic membrane (TM) found in humans with DFNA9 was not appreciably detected in Coch (G88E/G88E) mice at the evaluated age. We investigated cochlin localization first in the Coch (+/+)mouse and in normal human middle ears, and found prominent and specific cochlin staining in the incudomalleal joint, incudostapedial joint, and the pars tensa of the TM, which are the three sites where abnormal deposits are detected in DFNA9-affected middle ears. Cochlin immunostaining of Coch (G88E/G88E) and DFNA9-affected middle ears showed mutant cochlin localization within areas of aggregates. Cochlin staining was heterogeneous throughout DFNA9 middle ear deposits, which appear as unorganized and overlapping mixtures of both eosinophilic and basophilic substances. Immunostaining for type II collagen colocalized with cochlin in pars tensa of the tympanic membrane. In contrast, immunostaining for type II collagen did not overlap with cochlin in interossicular joints, where type II collagen was localized in the region of the chondrocytes, but not in the thin layer of the articular surface of the ossicles nor in the eosinophilic deposits with specific cochlin staining.
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Comparison of traditional histology and TSLIM optical sectioning of human temporal bones.
Otol. Neurotol.
PUBLISHED: 06-11-2014
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Thin-sheet laser imaging microscopy (TSLIM) optical sectioning can be used to assess temporal bone soft tissue morphology before celloidin sectioning.
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Development, implementation, and dissemination of the I-PASS handoff curriculum: A multisite educational intervention to improve patient handoffs.
Acad Med
PUBLISHED: 05-30-2014
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Patient handoffs are a key source of communication failures and adverse events in hospitals. Despite Accreditation Council for Graduate Medical Education requirements for residency training programs to provide formal handoff skills training and to monitor handoffs, well-established curricula and validated skills assessment tools are lacking. Developing a handoff curriculum is challenging because of the need for standardized processes and faculty development, cultural resistance to change, and diverse institution- and unit-level factors. In this article, the authors apply a logic model to describe the process they used from June 2010 to February 2014 to develop, implement, and disseminate an innovative, comprehensive handoff curriculum in pediatric residency training programs as a fundamental component of the multicenter Initiative for Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-outs (I-PASS) Study. They describe resources, activities, and outputs, and report preliminary learner outcomes using data from resident and faculty evaluations of the I-PASS Handoff Curriculum: 96% of residents and 97% of faculty agreed or strongly agreed that the curriculum promoted acquisition of relevant skills for patient care activities. They also share lessons learned that could be of value to others seeking to adopt a structured handoff curriculum or to develop large-scale curricular innovations that involve redesigning firmly established processes. These lessons include the importance of approaching curricular implementation as a transformational change effort, assembling a diverse team of junior and senior faculty to provide opportunities for mentoring and professional development, and linking the educational intervention with the direct measurement of patient outcomes.
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Cellular immunologic responses to cochlear implantation in the human.
Hear. Res.
PUBLISHED: 05-20-2014
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A cochlear implant array consists of biomaterials, including metal and polymeric in type which are biocompatible, but not necessarily bio-inert. Histologic evidence of a foreign body reaction has been described in temporal bones in patients who in life had undergone cochlear implantation. In the current study, the cellular immune response was characterized using immunohistochemical stains for B-cell lymphocytes (C20), T-cell lymphocytes (CD3), and macrophages (CD68). In addition, energy dispersive spectroscopy by scanning electron microscopy. (EDS-SEM) was performed to characterize the nature of particulate foreign material seen near the electrode array. Infiltrations of B-cell and Tcell lymphocytes and macrophages were identified immunohistochemically. The track of the electrode array was frequently lined by multi-nucleated foreign body giant cells. Energy dispersive X-ray spectroscopy identified the particulate material found in the fibrous sheeth surrounding the cochlear implant to be consistent with platinum. In conclusion, a cochlear implant generates a vigorous cellular immune response consisting of B and T lymphocytes, foreign body giant cells, and macrophages. Platinum was identified as one of the antigens likely responsible for this cellular response. This foreign body response may in certain cases result in migration or even extrusion of an implant device.
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Three-finger tracheal palpation to guide endotracheal tube depth in children.
Paediatr Anaesth
PUBLISHED: 05-13-2014
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Accurate endotracheal tube (ETT) depth is critical, especially in children. The current tools used to guide appropriate ETT depth have significant limitations.
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Multimodal neuroimaging evidence of alterations in cortical structure and function in HIV-infected older adults.
Hum Brain Mapp
PUBLISHED: 05-01-2014
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Combination antiretroviral therapy transformed human immunodefiency virus (HIV)-infection from a terminal illness to a manageable condition, but these patients remain at a significantly elevated risk of developing cognitive impairments and the mechanisms are not understood. Some previous neuroimaging studies have found hyperactivation in frontoparietal networks of HIV-infected patients, whereas others reported aberrations restricted to sensory cortices. In this study, we utilize high-resolution structural and neurophysiological imaging to determine whether alterations in brain structure, function, or both contribute to HIV-related cognitive impairments. HIV-infected adults and individually matched controls completed 3-Tesla structural magnetic resonance imaging (sMRI) and a mechanoreception task during magnetoencephalography (MEG). MEG data were examined using advanced beamforming methods, and sMRI data were analyzed using the latest voxel-based morphometry methods with DARTEL. We found significantly reduced theta responses in the postcentral gyrus and increased alpha activity in the prefrontal cortices of HIV-infected patients compared with controls. Patients also had reduced gray matter volume in the postcentral gyrus, parahippocampal gyrus, and other regions. Importantly, reduced gray matter volume in the left postcentral gyrus was spatially coincident with abnormal MEG responses in HIV-infected patients. Finally, left prefrontal and postcentral gyrus activity was correlated with neuropsychological performance and, when used in conjunction, these two MEG findings had a sensitivity and specificity of over 87.5% for HIV-associated cognitive impairment. This study is the first to demonstrate abnormally increased activity in association cortices with simultaneously decreased activity in sensory areas. These MEG findings had excellent sensitivity and specificity for HIV-associated cognitive impairment, and may hold promise as a potential disease marker. Hum Brain Mapp, 2014. © 2014 Wiley Periodicals, Inc.
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School sport participation during adolescence and mental health in early adulthood.
J Adolesc Health
PUBLISHED: 04-24-2014
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This longitudinal study examined the association between participation in school sport during adolescence and mental health in early adulthood.
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Development and pilot testing of a patient-participatory pressure ulcer prevention care bundle.
J Nurs Care Qual
PUBLISHED: 04-24-2014
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This study developed and piloted a patient-centered pressure ulcer prevention care bundle for adult hospitalized patients to promote patient participation in prevention. The care bundle had 3 core messages: (1) keep moving, (2) care for your skin, and (3) ensure a good diet. A brief video, combined brochure/checklist, and poster were developed as training resources. Patient evaluation identified benefits of the care bundle; however, the combined checklist/brochure was rarely used.
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Systemic lupus erythematosus is associated with increased incidence of hematologic malignancies: a meta-analysis of prospective cohort studies.
Leuk. Res.
PUBLISHED: 04-11-2014
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Our objective was to define the risk of lymphoma, leukemia and myeloma in adult patients with SLE with a meta-analysis of prospective cohort studies. A literature search from 1995 to 2013 revealed eight studies evaluating this association. The outcome of interest was the standardized incidence ratio (SIR). Our study included 401 cases in a cohort of approximately 68,000 SLE patients, and showed an increased incidence of all hematologic malignancies (SIR 2.9), non-Hodgkin lymphoma (SIR 5.7), Hodgkin lymphoma (SIR 3.1), leukemia (SIR 2.3) and myeloma (SIR 1.5) in SLE patients compared with the general population. The increased SIR was consistent regardless of age, sex or geographical region.
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Correlation between histologic and radiographic reconstruction of intracochlear electrode position in human temporal bones.
Audiol. Neurootol.
PUBLISHED: 03-27-2014
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In our laboratory, human temporal bone specimens from patients who in life have undergone cochlear implantation are routinely processed with the implant in situ, embedded in Araldite, sectioned at 20 µm and serially photographed during cutting, stained with toluidine blue and mounted on glass slides. From the images, two-dimensional and three-dimensional reconstructions can be made and a very accurate implant insertion depth can be calculated from the three-dimensional reconstructions. However, this method precludes subsequent special stains and further molecular investigations of the tissue including proteomics and immunostaining, which is now possible with celloidin-embedded tissue. In this study, we correlated measurement of the implant array insertion depth calculated from histologic three-dimensional reconstruction with that measured from three-dimensional radiologic multiplanar reconstruction. Four human temporal bones with cochlear implants underwent postfixation preprocessing CT imaging with a Siemens Somatom Sensation Scanner. The CT scans from these four bones were downloaded into the Voxar software application, reformatted using the multiplanar reconstruction tool, viewed in three dimensions and measurements of intracochlear insertion lengths of the implants were obtained. The bones were processed routinely for in situ Araldite embedding, serial images were made of the block during sectioning, postprocessed using PV-Wave® software, aligned with Amira® software, and used to create histologic three-dimensional reconstructions. From these three-dimensional reconstructions, the insertion depth of the electrode array was mathematically calculated. The range of insertion depths was 15.9 mm (case 1) to 26.6 mm (case 4). The two methods, radiographic multiplanar reconstruction and three-dimensional reconstruction, differed by 0.4-0.9%. This provides confidence that important localization information about the electrode in situ can be gleaned from CT scans, thereby allowing us to extract the implants prior to processing for celloidin embedment and allow further techniques such as special stains and immunostaining to be accomplished in order to evaluate molecular mechanisms involved in cochlear implantation.
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Association between accelerometer-measured physical activity intensities and sedentary time in 8- to 10-year-old children.
Pediatr Exerc Sci
PUBLISHED: 03-26-2014
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This study examines the association between objectively-measured physical activity (PA) intensities and sedentary behavior (SED) in a cohort of 532 children aged 8-10 y. PA and SED were assessed by accelerometer over 7-days. Television and computer/video-game use were self-reported. Associations between PA intensities and SED variables were assessed by Spearman correlations and adjusted multiple linear regression. Higher mean daily moderate-to-vigorous and vigorous PA (MVPA, VPA) were negatively associated with mean daily SED (r = -0.47 and -0.37; p < .001), and positively associated with mean daily total PA (r = .58 and 0.46; p < .001). MVPA was also positively associated with light PA (LPA; r = .26, p < .001). MVPA and VPA were not significantly associated with TV, computer/video or total screen time; accelerometer SED was only weakly associated with specific SED behaviors. On average, for each additional 10 min daily MVPA, children accumulated >14 min less SED, and for each additional 5 min VPA, 11 min less SED. Thus, over the course of a week, higher mean daily MVPA may displace SED time and is associated with higher total PA over and above the additional MVPA, due to concomitant higher levels of LPA. Public health strategies should target both MVPA and SED to improve overall PA and health in children.
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Relationships between body image, nutritional supplement use, and attitudes towards doping in sport among adolescent boys: implications for prevention programs.
J Int Soc Sports Nutr
PUBLISHED: 03-21-2014
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Reports of high levels of use of protein powders and nutritional supplements among young men is a concern because these substances may act as a gateway for the use of drugs and illegal substances to enhance appearance or sports performance. The aim of this study was to investigate the relationship between body dissatisfaction, weight change behaviors, supplement use, and attitudes towards doping in sport among an adolescent male sample.
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Can a video curriculum on the social determinants of health affect residents' practice and families' perceptions of care?
Acad Pediatr
PUBLISHED: 03-08-2014
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Screening and management of the social determinants of health (SDH) are critical for child health promotion. We sought to evaluate the impact of a facilitated video curriculum on resident SDH screening competence, parental perceptions of resident practice, resident-initiated referrals to a medical-legal partnership (MLP), and formula distribution to food-insecure families.
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Physical activity in preschool children: comparison between Montessori and traditional preschools.
J Sch Health
PUBLISHED: 02-27-2014
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Little is known about the influence of Montessori methods on children's physical activity (PA). This cross-sectional study compared PA of children attending Montessori and traditional preschools.
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Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6-year longitudinal cohort of Australian schoolchildren from 2007 to 2012.
BMC Public Health
PUBLISHED: 02-20-2014
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The prevalence of childhood overweight and obesity increased during the 1980s to the late 1990s. The prevalence of obesity is higher in socially and economically disadvantaged communities in most Westernised countries. The purpose of this study was to examine how the socioeconomic gradient in weight status, namely thinness, overweight and obesity, changes over time in a longitudinal cohort of Australian schoolchildren, from 2007-2012.
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The value of case-based teaching vignettes in clinical microbiology rounds.
Am. J. Clin. Pathol.
PUBLISHED: 02-12-2014
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To describe the implementation and evaluation of a case-based microbiology curriculum during daily microbiology rounds.
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Impact of Detection, Education, Research and Decolonization without Isolation in Long-term care (DERAIL) on methicillin-resistant Staphylococcus aureus colonization and transmission at 3 long-term care facilities.
Am J Infect Control
PUBLISHED: 02-08-2014
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We tested infection prevention strategies to limit exposure of long-term care facility residents to drug-resistant pathogens in a prospective, cluster randomized 2-year trial involving 3 long-term care facilities (LTCFs) using methicillin-resistant Staphylococcus aureus (MRSA) as a model. We hypothesized that nasal MRSA surveillance using rapid quantitative polymerase chain reaction and decolonization of carriers would successfully lower overall MRSA colonization. In year 1, randomly assigned intervention units received decolonization with nasal mupirocin and chlorhexidine bathing and enhanced environmental cleaning with bleach every 4 months. Newly admitted MRSA nares-positive residents were decolonized on admission. Control units were screened but not decolonized. All units received periodic bleach environmental cleaning and instruction on hand hygiene. In year 2, all units followed intervention protocol caused by failure of the cluster randomized approach to sufficiently segregate patients. MRSA colonization was monitored using point prevalence testing every 4-6 months. Colonization status at admission and discharge was performed 1 quarter per year to determine acquisition. Fisher exact test was used for statistical analysis. Baseline MRSA colonization rate was 16.64%. In year 1, the colonization rate of intervention units was 11.61% (P = .028) and 17.85% in control units (P = .613) compared with baseline. Intervention unit rate difference compared with the controls was significant (P = .001). In year 2, the colonization rate was 10.55% (P < .001) compared with baseline. The transmission rates were 1.66% and 3.52% in years 1 and 2, respectively (P = .034). The planned interventions of screening and decolonization were successful at lowering MRSA colonization.
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Breakfast patterns among low-income, ethnically-diverse 4th-6th grade children in an urban area.
BMC Public Health
PUBLISHED: 02-07-2014
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Increasing school breakfast participation has been advocated as a method to prevent childhood obesity. However, little is known about children's breakfast patterns outside of school (e.g., home, corner store). Policies that increase school breakfast participation without an understanding of children's breakfast habits outside of school may result in children consuming multiple breakfasts and may undermine efforts to prevent obesity. The aim of the current study was to describe morning food and drink consumption patterns among low-income, urban children and their associations with relative weight.
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Weight change in patients attempting to quit smoking post-myocardial infarction.
Am. J. Med.
PUBLISHED: 01-31-2014
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Current guidelines recommend smoking cessation and weight management for secondary prevention in patients post-myocardial infarction. However, little is known about the effects of smoking cessation on weight change post-myocardial infarction.
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The association between food patterns and adiposity among Canadian children at risk of overweight.
Appl Physiol Nutr Metab
PUBLISHED: 01-31-2014
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Identifying food patterns related to obesity can provide information for health promotion in nutrition. Food patterns and their relation with obesity among Canadian children have not been reported to date. Our aim was to identify and describe food patterns associated with obesity in children at risk of overweight. Caucasian children (n = 630) with at least 1 obese biological parent recruited into the Quebec Adiposity and Lifestyle Investigation in Youth (QUALITY) cohort were studied in cross-sectional analyses. Measures of adiposity (body mass index (BMI), waist circumference, body fat mass percentage measured by dual-energy X-ray absorptiometry), screen time, physical activity (accelerometer over 7 days), and dietary intake (three 24-h food recalls) were collected. Factor analysis was used to identify food patterns. The relationships between food patterns and overweight were investigated in logistic and multiple linear regression models. Three food patterns were retained for analysis: traditional food (red meats, main dishes-soups, high-fat dairy products, tomato products, dressings, etc.); healthy food (low-fat dairy products, whole grains, legumes-nuts-seeds, fruits, vegetables); and fast food (sugar-sweetened beverages, fried potatoes, fried chicken, hamburgers-hot dogs-pizza, salty snacks). Higher scores on the fast food pattern were associated with overweight (BMI ? 85th percentile), and other measures of adiposity (BMI, waist circumference, body fat mass percentage) after adjustment for age, sex, physical activity, screen time, sleep time, family income, and mother's obesity (p < 0.05). Controlling for energy intake did not change these relationships. Our results provide further evidence of a link between fast food intake and obesity in children.
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Night eating behavior and metabolic heath in mothers and fathers enrolled in the QUALITY cohort study.
Eat Behav
PUBLISHED: 01-22-2014
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Desynchrony between eating and sleeping patterns and poor sleep quality have been associated with obesity and metabolic abnormalities. This study examined the metabolic health correlates of night eating syndrome in adults enrolled in the QUALITY cohort study.
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Utilization of evidence-based therapy for acute coronary syndrome in high-income and low/middle-income countries.
Am. J. Cardiol.
PUBLISHED: 01-21-2014
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Limited data exist regarding the management of patients with acute coronary syndrome (ACS) in high-income countries compared with low/middle-income countries. We aimed to compare in-hospital trends of revascularization and prescription of medications at discharge in patients with ACS from high-income (Canada and United States) and low/middle-income (India, Iran, Pakistan, and Tunisia) countries. Data from a double-blind, placebo-controlled, randomized trial investigating the effect of bupropion on smoking cessation in patients after an enzyme-positive ACS was used for our study. A total of 392 patients, 265 and 127 from high-income and from low/middle-income countries, respectively, were enrolled. Patients from high-income countries were older, and were more likely to have diagnosed hypertension and dyslipidemia. During the index hospitalization, patients from high-income countries were more likely to be treated by percutaneous coronary intervention (odds ratio [OR] 19.7, 95% confidence interval [CI] 10.5 to 37.0). Patients with ST elevation myocardial infarction from high-income countries were more often treated by primary percutaneous coronary intervention (OR 16.3, 95% CI 6.3 to 42.3) in contrast with thrombolytic therapy (OR 0.24, 95% CI 0.14 to 0.41). Patients from high-income countries were also more likely to receive evidence-based medications at discharge (OR 2.32, 95% CI 1.19 to 4.52, a composite of aspirin, clopidogrel, and statin). In conclusion, patients with ACS in low/middle-income countries were less likely to be revascularized and to receive evidence-based medications at discharge. Further studies are needed to understand the underutilization of procedures and evidence-based medications in low/middle-income countries.
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Socioeconomic and racial disparities of pediatric invasive pneumococcal disease after the introduction of the 7-valent pneumococcal conjugate vaccine.
Pediatr. Infect. Dis. J.
PUBLISHED: 01-15-2014
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Racial differences have been well described for invasive pneumococcal disease (IPD), but little information exists on how race interacts with community socioeconomic factors.
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Development and evaluation of 'briefing notes' as a novel knowledge translation tool to aid the implementation of sex/gender analysis in systematic reviews: a pilot study.
PLoS ONE
PUBLISHED: 01-01-2014
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There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly 'briefing note' format and evaluate its potential in aiding the implementation of SGA in systematic reviews.
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Persistence and Change in Community Composition of Reef Corals through Present, Past, and Future Climates.
PLoS ONE
PUBLISHED: 01-01-2014
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The reduction in coral cover on many contemporary tropical reefs suggests a different set of coral community assemblages will dominate future reefs. To evaluate the capacity of reef corals to persist over various time scales, we examined coral community dynamics in contemporary, fossil, and simulated future coral reef ecosystems. Based on studies between 1987 and 2012 at two locations in the Caribbean, and between 1981 and 2013 at five locations in the Indo-Pacific, we show that many coral genera declined in abundance, some showed no change in abundance, and a few coral genera increased in abundance. Whether the abundance of a genus declined, increased, or was conserved, was independent of coral family. An analysis of fossil-reef communities in the Caribbean revealed changes in numerical dominance and relative abundances of coral genera, and demonstrated that neither dominance nor taxon was associated with persistence. As coral family was a poor predictor of performance on contemporary reefs, a trait-based, dynamic, multi-patch model was developed to explore the phenotypic basis of ecological performance in a warmer future. Sensitivity analyses revealed that upon exposure to thermal stress, thermal tolerance, growth rate, and longevity were the most important predictors of coral persistence. Together, our results underscore the high variation in the rates and direction of change in coral abundances on contemporary and fossil reefs. Given this variation, it remains possible that coral reefs will be populated by a subset of the present coral fauna in a future that is warmer than the recent past.
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Pediatric hospitalist perceptions of the impact of duty hour changes on education and patient care.
Hosp Pediatr
PUBLISHED: 12-18-2013
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The goal of this study was to measure the impact of the new 2011 Accreditation Council for Graduate Medical Education duty hour standards (DHS) on education, patient care, and overall satisfaction as perceived by pediatric hospitalist faculty.
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Consumption of Added Sugars from Liquid but Not Solid Sources Predicts Impaired Glucose Homeostasis and Insulin Resistance among Youth at Risk of Obesity.
J. Nutr.
PUBLISHED: 11-06-2013
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Little is known about longitudinal associations between added sugar consumption (solid and liquid sources) and glucose-insulin homeostasis among youth. Caucasian children (8-10 y) with at least one obese biological parent were recruited in the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort (n = 630) and followed-up 2 y later (n = 564). Added sugars were assessed by 3 24-h dietary recalls at baseline. Two-year changes were examined in multivariate linear regression models, adjusting for baseline level, age, sex, Tanner stage, energy intake, fat mass (dual-energy X-ray absorptiometry), and physical activity (7 d accelerometer). Added sugar intake in either liquid or solid sources was not related to changes in adiposity measures (fat mass, body mass index, or waist circumference). However, a higher consumption (10 g/d) of added sugars from liquid sources was associated with 0.04 mmol/L higher fasting glucose, 2.3 pmol/L higher fasting insulin, 0.1 unit higher homeostasis model assessment of insulin resistance (HOMA-IR), and 0.4 unit lower Matsuda-insulin sensitivity index (Matsuda-ISI) in all participants (P < 0.01). No associations were observed with consumption of added sugars from solid sources. Overweight/obese children at baseline had greater increases in adiposity indicators, fasting insulin, and HOMA-IR and decreases in Matsuda-ISI during those 2 y than normal-weight children. Consumption of added sugars from liquid or solid sources was not associated with changes in adiposity, but liquid added sugars were a risk factor for the development of impaired glucose homeostasis and insulin resistance over 2 y among youth at risk of obesity.
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Daily physical activity patterns of children with delayed eating behaviors.
J. Biol. Rhythms
PUBLISHED: 10-18-2013
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Night eating syndrome (NES) is a delayed pattern of energy intake. It is unknown if symptoms associated with this syndrome are accompanied by a delayed pattern of physical activity. This study examines the relationship between physical activity patterns and delayed eating behaviors in children. Children from the QUALITY cohort (n = 269, 45% female, aged 8-11 y) completed the Night Eating Questionnaire (NEQ), which measures NES symptoms on a continuous scale and identifies single NES symptoms. Daily accelerometer data were transformed into mean counts per wear-time minute for each hour of the day. Children with high NEQ scores had higher levels of daily (p < 0.001) and evening physical activity (p = 0.05) and reached 75% of their total daily physical activity 20 minutes later than children with low NEQ scores (p < 0.05). Excessive evening snacking and a strong urge to eat in the evening or at night were the symptoms most related to these physical activity patterns. Children with delayed eating behaviors had higher levels of physical activity in the late morning and evening and a delayed physical activity pattern compared to children with no or fewer symptoms. Future research is needed to determine if physical activity plays a role in the onset or maintenance of night eating.
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Including Health Equity Considerations in Development of Instruments for Rheumatology Research: An Introduction to a Novel OMERACT Paradigm.
J. Rheumatol.
PUBLISHED: 10-15-2013
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The Outcome Measures in Rheumatology (OMERACT) Equity Special Interest Group (SIG) was established in 2008 to create a preliminary core set of outcome measures for clinical trials that can assess equity gaps in healthcare and the effectiveness of interventions to close or narrow gaps between advantaged and disadvantaged populations with musculoskeletal (MSK) conditions. At the OMERACT 11 meeting in 2012, the Equity SIG workshop focused on health assessment scales and their applicability for disadvantaged patients with MSK conditions. The intent was to determine whether the items and domains in 2 common questionnaires, the Health Assessment Questionnaire and the Medical Outcome Study Short Form-36 Survey, are appropriate for the activities and life experiences of certain disadvantaged populations, and whether completion of any of the scales would present a challenge to disadvantaged persons. To generate discussion, we considered the reading level of items in these questionnaires and whether they would be accessible to people with different levels of literacy. The group concluded that the choice of measurement instrument may contribute to "outcome measure-generated inequalities" because disadvantaged groups might have difficulty understanding some of the questions. The future work of the Equity SIG will explore the appropriateness of different measurement scales as they relate to inequities in arthritis as well as the risk of exacerbating disadvantages for patients with low literacy.
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Conceptualizing the Research Culture in Postgraduate Medical Education: Implications for Leading Culture Change.
J Med Humanit
PUBLISHED: 10-12-2013
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By recognizing symbols of research culture in postgraduate medical education, educators and trainees can gain a deeper understanding of the existing culture and mechanisms for its transformation. First, I identify symbolic manifestations of the research culture through a case narrative of a single anesthesia residency program, and I offer a visual conceptualization of the research culture. In the second part, I theorize the application of Senges (1994) disciplines of a learning organization and discuss leverage for enhancing research culture. This narrative account is offered to inform the work of enhancing the broader research culture in postgraduate medical education.
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Association Between Accelerometer-Measured Physical Activity Intensities and Sedentary Time in 8-10 Year Old Children.
Pediatr Exerc Sci
PUBLISHED: 08-29-2013
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This study examines the association between objectively-measured physical activity (PA) intensities and sedentary behaviour (SED) in a cohort of 532 children aged 8-10 y. PA and SED were assessed by accelerometer over 7-days. Television and computer/video-game use were self-reported. Associations between PA intensities and SED variables were assessed by Spearman correlations and adjusted multiple linear regression. Higher mean daily moderate-to-vigorous and vigorous PA (MVPA, VPA) were negatively associated with mean daily SED (r=-0.47 and -0.37; p<0.001), and positively associated with mean daily total PA (r=0.58 and 0.46; p<0.001). MVPA was also positively associated with light PA (LPA; r=0.26, p<0.001). MVPA and VPA were not significantly associated with TV, computer/video or total screen time; accelerometer SED was only weakly associated with specific SED behaviours. On average, for each additional 10 minutes daily MVPA, children accumulated >14 minutes less SED, and for each additional 5 minutes VPA, 11 minutes less SED. Thus, over the course of a week, higher mean daily MVPA may displace SED time and is associated with higher total-PA over and above the additional MVPA, due to concomitant higher levels of LPA. Public health strategies should target both MVPA and SED to improve overall PA and health in children.
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Pharmacists smoking cessation counseling practices: a comparison between 2005 and 2010.
Nicotine Tob. Res.
PUBLISHED: 08-13-2013
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To determine if smoking cessation counseling practices and related psychosocial characteristics improved among pharmacists between 2005 and 2010.
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Absorption atelectasis: incidence and clinical implications.
AANA J
PUBLISHED: 08-09-2013
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General anesthesia is known to cause pulmonary atelectasis; in turn, atelectasis increases shunt, decreases compliance, and may lead to perioperative hypoxemia. One mechanism for the formation of atelectasis intraoperatively is ventilation with 100% oxygen. The goal of this review is to determine if research suggests that intraoperative ventilation with 100% oxygen leads to clinically significant pulmonary side effects. An initial literature search included electronic databases (Cumulative Index to Nursing & Allied Health Literature [CINAHL], PubMed, MEDLINE, Embase, and The GeneraCochrane Library) using the following search terms: oxygen (administration and dosage), atelectasis, pulmonary complications, and anesthesia. Results were limited to research studies, human subjects, and English-language publications between 1965 and 2011. From this body of research, it appears that absorption atelectasis does occur in healthy anesthetized adults breathing 100% oxygen. Data reviewed suggest that absorption atelectasis does not have significant clinical implications in healthy adults. However, further research is warranted in populations at increased risk of postoperative hypoxemia, including obese or elderly patients and those with preexisting cardiopulmonary disease.
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Decreased MEG beta oscillations in HIV-infected older adults during the resting state.
J. Neurovirol.
PUBLISHED: 07-05-2013
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The introduction of combination antiretroviral therapy significantly reduced the prevalence of the most severe form of HIV-associated neurocognitive disorders (HAND). Despite this decline, 35-70 % of HIV-infected patients continue to develop mild motor and cognitive impairments. Although neuropsychological studies have shown that HAND affects a wide array of cognitive functions, a formal diagnosis is still based on the exclusion of opportunistic infections and other common ailments, as no specific tests or biomarkers are currently available. In this study, we used magnetoencephalography (MEG) to measure neural activity during the resting-state in 15 HIV-infected older patients and a demographically matched group of 15 uninfected controls. MEG is a noninvasive and direct measure of neural activity with excellent spatiotemporal resolution. All MEG data were coregistered to structural magnetic resonance images, corrected for head motion, fitted to a regional-level source model, and subjected to spectral analyses to quantify population-level neural oscillatory activity. We found that HIV-infected persons exhibited decreased beta oscillations in the supplementary motor area bilaterally, paracentral lobule, posterior cingulate, and bilateral regions of the superior parietal lobule relative to healthy controls. Beta oscillations in the posterior cingulate, a critical component of the default mode network, were also positively correlated with patient scores on the memory recall aspect of the Hopkins Verbal Learning Test-Revised. These results demonstrate that chronic HIV infection does not uniformly disturb cortical function, and that neuronal populations in dorsomedial motor and parietal cortices are especially affected. These findings also suggest that resting-state MEG recordings may hold significant promise as a functional biomarker for identifying HAND and monitoring disease progression.
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Monitoring activities of teenagers to comprehend their habits: study protocol for a mixed-methods cohort study.
BMC Public Health
PUBLISHED: 06-28-2013
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Efforts to increase physical activity in youth need to consider which activities are most likely to be sustained over time in order to promote lifelong participation in physical activity. The Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study is a prospective cohort study that uses quantitative and qualitative methods to develop new knowledge on the sustainability of specific physical activities.
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Physical activity growth curves relate to adiposity in adolescents.
Ann Epidemiol
PUBLISHED: 06-02-2013
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Findings from prospective studies on associations between physical activity and adiposity among youth are inconsistent. Our aim was to describe physical activity trajectories during secondary school and examine the association with change in adiposity in youth.
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Correlation of computed tomography with histopathology in otosclerosis.
Otol. Neurotol.
PUBLISHED: 05-28-2013
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Until now, the use of computed tomography (CT) in the diagnosis and evaluation of otosclerosis has been based on correlation of radiologic findings to patient histories, intraoperative examinations, and audiologic data. The purpose of this study was to compare CT findings in otosclerosis to histopathology.
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Use of quantile regression to investigate the longitudinal association between physical activity and body mass index.
Obesity (Silver Spring)
PUBLISHED: 05-16-2013
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To examine associations among age, physical activity (PA), and birth cohort on body mass index (BMI) percentiles in men.
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Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health.
J Clin Epidemiol
PUBLISHED: 05-07-2013
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To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.
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Young childrens motor skill performance: Relationships with activity types and parent perception of athletic competence.
J Sci Med Sport
PUBLISHED: 05-06-2013
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The aims were to examine the relationship between childrens motor skill levels and types of physical activities performed during preschool attendance, and to examine the relationship between motor skill performance and parent perception of athletic competence.
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Interest of an individualized score among children using the OMNI cycle scale.
Med Sci Sports Exerc
PUBLISHED: 04-19-2013
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The study purposes were 1) to study the differences between perceived exertion measured by a generic (/10) or an individualized (/max value obtained during the test) score on the OMNI cycle scale (OMNImax and OMNI10) and the actual effort (peak oxygen consumption) at different stages of a maximal cycling test in a group of children age 8 to 10 yr old and 2) to assess whether the concordance between perceived exertion and actual effort differs according to body mass status or physical activity level.
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Health equity: evidence synthesis and knowledge translation methods.
Syst Rev
PUBLISHED: 04-17-2013
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At the Rio Summit in 2011 on Social Determinants of Health, the global community recognized a pressing need to take action on reducing health inequities. This requires an improved evidence base on the effects of national and international policies on health inequities. Although systematic reviews are recognized as an important source for evidence-informed policy, they have been criticized for failing to assess effects on health equity.
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N-acetylcysteine plus intravenous fluids versus intravenous fluids alone to prevent contrast-induced nephropathy in emergency computed tomography.
Ann Emerg Med
PUBLISHED: 03-22-2013
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We test the hypothesis that N-acetylcysteine plus normal saline solution is more effective than normal saline solution alone in the prevention of contrast-induced nephropathy.
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Mechanical efficiency during a cycling test is not lower in children with excess body weight and low aerobic fitness.
Obesity (Silver Spring)
PUBLISHED: 03-19-2013
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The aims of this study were to assess the association between (i) body weight status and mechanical efficiency (ME); and (ii) ME and aerobic fitness in children aged 8-10 years.
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Canada Acute Coronary Syndrome Risk Score: a new risk score for early prognostication in acute coronary syndromes.
Am. Heart J.
PUBLISHED: 03-17-2013
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Despite the availability of several acute coronary syndrome (ACS) prognostic risk scores, there is no appropriate score for early-risk stratification at the time of the first medical contact with patients with ACS. The primary objective of this study is to develop a simple risk score that can be used for early-risk stratification of patients with ACS.
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Insight and suicidality in first-episode psychosis: understanding the influence of suicidal history on insight dimensions at first presentation.
Early Interv Psychiatry
PUBLISHED: 03-14-2013
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AIM: Lack of insight is a cardinal feature of psychosis with crucial implications for outcome. Concerns have been raised regarding a link between insight and suicidality. This study aimed to test the relationship between suicidal behaviour preceding first-episode psychosis (FEP) and insight dimensions at treatment onset. METHODS: A total of 112 FEP inpatients were recruited. Suicidal events prior to admission were recorded. Insight was assessed multidimensionally with the Schedule for the Assessment of Insight - Expanded version shortly after admission. Suicidal and non-suicidal patients were compared regarding scores on total insight and three insight domains: awareness of mental illness, relabeling of psychotic experiences as abnormal and compliance. This analysis was also adjusted for a set of sociodemographic, clinical, neurocognitive and psychopathological variables. RESULTS: Bivariate analyses demonstrated a direct association between previous suicidality and all insight domains. However, these associations did not survive multivariable regression models, which demonstrated gender (female), shorter duration of untreated psychosis (DUP) and psychopathological symptoms - depression and disorganization - to mediate the influence of suicidal history on insight, and therefore to underlie the latter. CONCLUSIONS: Insight dimensions in FEP patients are influenced by having suicidal antecedents through some mediating variables such as gender, DUP and depression. Further prospective studies are needed to clarify the potential implications of these findings on the management of insight in FEP. As suicidal history is associated with greater levels of both depression and insight at first presentation, these three variables might be useful in predicting further suicidal events.
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Preneoplasia in the prostate gland with emphasis on high grade prostatic intraepithelial neoplasia.
Pathology
PUBLISHED: 03-13-2013
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There are a variety of morphological patterns and processes that have been implicated in the pathogenesis of prostate cancer. Prostatic intraepithelial neoplasia (PIN), inflammation with or without atrophy, and adenosis (atypical adenomatous hyperplasia) have all been given candidate status as precursor lesions of prostatic adenocarcinoma. Based on decades of research, high grade prostatic intraepithelial neoplasia (HPIN), a proliferative lesion of prostatic secretory cells, has emerged as the most likely morphological pre-invasive lesion involved in the evolution of many but not all prostatic adenocarcinomas. In this manuscript, we briefly discuss other proposed precursors of prostatic adenocarcinoma and then focus on the history, diagnostic criteria and morphology of HPIN. The incidence of HPIN and its relationship to prostate cancer is reviewed. The differential diagnosis of large glandular patterns in the prostate is discussed in depth. Finally, we summarise the recent clinicopathological studies evaluating the clinical significance of HPIN and discuss follow-up strategies in men diagnosed with HPIN.
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Increased lipid oxidation during exercise in obese pubertal girls: A QUALITY study.
Obesity (Silver Spring)
PUBLISHED: 03-12-2013
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This study explores differences in LO rates between pre-pubertal and pubertal girls of three body weight status groups.
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CYP2A6 slow nicotine metabolism is associated with increased quitting by adolescent smokers.
Pharmacogenet. Genomics
PUBLISHED: 03-07-2013
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Variation in the CYP2A6 gene, which decreases the rate of nicotine metabolic inactivation, is associated with higher adult smoking cessation rates during clinical trials. We hypothesized that slow metabolism is associated with increased quitting during adolescence. White adolescent smokers (N=308, aged 12-17, 36.3% male) from a cohort study were genotyped for CYP2A6, resulting in 7.8% slow, 14.0% intermediate and 78.2% normal metabolizers. Overall, 144 smokers quit smoking, as indicated by being abstinent for at least 12 months. In logistic regression analyses, the odds ratio for quitting was 2.25 (95% confidence interval 1.05, 4.80; P=0.037) for slow metabolizers relative to normal metabolizers. A linear trend toward increased quitting with decreasing CYP2A6 activity was also observed (odds ratio=1.44, 95% confidence interval 1.02, 2.01; P=0.034). Thus, CYP2A6 slow metabolism is associated with increased adolescent smoking cessation, indicating that even early in the smoking history, genetic variation is influencing smoking cessation.
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Cannabis users have higher premorbid IQ than other patients with first onset psychosis.
Schizophr. Res.
PUBLISHED: 02-26-2013
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A number of studies have reported that patients with psychosis who use cannabis have better cognitive performance than those who do not. This is surprising as cannabis can impair cognition in healthy subjects. An obvious question is whether the better current performance of psychotic patients who have used cannabis is a reflection of their having a higher premorbid IQ than those psychotic patients who havent used cannabis.
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Turning readmission reduction policies into results: some lessons from a multistate initiative to reduce readmissions.
Popul Health Manag
PUBLISHED: 02-25-2013
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Efforts are under way nationally to reduce avoidable hospital readmissions by changing payments to hospitals, but it is unclear how well or how quickly these policy changes will produce widespread reductions in hospital readmissions. To examine some of the challenges to implementing such approaches, the authors analyzed the early experiences of 3 statewide programs to reduce preventable readmissions that began in 2009. Based on interviews with program participants in 2011, the authors identified 3 key obstacles to progress: the difficulty of developing collaborative relationships across care settings, gaps in evidence for effective interventions, and deficits in quality improvement capabilities among some organizations. These findings underscore the uncertainty of success of current readmissions policies and suggest that immediate improvement in readmission rates through a change in reimbursement may be unlikely unless these other obstacles are addressed expeditiously. In particular, cultivation of productive collaboration across care settings will be critical because these kinds of relationships are not well established or naturally occurring in most communities.
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Functional brain abnormalities during finger-tapping in HIV-infected older adults: a magnetoencephalography study.
J Neuroimmune Pharmacol
PUBLISHED: 02-22-2013
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Despite the availability of combination antiretroviral therapy, at least mild cognitive dysfunction is commonly observed in HIV-infected patients, with an estimated prevalence of 35-70 %. Neuropsychological studies of these HIV-associated neurocognitive disorders (HAND) have documented aberrations across a broad range of functional domains, although the basic pathophysiology remains unresolved. Some of the most common findings have been deficits in fine motor control and reduced psychomotor speed, but to date no neuroimaging studies have evaluated basic motor control in HAND. In this study, we used magnetoencephalography (MEG) to evaluate the neurophysiological processes that underlie motor planning in older HIV-infected adults and a matched, uninfected control group. MEG is a noninvasive and direct measure of neural activity with good spatiotemporal precision. During the MEG recording, participants fixated on a central crosshair and performed a finger-tapping task with the dominant hand. All MEG data was corrected for head movements, preprocessed, and imaged in the time-frequency domain using beamforming methodology. All analyses focused on the pre-movement beta desynchronization, which is known to be an index of movement planning. Our results demonstrated that HIV-1-infected patients have deficient beta desynchronization relative to controls within the left/right precentral gyri, and the supplementary motor area. In contrast, HIV-infected persons showed abnormally strong beta responses compared to controls in the right dorsolateral prefrontal cortex and medial prefrontal areas. In addition, the amplitude of beta activity in the primary and supplementary motor areas correlated with scores on the Grooved Pegboard test in HIV-infected adults. These results demonstrate that primary motor and sensory regions may be particularly vulnerable to HIV-associated damage, and that prefrontal cortices may serve a compensatory role in maintaining motor performance levels in infected patients.
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Depressive symptoms in adolescence: a poor indicator of increases in body mass index.
J Adolesc Health
PUBLISHED: 02-20-2013
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The purpose of this study was to examine the association between depressive symptoms and subsequent body mass index (BMI) z scores among early-to-mid adolescents, extending previous research by using objectively measured weight and height data.
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Objectively measured sedentary time, physical activity and markers of body fat in preschool children.
Pediatr Exerc Sci
PUBLISHED: 02-15-2013
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The purpose of this study was to examine the associations between sedentary behavior and moderate to vigorous physical activity (MVPA), measured by accelerometry, with body mass index (BMI) and waist circumference in 357 preschool children. Linear mixed models were used adjusting for race/ethnicity, parental education, and preschool. Follow-up analyses were performed using quantile regression. Among boys, MVPA was positively associated with BMI z-score (b = 0.080, p = .04) but not with waist circumference; quantile regression showed that MVPA was positively associated with BMI z-score at the 50th percentile (b = 0.097, p < .05). Among girls, no associations were observed between sedentary behavior and MVPA in relation to mean BMI z-score and mean waist circumference. Quantile regression indicated that, among girls at the 90th waist circumference percentile, a positive association was found with sedentary behavior (b = 0.441, p < .05), and a negative association was observed with MVPA (b = -0.599, p < .05); no associations were found with BMI z-score. In conclusion, MVPA was positively associated with BMI z-score among boys, and MVPA was negatively associated and sedentary behavior was positively associated with waist circumference among girls at the 90th percentile.
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The social ecology of water in a Mumbai slum: failures in water quality, quantity, and reliability.
BMC Public Health
PUBLISHED: 02-13-2013
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Urban slums in developing countries that are not recognized by the government often lack legal access to municipal water supplies. This results in the creation of insecure "informal" water distribution systems (i.e., community-run or private systems outside of the governments purview) that may increase water-borne disease risk. We evaluate an informal water distribution system in a slum in Mumbai, India using commonly accepted health and social equity indicators. We also identify predictors of bacterial contamination of drinking water using logistic regression analysis.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.