705 research outputs found

    Policies for replacing long-term indwelling urinary catheters in adults

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    We would also like to thank the foll owing Cochrane Incontinence editorial base staff members for their help and support with this re-view: Cathryn Glazener, Sheila Wallace, Mandy Fader, Peter Her-bison and Suzanne Macdonald. The review authors are grateful to Toby Lasseron for his advice. The review authors are thankful to Dr Beverly Priefer for responding to our query about Priefer 1982. Policies for replacing long‐term indwelling urinary catheters in adults, Protocol, Fergus PM Cooper, Cameron Edwin Alexander, Sanjay Sinha, Muhammad Imran Omar; https://doi.org/10.1002/14651858.CD011115; 14 May 2014Peer reviewedPublisher PD

    The theology and practice of preaching in the ministry of Dr. John Erskine (1721-1803)

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    This thesis aims to portray the theology and practice of preaching in the ministry of one of the most prominent Evangelical ministers in the Church of Scotland in the eighteenth century, Dr John Erskine (1721-1803). There will first of all be a survey of Erskine's role and stature in the Church of Scotland of the eighteenth century and of his image in contemporary and subsequent literature. We will then proceed to a general survey of the history of preaching in the Christian Church until the eighteenth century to grasp how it was understood and practised and to set the subject of this thesis in its wider historical context. This will be followed by a focus on the history of Scottish preaching in particular. This is to gain some understanding of Erskine's place in the history of preaching and some of the influences which may have shaped his preaching. There will then be an examination of the elements of the preaching event as understood by Erskine: the synergy of preacher, the congregation and the Holy Spirit working through the proclaimed Word. Finally, there will be an examination of Erskine's homiletic practice: his preparation for the pulpit, the structure of his sermons, his contemporaneity, his theological emphasis and his delivery

    Adolescent ambivalence about diabetes technology—The Janus faces of automated care

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    The Janus face metaphor approach highlights that a technology may simultaneously have two opposite faces or properties with unforeseen paradoxes within human‐technology interaction. Suboptimal acceptance and clinical outcomes are sometimes seen in adolescents who use diabetes‐related technologies. A traditional linear techno‐determinist model of technology use would ascribe these unintended outcomes to suboptimal technology, suboptimal patient behavior, or suboptimal outcome measures. This paradigm has demonstratively not been successful at universally improving clinical outcomes over the last two decades. Alternatively, the Janus face metaphor moves away from a linear techno‐determinist model and focuses on the dynamic interaction of the human condition and technology. Specifically, it can be used to understand variance in adoption or successful use of diabetes‐related technology and to retrospectively understand suboptimal outcomes. The Janus face metaphor also allows for a prospective exploration of potential impacts of diabetes‐related technology by patients, families, and their doctors so as to anticipate and minimize potential subsequent tensions

    Diabetes MILES Youth–Australia: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 diabetes in Australian youth and their parents

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    Background Type 1 diabetes is a complex and demanding condition, which places a substantial behavioural and psychological burden on young people and their families. Around one-third of adolescents with type 1 diabetes need mental health support. Parents of a child with type 1 diabetes are also at increased risk of psychological distress. A better understanding of the motivators, behaviours and psychological well-being of young people with diabetes and their parents will inform improvement of resources for supporting self-management and reducing the burden of diabetes. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Youth–Australia Study is the first large-scale, national survey of the impact of diabetes on the psychosocial outcomes of Australian adolescents with type 1 diabetes and their parents. Methods/design The survey was web-based to enable a large-scale, national survey to be undertaken. Recruitment involved multiple strategies: postal invitations; articles in consumer magazines; advertising in diabetes clinics; social media (e.g. Facebook, Twitter). Recruitment began in August 2014 and the survey was available online for approximately 8 weeks. A total of 781 young people (aged 10–19 years) with type 1 diabetes and 826 parents completed the survey. Both genders, all ages within the relevant range, and all Australian states and territories were represented, although compared to the general Australian population of youth with type 1 diabetes, respondents were from a relatively advantaged socioeconomic background. Discussion The online survey format was a successful and economical approach for engaging young people with type 1 diabetes and their parents. This rich quantitative and qualitative dataset focuses not only on diabetes management and healthcare access but also on important psychosocial factors (e.g. social support, general emotional well-being, and diabetes distress). Analysis of the Diabetes MILES Youth–Australia Study data is ongoing, and will provide further insights into the psychosocial problems facing young people with type 1 diabetes and their parents. These will inform future research and support services to meet the needs of young Australians with type 1 diabetes and their families. Keywords Type 1 diabetes Psychological well-being National survey Adolescents Self-care Quality of life Diabetes distress Depressio

    Relief of neuropathic pain through epidermal growth factor receptor inhibition: a randomized proof-of concept trial

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    Objective. Case reports and a case series have described relief of neuropathic pain (NP) after treatment with epidermal growth factor receptor inhibitors (EGFR-Is). These observations are supported by preclinical findings. The aim of this trial was to explore a potential clinical signal supporting the therapeutic efficacy of EGFR-Is in NP. Methods. In a proof-of-concept trial using a randomized, double-blind, placebo-controlled design, 14 patients with severe, chronic, therapy-resistant NP due to compressed peripheral nerves or complex regional pain syndrome were randomized to receive a single infusion of the EGFR-I cetuximab and placebo in crossover design, followed by a single open-label cetuximab infusion. Results. The mean reduction in daily average pain scores three to seven days after single-blinded cetuximab infusion was 1.73 points (90% confidence interval [CI] = 0.80 to 2.66), conferring a 1.22-point greater reduction than placebo (90% CI = -0.10 to 2.54). Exploratory analyses suggested that pain reduction might be greater in the 14 days after treatment with blinded cetuximab than after placebo. The proportion of patients who reported &gt;= 50% reduction in average pain three to seven days after cetuximab was 36% (14% after placebo), and comparison of overall pain reduction suggests a trend in favor of cetuximab. Skin rash (grade 1-2) was the most frequent side effect (12/14, 86%). Conclusions. This small proof-of-concept evaluation of an EGFR-I against NP did not provide statistical evidence of efficacy. However, substantial reductions in pain were reported, and confidence intervals do not rule out a clinically meaningful treatment effect. Evaluation of EGFR-I against NP therefore warrants further investigation.</p

    The application of retinal fundus camera imaging in dementia:A systematic review

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    INTRODUCTION: The ease of imaging the retinal vasculature, and the evolving evidence suggesting this microvascular bed might reflect the cerebral microvasculature, presents an opportunity to investigate cerebrovascular disease and the contribution of microvascular disease to dementia with fundus camera imaging. METHODS: A systematic review and meta-analysis was carried out to assess the measurement of retinal properties in dementia using fundus imaging. RESULTS: Ten studies assessing retinal properties in dementia were included. Quantitative measurement revealed significant yet inconsistent pathologic changes in vessel caliber, tortuosity, and fractal dimension. Retinopathy was more prevalent in dementia. No association of age-related macular degeneration with dementia was reported. DISCUSSION: Inconsistent findings across studies provide tentative support for the application of fundus camera imaging as a means of identifying changes associated with dementia. The potential of fundus image analysis in differentiating between dementia subtypes should be investigated using larger well-characterized samples. Future work should focus on refining and standardizing methods and measurements

    Erratum:Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome (Future Cardiology (2014) 10:6 (693-698))

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    Following publication of the Clinical Trial Protocol by Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus McKiddie, Chim Lang, Dana Dawson and Michael Frenneaux, titled ‘Randomized double-blind placebo-controlled trial of perhexiline in heart failure with preserved ejection fraction syndrome’, which appeared in the December 2014 issue of Future Cardiology (Future Oncol. 10[6], 693–698 [2014]), it has been brought to our attention that the author names were presented incorrectly as:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Peter Nightingale, Chim Lang, Dana Dawson and Michael Frenneaux.The correct presentation should be:Satnam Singh, Roger Beadle, Donnie Cameron, Amelia Rudd, Maggie Bruce, Baljit Jagpal, Konstantin Schwarz, Gemma Brindley, Fergus Mckiddie, Chim Lang, Dana Dawson and Michael Frenneaux.The authors and editors of Future Cardiology would like to sincerely apologize for any inconvenience or confusion this may have caused our readers.<br/

    Population coverage of artemisinin-based combination treatment in children younger than 5 years with fever and Plasmodium falciparum infection in Africa, 2003–2015: a modelling study using data from national surveys

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    Background Artemisinin-based combination therapies (ACTs) are the most effective treatment for uncomplicated Plasmodium falciparum malaria infection. A commonly used indicator for monitoring and assessing progress in coverage of malaria treatment is the proportion of children younger than 5 years with reported fever in the previous 14 days who have received an ACT. We propose an improved indicator that incorporates parasite infection status (as assessed by a rapid diagnostic test [RDT]), which is available in recent household surveys. In this study we estimated the annual proportion of children younger than 5 years with fever and a positive RDT in Africa who received an ACT in 2003–15. Methods Our modelling study used cross-sectional data on treatment for fever and RDT status for children younger than 5 years compiled from all nationally available representative household surveys (the Malaria Indicator Surveys, Demographic and Health Surveys, and Multiple Indicator Cluster Surveys) across sub-Saharan Africa between 2003 and 2015. Estimates for the proportion of children younger than 5 years with a fever within the previous 14 days and P falciparum infection assessed by RDT who received an ACT were incorporated in a generalised additive mixed model, including data on ACT distributions, to estimate coverage across all countries and time periods. We did random effects meta-analyses to examine individual, household, and community effects associated with ACT coverage. Findings We obtained data on 201 704 children younger than 5 years from 103 surveys (22 MIS, 61 DHS, and 20 MICS) across 33 countries. RDT results were available for 40 of these surveys including 40 261 (20%) children, and we predicted RDT status for the remaining 161 443 (80%) children. Our results showed that ACT coverage in children younger than 5 years with a fever and P falciparum infection increased across sub-Saharan Africa in 2003–15, but even in 2015, only 19·7% (95% CI 15·6–24·8) of children younger than 5 years with a fever and P falciparum infection received an ACT. In meta-analyses, children younger than 5 years were more likely to receive an ACT for fever and P falciparum infection if they lived in an urban area (vs rural area; odds ratio [OR] 1·18, 95% CI 1·06–1·31), had household wealth above the national median (vs wealth below the median; OR 1·26, 1·16–1·39), had a caregiver with any education (vs no education; OR 1·31, 1·22–1·41), had a household insecticide-treated net (ITN; vs no ITN; OR 1·21, 1·13–1·29), were older than 2 years (vs ≤2 years; OR 1·09, 1·01–1·17), or lived in an area with a higher mean P falciparum prevalence in children aged 2–10 years (OR 1·12, 1·02–1·23). In the subgroup of children for whom treatment was sought, those who sought treatment in the public sector were more likely to receive an ACT (vs the private sector; OR 3·18, 2·67–3·78). Interpretation Despite progress during the 2003–15 malaria programme, ACT treatment for children with malaria remains unacceptably low. More work is needed at the country level to understand how health-care access, service delivery, and ACT supply might be improved to ensure appropriate treatment for all children with malaria
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