Digging deeper: quality of patient-provider communication across Hispanic subgroups

<p>Abstract</p> <p>Background</p> <p>Recent research suggests that ethnic subgroup designation plays an important role in health-related disparities among Hispanics. Our objective was to examine the influence of Hispanics' self-reported ethnic subgroup designation on perceptions of their health care providers' communication behaviors.</p> <p>Methods</p> <p>Cross-sectional analysis of the 2005 Medical Expenditure Panel Survey (MEPS). Participants included non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged ≥18 years, reporting visiting a health care provider within the past 12 months. Six (n = 6) items were used to capture respondents' perceptions of their health care providers' communication behaviors.</p> <p>Results</p> <p>After controlling for socio-demographic covariates, compared to Other Hispanics (reference group), very few differences in perceptions of health care providers communication emerged across ethnic subgroups. Puerto Ricans were more likely to report that their health care provider "always" showed respect for what they had to say (OR = 2.16, 95% CI 1.16-4.03). Both Puerto Ricans (OR = 2.28, 95% CI 1.06-4.92) and Mexicans (OR = 1.88, 95% CI 1.02-3.46) were more likely to indicate that their health care provider "always" spent enough time with them as compared to Other Hispanics.</p> <p>Conclusions</p> <p>We observed very few differences among Hispanics respondents in their perceived quality of interactions with health care providers as a function of their ethnic subgroup designation. While our findings somewhat contradict previous research, they do suggest that other underlying factors may influence the quality of perceived interactions with health care providers.</p

Implementation of Technology-based Patient Engagement Strategies within Practice-Based Research Networks (Poster)

Careyva, B. Shaak, K. Mills, G. Johnson, M. Goodrich, S. Stello, B. Wallace, L. (2016, Nov). Implementation of Technology-Based Patient Engagement Strategies within Practice-Based Research Networks. Poster Presented at: North American Primary Care Research Group, Colorado Springs, CO

Health literacy: setting an international collaborative research agenda

<p>Abstract</p> <p>Background</p> <p>Health literacy is an increasingly important topic in both the policy and research agendas of many countries. During the recent 36^thAnnual Meeting of the North American Primary Care Research Group, the authors led an audio-taped 3-hour forum, "<it>Studying Health Literacy: Developing an International Collaboration</it>," where the current state of health literacy (HL) in the United States (US) and United Kingdom (UK) was presented and attendees were encouraged to debate a future research agenda.</p> <p>Discussion of Forum Themes</p> <p>The debate centred around three distinct themes, including: (1) refining HL definitions and conceptual models, (2) HL measurement and assessment tools, and (3) developing a collaborative international research agenda. The attendees agreed that future research should be theoretically grounded and conceptual models employed in studies should be explicit to allow for international comparisons to be drawn.</p> <p>Summary and Authors Reflections</p> <p>The importance of HL research and its possible contribution to health disparities is becoming increasingly recognised internationally. International collaborations and comparative studies could illuminate some of the possible determinants of disparities, and also possibly provide a vehicle to examine other research questions of interest.</p

Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA): a randomised controlled trial of an integrated foot care programme for foot problems in JIA

&lt;b&gt;Background&lt;/b&gt;: Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated care for juvenile idiopathic arthritis patients with foot and ankle problems exists. &lt;b&gt;Methods/design&lt;/b&gt;: An exploratory phase II non-pharmacological randomised controlled trial where patients including young children, adolescents and adults with juvenile idiopathic arthritis and associated foot/ankle problems will be randomised to receive integrated podiatric care via a new foot care programme, or to receive standard podiatry care. Sixty patients (30 in each arm) including children, adolescents and adults diagnosed with juvenile idiopathic arthritis who satisfy the inclusion and exclusion criteria will be recruited from 2 outpatient centres of paediatric and adult rheumatology respectively. Participants will be randomised by process of minimisation using the Minim software package. The primary outcome measure is the foot related impairment measured by the Juvenile Arthritis Disability Index questionnaire's impairment domain at 6 and 12 months, with secondary outcomes including disease activity score, foot deformity score, active/limited foot joint counts, spatio-temporal and plantar-pressure gait parameters, health related quality of life and semi-quantitative ultrasonography score for inflammatory foot lesions. The new foot care programme will comprise rapid assessment and investigation, targeted treatment, with detailed outcome assessment and follow-up at minimum intervals of 3 months. Data will be collected at baseline, 6 months and 12 months from baseline. Intention to treat data analysis will be conducted. A full health economic evaluation will be conducted alongside the trial and will evaluate the cost effectiveness of the intervention. This will consider the cost per improvement in Juvenile Arthritis Disability Index, and cost per quality adjusted life year gained. In addition, a discrete choice experiment will elicit willingness to pay values and a cost benefit analysis will also be undertaken

Crop Updates 2000 - Weeds

This session covers thirty six papers from different authors: INTRODUCTION, Vanessa Stewart Agriculture Western Australia INTEGRATED WEED MANAGEMENT Effect of seeding density, row spacing and Trifluralin on the competitive ability of Annual Ryegrass in a minimum tillage system, David Minkey, Abul Hashem, Glen Riethmuller and Martin Harries, Agriculture Western Australia High wheat seeding rates coupled with narrow row spacing increases yield and suppresses grass, Peter Newman1 and Cameron Weeks2,1Agronomist, Elders Limited 2Mingenew/Irwin Group Resistant ryegrass management in a wheat – lupin rotation, Abul Hashem, Harmohinder S. Dhammu, Aik Cheam, David Bowran and Terry Piper, Agriculture Western Australia Integrated weed management – Will it work with my rotation? Alexandra Wallace, Agriculture Western Australia Long term herbicide resistance trial – Mingenew, Peter Newman Elders, Cameron Weeks Mingenew-Irwin Group Is two years enough? Bill Roy, Agricultural Consulting and Research Services The fate of ryegrass seed when sheep graze chaff cart heaps, Keith L. Devenish1 and Lisa J. Leaver2 1 Agriculture Western Australia, 2Curtin University of Technology, Muresk Institute of Agriculture Can blanket wiping and crop topping prevent seed set of resistant wild radish and mustard? StAbul Hashem, Harmohinder Dhammu, Vanessa Stewart, Brad Rayner and Mike Collins, Agriculture Western Australia The value of green manuring in the integrated management of ryegrass, Marta Monjardino1,2, David Pannell2, Stephen Powles1 ,1Western Australia Herbicide Resistance Initiative, 2Agricultural and Resource Economics, University of Western Australia Some ways of increasing wheat competitiveness against ryegrass,, Mike Collins Centre for Cropping Systems, Agriculture Western Australia WEED BIOLOGY Understanding and driving weed seed banks to very low levels, Sally Peltzer, Agriculture Western Australi HERBICIDE RESISTANCE Cross resistance of chlorsulfuron-resistant wild radish to imidazolinones, Abul Hashem, Harmohinder Dhammu and David Bowran, Agriculture Western Australia Investigation of suspected triazine resistant ryegrass populations for cross-resistance and multiple resistance to herbicides, Michael Walsh, Charles Boyle and Stephen Powles, Western Australian Herbicide Resistance Initiative, University of Western Australia Genetics and fitness of glyphosate resistant ryegrass, S. Powles1, P. Neve1, D. Lorraine-Colwill2, C. Preston2 ,1WAHRI, University of Western Australia 2 CRC Weed Management Systems, University of Adelaide Managing herbicide resistance – the effect of local extinction of resistance genes, Art Diggle1, Paul B. Neve2, Stephen B. Powles2 ,1Agriculture Western Australia, 2WAHRI, Faculty of Agriculture, University of Western Australia The double knock - the best strategy for conserving glyphosate susceptibility? Paul B. Neve1, Art Diggle2, Stephen B. Powles1,1WAHRI, Faculty of Agriculture, University of Western Australia, 2Agriculture Western Australia Wild radish had evolved resistance to triazines, Abul Hashem, Harmohinder S. Dhammu, David Bowran and Aik Cheam, Agriculture Western Australia Ryegrass resistance in Western Australia – where and how much? Rick Llewellyn and Stephen Powles, Western Australian Herbicide Resistance Initiative, Faculty of Agriculture, University of Western Australia Wild radish herbicide resistance survey, Michael Walsh, Ryan Duane and Stephen Powles, Western Australian Herbicide Resistance Initiative, University of Western Australia Knockdown resistance in the Western Australian wheatbelt – a proposed survey, Paul B. Neve1, Abul Hashem2, Stephen B. Powles1,1Western Australian Herbicide Resistance Initiative, University of Western Australia, 2Agriculture Western Australia Diflufenican resistant wild radish, Aik Cheam, Siew Lee, David Bowran, David Nicholson and Abul Hashem, Agriculture Western Australi Multiple resistance to triazines and diflufenican further complicates wild radish control, Aik Cheam, Siew Lee, David Bowran, David Nicholson and Abul Hashem, Agriculture Western Australia HERBICIDE TOLERANCE 25. Herbicide tolerance of lupins, Terry Piper, Weed Science Group, Agriculture Western Australia 26. Tanjil lupins will tolerate metribuzin under the right conditions, Peter Newman, Agronomist Elders Limited and Cameron Weeks, Mingenew/Irwin Group 27. Herbicide damage does not mean lower yield in Lupins, Peter Carlton, Trials Coordinator, Elders Limited 28. Herbicide tolerance of new pea varieties, Dr Terry Piper, Agriculture Western Australia 29. Herbicide tolerance of (waterlogged) wheat, Dr Terry Piper, Agriculture Western Australia 30. Wheat tolerance trials – Mingenew 1999, Peter Newman1, Cameron Weeks2 and Stewart Smith3,1Elders, Mingenew, 2Mingenew-Irwin Group,3Agriculture Western Australia ISSUES OF TRIFLURALIN USE 31. Trifluralin works better on ryegrass when no-tilling into thick wheat stubbles as granules, or mixed with limesand, Bill Crabtree, WANTFA Scientific Officer 32. Increasing trifluralin rate did not compensate for delaying incorporation, Bill Crabtree, WANTFA Scientific Officer 33. Poor emergence survey, 1999, Terry Piper, Weed Science Group, Agriculture Western Australia HERBICIDES – ISSUES AND OPTIONS 34. AFFINITY 400DF – A new herbicide with a new mode of action (Group G) for Broadleaf Weed Control in Cereals, Gordon Cumming, Technical Officer, Crop Care Australasia 35 Herbicide screening for Marshmallow, David Minkey1 and David Cameron2,1Agriculture Western Australia, 2Elders Ltd, Merredin 36. The control of Capeweed in Clearfield Production System for Canola, Mike Jackson and Scott Paton, Cyanamid Agriculture Pty Ltd 37.Effect of herbicides Tordonä 75D and Lontrelä,used for eradication of Skeleton Weed, on production of Lupins I the following seasons, John R. Peirce and Brad J. Rayner, Agriculture Western Australia INDUSTRY PROTECTION 38. Graingaurd – Opportunities for agribusiness to help protect the West Australian grains industry, Greg Shea, Executive Officer, GrainGuard Agriculture Western Australi

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden