76 research outputs found
Playing the Way to Equality in the Civil RIghts, Feminism, and LGBTQ Movements
Music culture is where a group of people share a common involvement, or interest, in music. This culture spans across time and area as music evolves. Whether it be rap or country, classical or punk, people have found their niches in the world of music. People relate to music, and it makes them feel good. Music comes with an emotional attachment in this way. This bond is seen between listeners and performers, as well as the listeners themselves. This common love of music is seen very blatantly, as it’s played on every kind of social media, and is seen in schools across the country. In some cases, music helps with more than just mood and friendships. Music helps people feel included and equal in their societies. When it comes to the fight for equality, music is a fundamental supporter
Improving Colorectal Cancer Screening Decision Making Processes
Introduction:
Although shared decision making is recommended for cancer screening, it is not routinely completed in practice because of time constraints. We evaluated a process for improving decision making about colorectal cancer (CRC) screening using mailed decision aids (DA) with follow-up telephone support in primary care practices.
Methods:
We identified patients aged 50-75 who were not up to date with CRC screening in three primary care practices. DA were distributed via mail with telephone follow-up to eligible patients, and charts were reviewed six months later for CRC screening completion.
Results:
Among 1,064 eligible patients who received the mailed DA, 513 (48.2%) were reached by phone. During the six months after the intervention, 148/1064 (13.9%) patients were screened for CRC (4.8% underwent FIT, 9.1% underwent colonoscopy). Younger patients (aged 50-54) had higher rates of any screening (32.4%) compared with all other age groups (range 12.8%-19.6%), p=0.026, while Medicaid patients had the lowest rates of screening (4.0%), and insured patients had the highest rates (45.3%), p=0.003. Overall, 113/513 (22.0%) who were reached by phone went on to complete screening within 6 months, compared with 35/551 (6.4%) of patients who were not reached by phone (p
Conclusion:
A standard process for identifying patients unscreened for CRC and DA distribution via mail with telephone decision support modestly increased CRC screening and is consistent with the goal of providing preference-sensitive care and informed decision making. Improving care processes to include decision support outside of office visits is possible in primary care practices
Body mass index and blood pressure in a semi-urban community in Ota, Nigeria
This study was designed to establish the relationship between body mass index (BMI) and blood pressure (BP) in an increasingly industrialised town in Nigeria due to the rising prevalence of hypertension in non-industrialised countries. Factors associated with BMI and BP levels were determined in three hundred adult male and female subjects in Ota community of Ogun State, Nigeria. The levels of the overweight among the male and female subjects were 53.03 % and 47.37 % respectively. The levels of hypertensive male and female subjects were 40.91 % and 35.34 % respectively. The overweight and underweight among the hypertensive male were 54.29 % and 0 % respectively; while the overweight and underweight among the hypertensive female were 42.86 % and 28.57 % respectively. Hypertension among the overweight, and hypotension among the underweight, are major health concern in Ota that requires intensive medical care
Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: an Irish population-based study.
BACKGROUND: This study investigated the prevalence of DSM-IV Axis 1 mental disorders, deliberate self-harm and suicidal ideation in a sample of Irish adolescents aged 11-13 years.
METHODS: A total of 1131 students was surveyed for general psychopathology using the Strengths and Difficulties Questionnaire. Following this, a representative sample of 212 adolescents was assessed for mental disorders, deliberate self-harm and suicidal ideation using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children.
RESULTS: 14.6% of the sample met criteria for a borderline score and 6.9% for an abnormal score on the Strengths and Difficulties Questionnaire. Following clinical diagnostic interviews, 27.4% of participants received a current diagnosis of an Axis 1 disorder and 36.8% received a lifetime diagnosis, those rates falling to 15.4% and 31.2% respectively when specific phobias were excluded.
CONCLUSIONS: Findings from this study reveal that Irish adolescents aged 11-13 years are experiencing high levels of mental ill-health
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A reference human induced pluripotent stem cell line for large-scale collaborative studies.
Human induced pluripotent stem cell (iPSC) lines are a powerful tool for studying development and disease, but the considerable phenotypic variation between lines makes it challenging to replicate key findings and integrate data across research groups. To address this issue, we sub-cloned candidate human iPSC lines and deeply characterized their genetic properties using whole genome sequencing, their genomic stability upon CRISPR-Cas9-based gene editing, and their phenotypic properties including differentiation to commonly used cell types. These studies identified KOLF2.1J as an all-around well-performing iPSC line. We then shared KOLF2.1J with groups around the world who tested its performance in head-to-head comparisons with their own preferred iPSC lines across a diverse range of differentiation protocols and functional assays. On the strength of these findings, we have made KOLF2.1J and its gene-edited derivative clones readily accessible to promote the standardization required for large-scale collaborative science in the stem cell field
Expanding the diversity of mycobacteriophages: insights into genome architecture and evolution.
Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists
Robust estimation of bacterial cell count from optical density
Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data
New Australian guidelines for the treatment of alcohol problems: an overview of recommendations
Summary of recommendations and levels of evidence
Chapter 2: Screening and assessment for unhealthy alcohol use
Screening
Screening for unhealthy alcohol use and appropriate interventions should be implemented in general practice (Level A), hospitals (Level B), emergency departments and community health and welfare settings (Level C).
Quantity–frequency measures can detect consumption that exceeds levels in the current Australian guidelines (Level B).
The Alcohol Use Disorders Identification Test (AUDIT) is the most effective screening tool and is recommended for use in primary care and hospital settings. For screening in the general community, the AUDIT-C is a suitable alternative (Level A).
Indirect biological markers should be used as an adjunct to screening (Level A), and direct measures of alcohol in breath and/or blood can be useful markers of recent use (Level B).
Assessment
Assessment should include evaluation of alcohol use and its effects, physical examination, clinical investigations and collateral history taking (Level C).
Assessment for alcohol-related physical problems, mental health problems and social support should be undertaken routinely (GPP).
Where there are concerns regarding the safety of the patient or others, specialist consultation is recommended (Level C).
Assessment should lead to a clear, mutually acceptable treatment plan which specifies interventions to meet the patient’s needs (Level D).
Sustained abstinence is the optimal outcome for most patients with alcohol dependence (Level C).
Chapter 3: Caring for and managing patients with alcohol problems: interventions, treatments, relapse prevention, aftercare, and long term follow-up
Brief interventions
Brief motivational interviewing interventions are more effective than no treatment for people who consume alcohol at risky levels (Level A).
Their effectiveness compared with standard care or alternative psychosocial interventions varies by treatment setting. They are most effective in primary care settings (Level A).
Psychosocial interventions
Cognitive behaviour therapy should be a first-line psychosocial intervention for alcohol dependence. Its clinical benefit is enhanced when it is combined with pharmacotherapy for alcohol dependence or an additional psychosocial intervention (eg, motivational interviewing) (Level A).
Motivational interviewing is effective in the short term and in patients with less severe alcohol dependence (Level A).
Residential rehabilitation may be of benefit to patients who have moderate-to-severe alcohol dependence and require a structured residential treatment setting (Level D).
Alcohol withdrawal management
Most cases of withdrawal can be managed in an ambulatory setting with appropriate support (Level B).
Tapering diazepam regimens (Level A) with daily staged supply from a pharmacy or clinic are recommended (GPP).
Pharmacotherapies for alcohol dependence
Acamprosate is recommended to help maintain abstinence from alcohol (Level A).
Naltrexone is recommended for prevention of relapse to heavy drinking (Level A).
Disulfiram is only recommended in close supervision settings where patients are motivated for abstinence (Level A).
Some evidence for off-label therapies baclofen and topiramate exists, but their side effect profiles are complex and neither should be a first-line medication (Level B).
Peer support programs
Peer-led support programs such as Alcoholics Anonymous and SMART Recovery are effective at maintaining abstinence or reductions in drinking (Level A).
Relapse prevention, aftercare and long-term follow-up
Return to problematic drinking is common and aftercare should focus on addressing factors that contribute to relapse (GPP).
A harm-minimisation approach should be considered for patients who are unable to reduce their drinking (GPP).
Chapter 4: Providing appropriate treatment and care to people with alcohol problems: a summary for key specific populations
Gender-specific issues
Screen women and men for domestic abuse (Level C).
Consider child protection assessments for caregivers with alcohol use disorder (GPP).
Explore contraceptive options with women of reproductive age who regularly consume alcohol (Level B).
Pregnant and breastfeeding women
Advise pregnant and breastfeeding women that there is no safe level of alcohol consumption (Level B).
Pregnant women who are alcohol dependent should be admitted to hospital for treatment in an appropriate maternity unit that has an addiction specialist (GPP).
Young people
Perform a comprehensive HEEADSSS assessment for young people with alcohol problems (Level B).
Treatment should focus on tangible benefits of reducing drinking through psychotherapy and engagement of family and peer networks (Level B).
Aboriginal and Torres Strait Islander peoples
Collaborate with Aboriginal or Torres Strait Islander health workers, organisations and communities, and seek guidance on patient engagement approaches (GPP).
Use validated screening tools and consider integrated mainstream and Aboriginal or Torres Strait Islander-specific approaches to care (Level B).
Culturally and linguistically diverse groups
Use an appropriate method, such as the “teach-back” technique, to assess the need for language and health literacy support (Level C).
Engage with culture-specific agencies as this can improve treatment access and success (Level C).
Sexually diverse and gender diverse populations
Be mindful that sexually diverse and gender diverse populations experience lower levels of satisfaction, connection and treatment completion (Level C).
Seek to incorporate LGBTQ-specific treatment and agencies (Level C).
Older people
All new patients aged over 50 years should be screened for harmful alcohol use (Level D).
Consider alcohol as a possible cause for older patients presenting with unexplained physical or psychological symptoms (Level D).
Consider shorter acting benzodiazepines for withdrawal management (Level D).
Cognitive impairment
Cognitive impairment may impair engagement with treatment (Level A).
Perform cognitive screening for patients who have alcohol problems and refer them for neuropsychological assessment if significant impairment is suspected (Level A).
Summary of key recommendations and levels of evidence
Chapter 5: Understanding and managing comorbidities for people with alcohol problems: polydrug use and dependence, co-occurring mental disorders, and physical comorbidities
Polydrug use and dependence
Active alcohol use disorder, including dependence, significantly increases the risk of overdose associated with the administration of opioid drugs. Specialist advice is recommended before treatment of people dependent on both alcohol and opioid drugs (GPP).
Older patients requiring management of alcohol withdrawal should have their use of pharmaceutical medications reviewed, given the prevalence of polypharmacy in this age group (GPP).
Smoking cessation can be undertaken in patients with alcohol dependence and/or polydrug use problems; some evidence suggests varenicline may help support reduction of both tobacco and alcohol consumption (Level C).
Co-occurring mental disorders
More intensive interventions are needed for people with comorbid conditions, as this population tends to have more severe problems and carries a worse prognosis than those with single pathology (GPP).
The Kessler Psychological Distress Scale (K10 or K6) is recommended for screening for comorbid mental disorders in people presenting for alcohol use disorders (Level A).
People with alcohol use disorder and comorbid mental disorders should be offered treatment for both disorders; care should be taken to coordinate intervention (Level C).
Physical comorbidities
Patients should be advised that alcohol use has no beneficial health effects. There is no clear risk-free threshold for alcohol intake. The safe dose for alcohol intake is dependent on many factors such as underlying liver disease, comorbidities, age and sex (Level A).
In patients with alcohol use disorder, early recognition of the risk for liver cirrhosis is critical. Patients with cirrhosis should abstain from alcohol and should be offered referral to a hepatologist for liver disease management and to an addiction physician for management of alcohol use disorder (Level A).
Alcohol abstinence reduces the risk of cancer and improves outcomes after a diagnosis of cancer (Level A)
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