BMI scatterplot and regression line according to mean daily sleeping hours.

<p>BMI scatterplot and regression line according to mean daily sleeping hours.</p

Selected characteristics of the study population and results of univariate and multivariate analyses relating several variables to BMI.

a<p>N = 496 subjects after exclusion of participants with missing data.</p>b<p>The mean and standard deviation (SD) of BMI of the sample is 19.45±3.4.</p>c<p>referred to the age of 10 years.</p>d<p>the number that do not add to 542 are due to missing data for the variable.</p>e<p>referred to the parental education of 13 years.</p>f<p>referred to birth weight ≥4 kilograms.</p>g<p>referred to recommended daily servings.</p

Appraising Hospital Performance by Using the JCHAO/CMS Quality Measures in Southern Italy

<div><h3>Objectives</h3><p>The main objective of the present study was to estimate the uptake to quality indicators that reflect the current evidence-based recommendations and guidelines.</p> <h3>Methods</h3><p>A retrospective review of medical records of patients admitted to two hospitals in the South of Italy was conducted. For the purposes of the analysis, a sets of quality indicators has been used from the Joint Commission on Accreditation of Hospital Organizations and Centers for Medicare & Medicaid Services. Four areas of care were selected: acute myocardial infarction (AMI), heart failure (HF), pneumonia (PN), and surgical care improvement project (SCIP). Frequency or median was calculated, as appropriate, for each indicator. A composite score was calculated to estimate the overall performance for each area of care.</p> <h3>Results</h3><p>A total of 1772 medical records were reviewed. The adherence rates showed a wide-ranging variability among the selected indicators. The use of aspirin and angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for AMI, the use of ACEI or ARB for HF, the use of appropriate thromboembolism prophylaxis and appropriate hair removal for surgical patients almost approached optimal adherence. At the other extreme, rates regarding adherence to smoking-cessation counseling in AMI and HF patients, discharge instructions in HF patients, and influenza and pneumococcal vaccination in pneumonia patients were noticeably intangible. Overall, the recommended processes of care among eligible patients were provided in 70% for AMI, in 32.4% for HF, in 46.4% for PN, and in 46% for SCIP.</p> <h3>Conclusions</h3><p>The results show that there is still substantial work that lies ahead on the way to improve the uptake to evidence-based processes of care. Improvement initiatives should be focused more on domains of healthcare than on specific conditions, especially on the area of preventive care.</p> </div

Quality of Care in One Italian Nursing Home Measured by ACOVE Process Indicators

<div><p>Objectives</p><p>To adapt the Assessing Care of Vulnerable Elders Quality Indicators (ACOVE QIs) for use in Italy, to assess the adherence to these indicators as reported in the medical records of residents in a nursing home (NH), to compare this adherence for general medical and geriatric conditions, and eventually, to identify the relationships between patients' characteristics and reported processes of care.</p><p>Methods</p><p>Two physicians collected the data by reviewing medical records of all NH residents in the previous 5 years, for a period of one year. Patients aged <65 years were excluded. A total of 245 patients were reviewed during the study period. The ACOVE QIs set, developed for NH processes of care, was used to assess the quality of care. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on quality of processes of care by several domains of care in general medical and geriatric conditions.</p><p>Results</p><p>With the exception of diabetes management, quality of processes of care for general medical conditions approached adequate adherence. Care falls substantially short of acceptable levels for geriatric conditions (pressure ulcers, falls, dementia). On the contrary, the recommended interventions for urinary incontinence were commonly performed. Adherence to indicators varied for the different domains of care and was proven worse for the screening and prevention indicators both for geriatric and general medical conditions. Statistical analysis showed disparities in provision of appropriate processes of care associated with gender, age, co-morbidities, level of function and mobility, length of stay and modality of discharge by NHs.</p><p>Conclusions</p><p>Adherence to recommended processes of care delivered in NH is inadequate. Substantial work lies ahead for the improvement of care. Efforts should focus particularly on management of geriatric conditions and on preventive healthcare.</p></div

Adherence to quality processes of care for general medical versus geriatric conditions by domain of care.

a<p>Quality Indicators; ^bStandard Deviation.</p

Flow diagram of case-control studies identified in the literature for the association between the <i>HMGA1</i> rs146052672 variant and the risk of T2D.

<p>Flow diagram of case-control studies identified in the literature for the association between the <i>HMGA1</i> rs146052672 variant and the risk of T2D.</p

Frequency distribution of quality measures evaluated.

<p>AMI = acute myocardial infarction; HF = heart failure; PN = pneumonia; SCIP = surgical care improvement project; ACEI = angiotensin-converting enzyme inhibitors; ARB = angiotensin receptor blockers; LSVD = left systolic ventricular dysfunction; PCI = percutaneous cardiac intervention; ICU = intensive care unit; ED = emergency department; CAP = community-acquired pneumonia.</p><p><i>°</i>In brackets is reported the overall number of patients for each set of measures.</p>§<p>Not documented in 122 (54.5%) medical records.</p>§§<p>Not documented in 367 (93.9%) medical records.</p>§§§<p>Not documented in 72 (84.7%) medical records.</p>a<p>AMI inpatient mortality not included for the calculation of the composite measure.</p>b<p>Values are expressed as mean ± SD.</p

The Association between <i>HMGA1</i> rs146052672 Variant and Type 2 Diabetes: A Transethnic Meta-Analysis

<div><p>The high-mobility group A1 (<i>HMGA1</i>) gene has been previously identified as a potential novel candidate gene for susceptibility to insulin resistance and type 2 diabetes (T2D) mellitus. For this reason, several studies have been conducted in recent years examining the association of the <i>HMGA1</i> gene variant rs146052672 (also designated IVS5-13insC) with T2D. Because of non-univocal data and non-overlapping results among laboratories, we conducted the current meta-analysis with the aim to yield a more precise and reliable conclusion for this association. Using predetermined inclusion criteria, MEDLINE, PubMed, Web of Science, Scopus, Google Scholar and Embase were searched for all relevant available literature published until November 2014. Two of the authors independently evaluated the quality of the included studies and extracted the data. Values from the single studies were combined to determine the meta-analysis pooled estimates. Heterogeneity and publication bias were also examined. Among the articles reviewed, five studies (for a total of 13,789 cases and 13,460 controls) met the predetermined criteria for inclusion in this meta-analysis. The combined adjusted odds ratio estimates revealed that the rs146052672 variant genotype had an overall statistically significant effect on increasing the risk of development of T2D. As most of the study subjects were Caucasian, further studies are needed to establish whether the association of this variant with an increased risk of T2D is generalizable to other populations. Also, in the light of this result, it would appear to be highly desirable that further in-depth investigations should be undertaken to elucidate the biological significance of the <i>HMGA1</i> rs146052672 variant.</p></div

Sensitivity analysis.

<p>The effect of <i>HMGA1</i> rs146052672 variant on T2D risk was evaluated according to a set of covariates taking into account recruitment in the general population <b>(A)</b>, quality of studies (<b>B</b>), Caucasian ethnicity <b>(C)</b>, Hispanic ethnicity <b>(D)</b>, and genotyping method <b>(E)</b>.</p

Forest plot for the relationship between <i>HMGA1</i> rs146052672 variant and T2D risk.

<p><b>(A)</b> Meta-analysis included 784 unaffected healthy individuals, in the Italian control group, who were selected on the basis of a self-reported medical questionnaire, without a personal interview. <b>(B)</b> Meta-analysis included 2,544 interviewed healthy individuals, in the Italian control group, who had neither a personal nor a family history of T2D or related diseases.</p