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141. Effectiveness of a motivational-volitional group intervention to increase physical activity among breast cancer survivors compared to standard medical rehabilitation-Study protocol of a prospective controlled bi-centred interventional trial. (Abstract)

Effectiveness of a motivational-volitional group intervention to increase physical activity among breast cancer survivors compared to standard medical rehabilitation-Study protocol of a prospective controlled bi-centred interventional trial. Despite proven benefits of regular physical activity, the majority of breast cancer survivors do not meet recommended physical activity guidelines. The Motivation-Volition (MoVo) Concept was designed to help people to set up and maintain a health-enhancing (...) rehabilitation. Our target groups are inactive women after breast cancer. Primary outcome is the amount of physical activity per week. Secondary outcomes include physical functioning, fatigue and depression. 800 patients diagnosed with breast cancer on medical rehabilitation will be included, 400 participants per clinic and group. Participants will be assessed by questionnaires upon clinic arrival, before discharge and six and twelve months after discharge. The study will provide evidence on the effect

2019 European journal of cancer care Controlled trial quality: uncertain

142. Does Cardiac Physical Exam Teaching Using a Cardiac Simulator Improve Medical Students' Diagnostic Skills? (Full text)

Does Cardiac Physical Exam Teaching Using a Cardiac Simulator Improve Medical Students' Diagnostic Skills? Background Challenges in bedside teaching may be overcome by the use of high-fidelity simulators for teaching the cardiac physical exam. The purpose of this study is to compare the ability of first-year medical students (MS1) to perform a cardiac physical exam and make the correct diagnosis after instruction using standardized patients (SPs) as compared to a cardiac simulator (Harvey (...) , Laerdal Medical Corporation, NY, US). Methods Thirty-two MS1 were randomized to a teaching module on either SPs or Harvey. Their performance and ability to make the correct diagnosis were evaluated during a posttest objective structured clinical examination (OSCE) on real patients. Results No difference in the mean OSCE score was observed (SP: M=62.2% vs. Harvey: M=57.2%, p=0.32). The SP group obtained a higher frequency of correct diagnoses (M=61.5% SP vs. M=21.0% Harvey, p=0.03). Student feedback

2019 Cureus Controlled trial quality: uncertain PubMed abstract

143. Physical activity in COPD: Minimal clinically important difference for medical events. (Full text)

Physical activity in COPD: Minimal clinically important difference for medical events. Estimates of the minimal clinically important difference (MCID) for physical activity (PA) in chronic obstructive pulmonary disease (COPD) are needed. The objective is to provide an anchor-based estimate of the MCID for daily step count. PA was promoted in persons with COPD using a pedometer (Omron HJ-720ITC) alone or a pedometer plus interactive website for 3 months. Participants wore the pedometer daily (...) and received phone calls monthly to ascertain medical events. Medical events were counted when a participant self-reported that he/she had (1) worsening of breathing, (2) change to breathing medications, (3) medical care from an emergency room for any reason, or (4) hospitalization for any reason. Generalized linear regression models assessed daily step count as change at the end of study and averaged over the 15, 31, or 61 days centered on the event, in those with an event compared to those without one

2019 Chronic respiratory disease PubMed abstract

144. Moderation of the association between chronic medical conditions and functional limitations over time by physical activity: Effects of age. (Full text)

Moderation of the association between chronic medical conditions and functional limitations over time by physical activity: Effects of age. Age-related accumulation of chronic medical conditions increases disability in older adults. Physical activity potently combats chronic conditions and disability. However, it is unclear whether activity maintenance alleviates the effects of chronic conditions on disability and if this buffering effect differs with age. This study examined whether long-term (...) physical activity can forestall functional limitations in the face of accumulating chronic conditions among middle-aged and older adults.Participants (n = 2,119; 54.7% female) were from the Survey of Midlife Development in the United States. Self-reported physical activity, number of chronic conditions, and functional limitations were obtained across 18-20 years. Functional limitations were regressed against the change in chronic conditions, physical activity, and their interaction over time in a multi

2019 Biological Sciences and Medical Sciences PubMed abstract

145. Helpful ways providers can communicate about persistent medically unexplained physical symptoms. (Full text)

Helpful ways providers can communicate about persistent medically unexplained physical symptoms. Communication between patients and providers about persistent "medically unexplained" physical symptoms (MUS) is characterized by discordance. While the difficulties are well documented, few studies have examined effective communication. We sought to determine what veterans with Gulf War Illness (GWI) perceive as the most helpful communication from their providers. Veterans with GWI, a type of MUS (...) , have historically had complex relationships with medical providers. Determining effective communication for patients with particularly complex relationships may help identify the most critical communication elements for all patients with MUS.Two hundred and-ten veterans with GWI were asked, in a written questionnaire, what was the most useful thing a medical provider had told them about their GWI. Responses were coded into three categories with 10 codes.The most prevalent helpful communication

2019 BMC Family Practice PubMed abstract

146. Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life. (Full text)

Long-term exposure to anticholinergic and sedative medications and cognitive and physical function in later life. Anticholinergic and sedative medications are frequently prescribed to older individuals. These medications are associated with short-term cognitive and physical impairment, but less is known about long-term associations. We therefore examined over twenty years whether cumulative exposure to these medications was related to poorer cognitive and physical functioning.Older adult (...) participants of the Longitudinal Aging Study Amsterdam (LASA) were followed from 1992-2012. On 7 measurement occasions, cumulative exposure to anticholinergic and sedative medications was quantified with the Drug Burden Index (DBI), a linear additive pharmacological dose-response model. Cognitive functioning was assessed with the Mini Mental State Examination (MMSE), Alphabet Coding Task (ACT, 3 trials), Auditory Verbal Learning Test (AVLT, learning and retention condition), and Raven Colored Progressive

2019 Biological Sciences and Medical Sciences PubMed abstract

147. Prevalence and Correlates of Receiving Medical Advice to Increase Physical Activity in U.S. Adults: National Health and Nutrition Examination Survey 2013-2016. (Abstract)

Prevalence and Correlates of Receiving Medical Advice to Increase Physical Activity in U.S. Adults: National Health and Nutrition Examination Survey 2013-2016. National objectives recommend healthcare professionals provide physical activity advice. This study examined health and demographic characteristics associated with receipt of medical advice to increase physical activity among U.S. health care-utilizing adults and differences in associations by age group.Analyses included 8,410 health (...) care-utilizing adults aged ≥20 years from the 2013-2016 National Health and Nutrition Examination Surveys (analyzed in 2018). Logistic regression was used to examine associations between receipt of medical advice to increase physical activity in the past year and measured health conditions, reported health behaviors, and demographic characteristics. Models were stratified by age group (20-39, 40-59, and ≥60 years).Physical activity medical advice was received by 42.9% (95% CI=40.8, 44.9) of adults

2019 American journal of preventive medicine

148. Utilizing mobile technologies to improve physical activity and medication adherence in patients with heart failure and diabetes mellitus: Rationale and design of the TARGET-HF-DM Trial. (Abstract)

Utilizing mobile technologies to improve physical activity and medication adherence in patients with heart failure and diabetes mellitus: Rationale and design of the TARGET-HF-DM Trial. Heart failure (HF) and diabetes mellitus (DM) are major public health issues that place significant burden on patients and health care systems. Patients with both HF and DM are at higher risk of adverse cardiovascular and HF outcomes than those with either disease in isolation. Different antihyperglycemic (...) medications (even within the same medication class) have conflicting results of benefit or harm in patients with established and incident HF. Recent data highlight the importance of a renewed focus on optimal pharmacotherapy for this population with DM and HF (or at risk for HF). Both HF and DM require major lifestyle modification for optimal management, in terms of both optimizing health behaviors (eg, physical activity, diet) and adherence to complex medical and self-care regimens. Mobile health

2019 American Heart Journal

149. Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis. (Abstract)

Association of physical activity and medication with enthesitis on ultrasound in psoriatic arthritis. Enthesitis is a manifestation of psoriatic arthritis (PsA), but its symptoms are difficult to interpret clinically. We investigated the associations of ultrasonographic changes in entheses with clinical characteristics in PsA patients, and compared enthesis changes of PsA patients aged 35 to 60 with healthy volunteers of that age.Consecutive PsA patients participated in this cross-sectional (...) study, irrespective of enthesitis complaints and age. We collected data about complaints, physical activity and activity avoidance, medication and clinical enthesitis. Inflammatory and structural enthesis changes were scored with the modified MAdrid Sonographic Enthesitis Index (MASEI). Among all PsA patients, associations between ultrasound scores and clinical characteristics were investigated using linear regression. We compared ultrasound scores of healthy volunteers and PsA patients aged 35-60

2019 Journal of Rheumatology

150. Development and evaluation of the medication-based index of physical function (MedIP) (Full text)

Development and evaluation of the medication-based index of physical function (MedIP) the development of an objective and comprehensive drug-based index of physical function for older adults has the potential to more accurately predict fall risk.the index was developed using 862 adults (ages 57-85) from the National Social Life, Health, and Aging Project (NSHAP) Wave 1 study. The index was evaluated in 70 adults (ages 51-88) from a rehabilitation study of dizziness and balance.the prevalence (...) among 601 drugs for 1,694 side effects was used with fall history to determine the magnitude of each side effect's contribution towards physical function. This information was used to calculate a Medication-based Index of Physical function (MedIP) score for each individual based on his or her medication profile. The MedIP was compared to the timed up and go (TUG) test as well as drug counts using receiver operating characteristic (ROC) analysis. The associations between various indices of physical

2017 EvidenceUpdates PubMed abstract

151. Factors associated with physical activity promotion by allied and other non-medical health professionals: A systematic review. (Abstract)

Factors associated with physical activity promotion by allied and other non-medical health professionals: A systematic review. To identify factors associated with non-medical health professionals' engagement in physical activity (PA) promotion.Five electronic databases were searched for studies including practising health professionals (excluding medical doctors), a PA promotion practice measure, a test of association between potential influencing factors and PA promotion practice, and written (...) in English. Two researchers independently screened studies and extracted data. Extracted data were synthesized in a tabular format with a narrative summary (thematic analysis).Thirty studies involving 7734 non-medical health professionals were included. Self-efficacy in PA promotion, positive beliefs in the benefits of PA, assessing patients' PA, and PA promotion training were the main factors associated with engaging in PA promotion. Lack of remuneration was not associated. Common study limitations

2019 Patient education and counseling

152. Australian Institute of Sport and Australian Medical Association position statement on concussion in sport

is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. “If in doubt, sit them out.” A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management (...) Australian Institute of Sport and Australian Medical Association position statement on concussion in sport Australian Institute of Sport and Australian Medical Association position statement on concussion in sport | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date range from Date range to Article type Author's surname Volume First page doi: 10.5694/mja__.______ Search Reset  close Individual Login Purchase options Connect

2017 MJA Clinical Guidelines

153. CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy

. Certain medical conditions in the mother result in neonatal complications that require special resuscitative measures. This is particularly true of many chemical dependency states, and anticipatory management of these patients is essential. Rosen’s in Perspective The enormous breadth of physical and physiologic changes that occur in pregnancy may overwhelm a woman’s compensatory mechanisms and lead to deterioration of pre-existing disease. This has implications for the mother, the fetus (...) and the first dose of vaccine within 12 hours of birth. Two additional doses of vaccine are administered at a later date. This post was copy-edited and uploaded by Andrew Guy. (Visited 665 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing

2018 CandiEM

154. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications Interventional Spine and Pain Procedures in Patients on Anti... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account (...) and the evidentiary basis for such recommendations. This publication is intended as a living document to be updated periodically with consideration of new evidence. From the *Western Reserve Hospital, Cuyahoga Falls, OH; †Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL; ‡Pain Diagnostics and Interventional Care, Pittsburgh, PA; §Department of Anesthesiology, Rush University Medical Center, Chicago, IL; ∥Valencia University Medical School and Department

2018 American Society of Regional Anesthesia and Pain Medicine

155. Evidence Bite: Medical Education and caring for transgender patients (Full text)

Evidence Bite: Medical Education and caring for transgender patients Evidence Bite: Medical Education and caring for transgender patients - CanadiEM Evidence Bite: Medical Education and caring for transgender patients In by Alexandre Coutin November 1, 2018 Transgender (trans) people make up 0.6% of the population 1 , yet are among the most underserved in health care. 2–5 Barriers to accessing care have been linked to unsafe surgical practices, self-prescribed hormone therapy, and even (...) specialties. Within this post we aim to translate the findings of the following article 20 : Coutin, A., Wright, S., Li, C., & Fung, R. (2018). Missed opportunities: are residents prepared to care for transgender patients? A study of family medicine, psychiatry, endocrinology, and urology residents. Canadian Medical Education Journal , 9 (3), 41-55. Central Questions: What is the nature of education gaps for residents? How might these gaps influence residents’ perceptions of their responsibilities

2018 CandiEM PubMed abstract

156. CRACKCast E189 – Air Medical Transport

CRACKCast E189 – Air Medical Transport CRACKCast E189 – Air Medical Transport - CanadiEM CRACKCast E189 – Air Medical Transport In , by Adam Thomas June 25, 2018 This episode of CRACKCast covers Chapter 191 in Rosen’s Emergency Medicine (9th Ed.) – Air Medical Transport. Including a review of clinically relevant physics! Fun stuff! Shownotes – Key concepts Boyle’s law and Dalton’s law have the greatest impact and explain the development of hypoxia and most common altitude-related symptoms (...) the University of British Columbia. Currently spending his days between a fellowship in critical care and making sure his toddler survives past age 5. - 3 hours ago Latest posts by Adam Thomas ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors

2018 CandiEM

157. Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory From the American Heart Association

medicine (LM) thread or track, an approach aligned with calls for more individualization in medical education. Rather than offering a distinct course or integration into standard UME curricula, some medical schools, such as Northwestern University Feinberg School of Medicine and the University of South Carolina–Greenville School of Medicine, have introduced separate LM tracks that provide in-depth UME in nutrition alongside other lifestyle factors, including physical activity, substance and tobacco use (...) are especially important for those planning careers in primary care, cardiology, neurology, endocrinology, obesity treatment, gastroenterology, oncology, intensive care medicine, and some surgical subspecialties. Although expanded nutrition competencies are needed across all health professions, those presented herein are limited to medical students and trainees and form the basis of the entrustable professional activities (EPAs) related to nutrition that are also presented. Educational resources for building

2018 American Heart Association

158. Non-medical Prescription Stimulant Use among Post-secondary Students

to the greater negative impacts of street drugs, a finding consistent with other qualitative studies (Judson & Langdon, 2009; Kerley, Copes, & Giffin, 2015). Moreover, none of the 175 participants recognized that using prescription stimulants non-medically posed a significant health risk, and felt that because a pharmaceutical company manufactured them they were relatively safe. Other justifications for use included students’ beliefs that they were doing it for the right reasons (i.e., academic enhancement (...) of Use According to the 2015 Canadian Tobacco, Alcohol and Drug Survey (CTADS), 0.2% of the general population report the non-medical use of prescription stimulants (Statistics Canada, 2015). This statistic was not reportable among emerging adults, aged 18–25, in the 2015 CTADS due to high sampling variability, but other survey results suggest rates are highest among this subgroup. For example, the 2015 National Survey on Drug Use and Health in the United States showed that 2.2% of emerging adults

2018 Canadian Centre on Substance Abuse

159. Meeting Report: FDA Public Meeting on Patient-Focused Drug Development and Medication Adherence in Solid Organ Transplant Patients. (Full text)

grafts. Participants described the physical, emotional, and social impacts of their transplant on daily life. They also discussed their posttransplant treatment regimens, including the most burdensome side effects and their hopes for future treatment. The afternoon scientific session consisted of presentations on prevalence and risk factors for medication nonadherence after transplantation in adults and children, and interventions to manage it. As new modalities of Immunosuppressive Drug Therapy (...) Meeting Report: FDA Public Meeting on Patient-Focused Drug Development and Medication Adherence in Solid Organ Transplant Patients. The Food and Drug Administration (FDA) held a public meeting and scientific workshop in September 2016 to obtain perspectives from solid organ transplant recipients, family caregivers, and other patient representatives. The morning sessions focused on the impact of organ transplantation on patients' daily lives and the spectrum of activities undertaken to maintain

2017 American Journal of Transplantation PubMed abstract

160. Medical and Behavioral Approaches to Engage People Who Inject Drugs Into Care for Hepatitis C Virus Infection (Full text)

reinfection among persons with substance use disorders. Widespread prescription of therapy for hepatitis C virus infection to substance users will be required to achieve the ultimate goal of global virus elimination. Combinations of medical and behavioral interventions should be used to promote persons with substance use disorders engagement into and adherence with direct-acting antiviral-based treatment approaches. Ultimately, either physical or virtual colocation of hepatitis C virus and substance use (...) Medical and Behavioral Approaches to Engage People Who Inject Drugs Into Care for Hepatitis C Virus Infection Direct-acting antivirals for hepatitis C virus infection may revolutionize treatment among persons with substance use disorders. Despite persons with substance use disorders having the highest hepatitis C virus prevalence and incidence, the vast majority have not engaged into care for the infection. Previously, interferon-based treatments, with substantial side effects

2017 Addictive disorders & their treatment PubMed abstract

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