Relationship of Homocysteine level and Comorbidities in VA Patients: A Retrospective Chart Review

Introduction: Elevated serum homocysteine is known to be associated with endothelial dysfunction, which is seen in multiple chronic diseases which include, but is not limited to Alzheimer’s, Dementia, and cardiovascular disease. This necessitated our investigation into serum homocysteine levels in VA patients and their associated comorbid disorders. Our study aimed to investigate comorbidities associated with elevated homocysteine levels, defined by being greater than 15 micromole/liter. Methods: Informatics at the VA was used to obtain a list of 654 patients with homocysteine drawn during the period of the study (7/21/2009 through 12/31/2013) at the John D. Dingell VAMC. Subjects were adults over 18 years of age. Patient gender, BMI, vitals, vitamin supplementation, and associated comorbidities were retrospectively analyzed and documented in an Excel file. The data from the excel file were statistically analyzed using SPSS 25. For each comorbidity and patient characteristic, homocysteine levels were compared using Independent Samples Mann-Whitney U test. Results: After completing statistical analysis of comorbidities commonly found in our Veteran population, those with statistically significant elevated levels (P-value \u3c0.05) of homocysteine were found to be Hypertension (P-value 0.001), Chronic Kidney Disease (P-value \u3c0.001), Dementia (P-value 0.004), Alzheimer’s (P-value 0.018), Peripheral Vascular Disease (P-value 0.046), and male gender (P-value 0.037). Of note, psoriasis was not statistically significant (P-value 0.855). Conclusion: Elevated homocysteine levels are known to be pro-inflammatory, which likely plays a role in their elevation in hypertension, chronic kidney disease, dementia, Alzheimer’s, and Peripheral Vascular Disease, necessitating a need to reduce homocysteine levels to improve patient outcomes

Patients’ Compliance to Active Surveillance (AS) Protocol in Low-risk Prostate Cancer

Aim/Introduction Active surveillance (AS) is currently the preferred initial option for patients with low risk prostate cancer (PC). AS requires patients to undergo regular office visits with periodic testing. We measured patient compliance to NCCN guidelines for AS through review of medical record abstractions. Methods White and Black patients (n=221) with newly diagnosed low-risk PC on AS identified through a population-based cancer registry were surveyed at baseline (4 months after diagnosis) and at 2 year follow-up. 186 medical records reviewed and confirmed the AS protocol and compliance. Patient self-reported data were then compared with medical records data. Results Of the 186 patients who initially on AS, 151 remained on AS at 2 year follow-up. Overall, 55.2% (n=90) were guideline-concordant of having at least three PSA tests and one prostate biopsy during 2 year follow-up. Patients more likely guideline-concordant for PSA testing than guideline-concordant with prostate biopsy (76.7% vs. 66.9 %, respectively). Discussion Majority of patients on AS in this sample follow practice guidelines, but there is significant variation in the proportion of men on AS that meet guideline recommendations for follow-up PSA testing and repeat biopsy. These data highlight the need for further patients and providers education that emphasize the need of repeated testing including prostate biopsies to ensure safety of AS

Exploring modifiable risk factors for premature birth in the context of COVID-19 mitigation measures: A discussion paper

© 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.Peer reviewe

An analysis of the information technology (IT) attitudes, and anxieties of leaders at the Phillips Plastics Corporation

Includes bibliographic references

Implementation and Evaluation of a Multidimensional Nutrition and Physical Activity Initiative Funded by a Community Health Foundation

· Poor diet and physical inactivity have been estimated to account for nearly 400,000 deaths a year in the U.S. and are contributing factors to obesity. Nearly one-third of children and two-thirds of adults are overweight or obese. Therefore, in early 2007 Health Foundation of South Florida (HFSF) embarked on a five-year responsive grantmaking initiative, Healthy Eating Active Communities. · The initiative\u27s aim was to improve healthy eating habits and physical activity levels through two major approaches: individual-level programs grounded in an educational approach and organizational, environmental, policy, and systems-change interventions. As additional research has emerged in the field, policies and practices that create supportive environments and healthier communities have been a major focal point of this initiative. · The project adopted a multisector orientation and expanded its partners beyond traditional healthrelated organizations. Moreover, several grantee organizations were funded to implement evidenced- based approaches targeting nutrition and physical activity in children and adults. As program evaluator for the initiative, Research & Evaluation Network (REN) collaborated with HFSF to develop the project logic model, guide the development of the evaluation plan, and evaluate the outcomes associated with the grantees\u27 programs. · This article provides a detailed overview of the initiative and documents the collaborative process that the foundation, evaluator, and grantees undertook to initiate and maintain this effort. It provides an example of the potential for partnerships to facilitate effective program implementation in this area, utilize practical program evaluation, and promote program growth and sustainability

Where Does Work Stress Come From? A Generalizability Analysis of Stress in Police Officers

Differences among workers and workplace stressors both contribute to perceiving work as stressful. However, the relative importance of these sources to work stress is not well delineated. Moreover, the extent to which work stress additionally reflects unique matches between specific workers and particular job stressors is also unclear. In this study, we use generalizability theory to specify and compare sources of variance in stress associated with police work. US police officers (N = 115) provided ratings of 60 stressors commonly associated with policing duties. Primary and secondary stress appraisal ratings reflected differences among officers in tendencies to generally perceive work stressors as stressful (14–15% officer effect), and also agreement among officers in viewing some stressors as more stressful than others (18–19% stressor effect). However, ratings especially reflected distinct pairings of officers and stressors (38–41% interaction effect). Additional analyses revealed individual differences and stressor characteristics associated with each variance component, including an officer × stressor interaction – compared to officers low in neuroticism, highly neurotic officers provided lower primary appraisal ratings of stressors generally seen as not serious, and also higher primary appraisal ratings of stressors that were seen as serious. We discuss implications of the current approach for the continued study of stress at work