Search

Background: The Case-finding for Complex Chronic Conditions in Adults 75+ (C5-75) involves annual frailty screening in primary care using dual-trait screening measures of handgrip strength and gait speed, with additional screening for co-existing conditions in those deemed frail.Objective: To identify low-risk individuals who could be screened for frailty every 2 years, rather than annually.Methods: This study examined a prospective cohort of patients who completed at least two annual C5-75 screenings between April 2014 and December 2018. Handgrip strength and gait speed on initial assessment were categorized based on proximity to frailty thresholds and were used to predict frailty risk on the second assessment. We used Fisher's exact test to assess differences in risk. Logistic regression models tested associations between independent variables of age, patient activity level, falls history, grip strength and gait speed on first assessment and dependent variable of frailty on subsequent assessment.Results: Analyses included 571 patients with two annual assessments. Frailty risk on the second assessment was significantly higher for patients who had gait speed or grip strength within 20% of the frailty threshold (5.7%), compared with the other categories (0.7%, 0.9%, 0%; P = 0.002); 60% of patients fell within these lower risk categories. Controlling for grip strength and gait speed, no other measures had significant associations with frailty risk.Conclusions: Our results demonstrate that 60% patients are at low risk (<1%) of transitioning to frailty by the next annual assessment. Reducing screening frequency from annually to every 2 years may be appropriate for these patients. [ABSTRACT FROM AUTHOR]

Following the outbreak of COVID‐19 (coronavirus), the UK entered a national lockdown, and all sport was suspended. The study aimed to explore the process of returning to gymnastics training after several months away from the gym, with a particular interest towards training load and injury. Twenty‐six, national programmed gymnasts from Men's artistic, Women's artistic and Trampoline gymnastics recorded training load and injury whilst returning to training. At the end of data collection, three coaches were interviewed to further explore the experiences and practices of returning to training. Home‐based training during lockdown was seen as beneficial in maintaining a level of fitness. Coaches described a gradual increase in training to reduce the risk of injury, and this partly explains a non‐significant association between training load and a substantial injury (p = 0.441). However, week‐to‐week changes in training load following periods of additional restrictions (additional lockdown, periods of isolation, or substantial restrictions) were not always gradual. There was a significant association between an injury in the preceding week (niggle or substantial injury to a different body part) and a substantial injury in the subsequent week (RR: 5.29, p = 0.011). Monitoring training was described to be a useful practice during the process of returning to training. Coaches believed that although the short‐term development of their gymnasts was affected, the long‐term development would not be impacted from COVID‐19. It is anticipated that learnings from this study can be applied to future practices and situations, particularly when gymnasts are away from the gym for an extended period. [ABSTRACT FROM AUTHOR]

Background Medication mismanagement can lead to non-optimal management of chronic diseases and poor health outcomes. Objective The purpose of this study was to better understand meanings associated with in-home medication management and storage practices of older adults with chronic diseases. Methods A modified ethnographic approach using digital photography walkabouts, observation protocols and field notes were used to document in-home medication organisation and storage locations. Thematic analysis was used to generate themes and sub-themes. Results Data from multiple home visits of 10 participants (mean age = 76 years; 80% females) including 30 photographs, 10 observation protocols and field notes were analysed. The average number of medications used was reported to be 11.1 (range: 5–20). Themes and sub-themes include choice of storage location (sub-themes: impact on medication behaviour, visibility of medications and storage with other items), knowledge regarding appropriate medication storage conditions (sub-themes: impact on safety of patient and impact on stability of medications) and systems to manage in-home medication intake. Discussion In-home medication management reflects older adults perspectives regarding privacy, medication taking routine, knowledge about safe and effective storage and organisation systems. The lack of knowledge causing inappropriate medication storage not only impacts the stability of medications, but also increases risk of medication errors and safety, ultimately affecting medication intake behaviours. [ABSTRACT FROM AUTHOR]

To explore the attitudes, beliefs and experiences pertaining to the management of prescribed and unprescribed medications among community-dwelling adults with spinal cord injury/dysfunction (SCI/D) in Ontario, Canada. In-depth semi-structured interviews were conducted by telephone. Each interview was audio-recorded, transcribed verbatim and analyzed using inductive thematic analysis. Of the 19 participants, 11 were male and 8 were female, with an age range from 36 to 76 years; 14 participants had traumatic SCI and 5 had non-traumatic spinal cord dysfunction. All but three participants were taking five or more medications, including prescription medications, over-the-counter medications and natural health products. The three main themes identified were: disruptive nature of medications, fear of negative outcomes and self-management: playing a critical role. Medication management is a complex, multifaceted and non-linear process. Persons with SCI/D described experiences with medication-taking that are not well understood by current medication management frameworks. Thus, it is essential to broaden our lens and situate persons with SCI/D medication-taking experiences within self-management frameworks to allow for a more comprehensive and reflective understanding of their experiences. Based on the findings from this study, recommendations for future research, practice and policy have been suggested. Persons with spinal cord injury/dysfunction identified numerous challenges and concerns with medication use post-injury. Educational medication management programs should be implemented post-discharge to improve the state of knowledge around medications (indication, side effects, strategies for taking medications) and how to optimize medication management. In order to optimize experiences and outcomes, there is a need for explicit and ongoing discussions around medication management between persons with spinal cord injury/dysfunction and their healthcare providers. [ABSTRACT FROM AUTHOR]

Byline: Swapna. Sawardekar, Tejal. Patel, Dinesh. Uchil Introduction: The objective was to compare antiplatelet effect of lycopene with aspirin and to study effect of combination of the two on platelet [...]

Background: MBBS students lack training in research ethics which is crucial when they enter clinical practice and venture into clinical research in future. This study was planned to implement an educational module to build concepts in research ethics Objective: To assess the change in the knowledge and attitude of medical students towards research ethics. Methods: The study was initiated after obtaining institutional ethics committee approval. It was an interventional study, conducted on 2nd MBBS students (N=130) subjected to an educational program which comprised of three modules viz., theme lectures, educational visits and small group case based learning. A prevalidated questionnaire(35 items), was administered at baseline and at the end of 3 modules, to assess the change in the knowledge gained and in the attitude towards ethics in animal and human research. Feedback was obtained from students and faculty to assess the outcome of this program. Results: On analyzing the knowledge gained post intervention in 130 students, it was observed that in the post test for the items on ethics committee- need and composition, principles of research ethics was answered correctly by more number of students, which was statistically significant. The statistically significant positive change was observed for attitude of these students towards both animal and human research ethics. Case based discussions provided better understanding of ethical practices and its importance in conducting research as responded by majority students and faculty. Conclusions: Educational program on research ethics enhanced learning and brought about the positive attitudinal change. Majority students' and faculty appreciated the program and considered it as relevant for undergraduate training. [ABSTRACT FROM AUTHOR]

Growth-related and overuse injuries are commonly reported in young gymnasts. Two risk factors of these injuries are growth and maturation, and training load. However, little is known regarding current coaching knowledge and practice in relation to these risk factors. To help understand current knowledge and practice, 44 coaches of competitive, young gymnasts, from 3 gymnastics disciplines (men's artistic, women's artistic, trampoline) took part in focus groups. The focus groups explored the awareness, experience and practice of coaches in relation to growth and maturation, training load and injury in competitive, young gymnasts. Data were analysed manually using an inductive thematic approach to identify core themes. The findings showed that coaches were aware of the physical changes and injuries that occur during the adolescent growth spurt. Both psychological changes and skill loss/confusion were also identified as challenges during this time. The knowledge and practice of monitoring growth and maturation, and training load did however differ between disciplines. Sports science and medicine practitioners were recognised as key stakeholders in helping manage and reduce the risk of injuries during growth. There appears to be gap between coach knowledge of growth and maturation, and training load, and practices such as monitoring training load and growth. Educating coaches and further research in these areas will aid coaches in reducing the risk of injuries in young, competitive gymnasts. [ABSTRACT FROM AUTHOR]