Knowledge, Attitudes, and Beliefs of Cardiovascular Disease Prevention in Young Georgian Adults

Introduction: Cardiovascular disease (CVD) accounts for 46% of all mortality in the country of Georgia (former Soviet Union). Young adults in that country have not been studied regarding CVD and a need exists to understand lifestyle modifications to promote cardiovascular health. Design: An interpretive description qualitative design was used to explore Georgian young adults’ knowledge, attitudes, and beliefs of CVD preventative practices and life experiences. Methods: A convenience sample of 19 ethnic Georgian participants (18 to 40 years old) who were fluent in either English, Georgian, or Russian from a local private university was used. Semi-structured interviews were conducted via video conferencing utilizing an interpreter. Results: Four themes were identified: 1) CVD and risk factor knowledge, 2) prevention attitudes, beliefs, and gender differences, 3) health literacy influences, and 4) culture and societal impacts. CVD knowledge was limited and influenced by health literacy and the current healthcare system in Georgia. Conclusion: Cultural and societal gender norms influence cardiovascular health behaviors

A case for the standardized assessment of testamentary capacity

© 2018 Author(s). Published by the Canadian Geriatrics Society. Background: With an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will. Method: This paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts. Results: The legal criteria, often referred to as a test , for determining requisite TC (Banks v. Goodfellow) have remained much the same since 1870 with minimal clinical input and, as such, there has been little development in TC assessment instruments. Decisional instruments designed to assess Consent to Treatment may have relevance for TC. Conclusion: We make the case for a semi-structured interview that includes standardized criteria for the legal test for TC, supplemented by a validated brief neuropsychological assessment, which together comprise a Contemporaneous Assessment Instrument (CAI) for TC

Medical consequences of pathogenic CNVs in adults: Analysis of the UK Biobank

Background: Genomic CNVs increase the risk for early-onset neurodevelopmental disorders, but their impact on medical outcomes in later life is still poorly understood. The UK Biobank allows us to study the medical consequences of CNVs in middle and old age in half a million well-phenotyped adults. Methods: We analysed all Biobank participants for the presence of 54 CNVs associated with genomic disorders or clinical phenotypes, including their reciprocal deletions or duplications. After array quality control and exclusion of first-degree relatives, we compared 381 452 participants of white British or Irish origin who carried no CNVs with carriers of each of the 54 CNVs (ranging from 5 to 2843 persons). We used logistic regression analysis to estimate the risk of developing 58 common medical phenotypes (3132 comparisons). Results and conclusions: Many of the CNVs have profound effects on medical health and mortality, even in people who have largely escaped early neurodevelopmental outcomes. Forty-six CNV–phenotype associations were significant at a false discovery rate threshold of 0.1, all in the direction of increased risk. Known medical consequences of CNVs were confirmed, but most identified associations are novel. Deletions at 16p11.2 and 16p12.1 had the largest numbers of significantly associated phenotypes (seven each). Diabetes, hypertension, obesity and renal failure were affected by the highest numbers of CNVs. Our work should inform clinicians in planning and managing the medical care of CNV carriers

DPOAEs in Children With Sickle Cell Disease

The purpose of this study was to investigate distortion product otoacoustic emissions (DPOAEs) in young normal-hearing children with sickle cell disease (SCD). It was hypothesized that the prevalence of DPOAEs and response amplitudes would be lower than those in children with normal hemoglobin due to suspected compromised cochlear function as a result of vaso-occlusive events characteristic of SCD. Twenty African-American children with SCD and 15 African-American children with normal hemoglobin participated. Distortion product OAEs were evoked by thirteen primary tone pairs with f2 frequencies ranging from 1000 to 4500 Hz. The primary tones were presented at and L1 and L2 levels of 70 and 60 dB SPL (high) and 50 and 40 dB SPL (low), respectively. The findings of this study were completely unexpected and contrary to our original hypotheses. The likelihood of detecting a DPOAE response was not related to the clinical status of the children. Distortion product OAE amplitudes were significantly larger for children with SCD (p = .01). Educational Objectives: After completing this article the reader will (1) have a basic knowledge of the audiometric complications of sickle cell disease and (2) appreciate the differences in DPOAEs between young normal-hearing children with sickle cell DPOAEs in Children With Sickle Cell Disease 3 disease and young normal-hearing children with normal hemoglobin