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Although it is known that headache can be caused by many factors, it is difficult to assess whether it is related to meteorological data. The aim of this study was to investigate the relationship between headache observed in patients presenting to emergency units and the Southwest wind parameters.This was a prospective study including patients over 18 years of age who had presented to the University of Health Sciences Umraniye Education and Research Hospital emergency unit with headache symptoms between 01.01.2017 and 31.06.2017. The patient data were compared to the parameter presence of southwest wind, which was obtained from the Forests, Water Sources and Meteorology Directorate Office of Republic of Turkey. Records that were determined to comprise insufficient data were excluded during the data collection. A total of 286 patients were investigated in our prospective study. 93 patients (32.5%) had presented on days when there was southwest wind. 187 had no diagnosed type of headache and were evaluated to have primary headache. Primary headache was more common in patients with no wind exposure, which was statistically significant (p [Med-Science 2020; 9(1.000): 150-3]

With the start of individuals from different cultures and subcultures taking part in the same society, the process of understanding and recognizing cultures has found its place in psychology and counseling. While multicultural counseling evaluates the counselor’s cultural values in the counseling environment, various ideas have been formed to address spirituality. This article summarizes the place of counseling in the psychology literature, along with perspectives on dealing with religion and spirituality. It then aims to examine the process of multiculturalism and multicultural counseling in terms of spirituality and traditional approaches.

A Harris Interactive survey of 1548 hypertensive persons aged 44 and older confirms the findings of previous studies that showed suboptimal rates of adherence to medication and lifestyle regimens to lower blood pressure, despite a high level of awareness of the health consequences of uncontrolled blood pressure. When the study population was analyzed by age group (baby boomers, ages 44 to 62 years, and seniors, ages >or=63 years), nonadherence was greater in the baby boomer cohort, which nevertheless had a higher level of concern than the seniors. Poor communication between patients and health care providers contributes to nonadherence to treatment regimens. Patients' age plays an important role in their attitudes and behaviors regarding illness and treatment as well as their preferences as to the types of educational materials they would find helpful and the ways those materials can best be delivered. Because of the growing population of baby boomers further studies are warranted to evaluate attitudes, knowledge, and behaviors concerning the identification and treatment of hypertension. [ABSTRACT FROM AUTHOR]

Diseases of the heart and vascular systems are the leading cause of death in the United States and worldwide. High-risk patients have been the focus of lipid-lowering trials and treatment guidelines, which recognize that more intensive reduction of low-density lipoprotein cholesterol is appropriate for a redefined, broader high-risk population. Lifestyle modifications and lipid-lowering drug therapy form the foundation of primary- and secondary-prevention programs for patients at moderate to very high risk. Evidence shows that despite the availability of effective agents, such as HMG CoA reductase inhibitors (statins), many patients still do not achieve low-density lipoprotein cholesterol goals. Nurse-centered case management programs that support early and continued adherence with lifestyle and medical therapies have been consistently successful at improving the rates of achieving lipid goals in high-risk patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite clinical guidelines, many patients with hypercholesterolemia do not achieve treatment goals in clinical practice. OBJECTIVES: This study examined physician attitudes and beliefs about hyperlipidemia and whether they are associated with lipid treatment decisions. METHODS: This was a cross-sectional study of 107 physicians who completed a validated survey of attitudes and beliefs about hyperlipidemia and provided treatment histories for 1187 statin-treated patients with coronary heart disease (CHD) or who were CHD risk-equivalent. Logistic regressions (using generalized estimating equation) estimated the impact of patient characteristics and physician attitudes and beliefs on whether a patient received increases in the statin dose. RESULTS: Approximately 70% of the 843 patients who were not at low-density lipoprotein cholesterol goal (<100 mg/dL) with initial statin therapy received a dose increase, although only one-half attained goal. Controlling for patient characteristics, patients whose physicians believed 'close enough to goal is good enough' had 47% lower odds of having a dose increase (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.34-0.82), whereas patients whose physicians believed 'statins are effective' had almost twice the odds of having a dose increase (OR, 1.78; 95% CI, 1.05-3.00). CONCLUSIONS: Although the understanding of basic and clinical science remains fundamental, clinical guideline authors may want to consider the importance of physician attitudes and beliefs in determining translation of their guidelines into clinical practice. [ABSTRACT FROM AUTHOR]

Patient adherence with cholesterol-lowering medications is a crucial component in helping patients achieve lipid goals. Understanding patient attitudes and beliefs about hyperlipidemia and its pharmacological treatments may be useful in improving patient adherence with their treatment plan. The objectives of this study were to develop a theoretically based, statistically reliable, and valid survey instrument for measuring the attitudes and beliefs of patients towards hyperlipidemia and its treatments, and to determine whether the attitudes measured were associated with patient-reported medication adherence. We assessed the reliability of the instrument through an examination of the internal consistency and factor structure of 8 attitude constructs including attitudes about the effectiveness of medications and the quality of doctor-patient communication. Validity was assessed through correlations among the attitudes and the relationship between the attitudes and the number of medication adherence problems the patient experienced in the past month. Internal consistency scores for the 8 constructs ranged from .46 to .82. Factor loadings indicated that the individual items belonged to their respective constructs, as hypothesized. The validity of the instrument was demonstrated by significant relationships between 4 of the attitudinal constructs and self-reported medication adherence problems. This study provides preliminary evidence of the reliability and validity of the HABIT (Hyperlipidemia: Attitudes and Beliefs in Treatment) patient survey of attitudes about the treatment of hyperlipidemia. [ABSTRACT FROM AUTHOR]

PURPOSE: To update nurse practitioners (NPs) on the latest National Cholesterol Education Program (NCEP) guidelines for the management of high blood cholesterol in adults. DATA SOURCES: The 2001 NCEP Adult Treatment Panel (ATP) III guidelines and supporting scientific reviews and reports of clinical trials related to the evidence upon which the guidelines are based. CONCLUSIONS: The many new features of the ATP III guidelines include an increased emphasis on the patient with multiple risk factors in order to identify appropriate candidates for primary prevention and on more stringent classifications of elevated lipid/lipoprotein levels. However, elevated levels of low-density lipoprotein (LDL) cholesterol continue to be the focus for both primary and secondary prevention, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are clearly the drugs of choice for decreasing LDL cholesterol in most patients. IMPLICATIONS FOR PRACTICE: Because NPs play key roles in optimizing treatment management, it is important that they become familiar with, and be prepared to help implement, these latest guidelines. By embracing the global risk assessment approach of ATP III and aggressively treating all at-risk patients, NPs can take a proactive role in helping to halt the progression of coronary heart disease and its consequences. [ABSTRACT FROM AUTHOR]

In the 1990s a number of randomized controlled trials provided compelling evidence for the importance of aggressively managing hypercholesterolemia. Control of low-density lipoprotein cholesterol reduces cardiac events and stroke in at risk individuals without known cardiac disease and in patients with coronary heart disease. The National Cholesterol Education Program Adult Treatment Panel has published 3 sets of guidelines. The most recent expanded definitions of those at risk by defining new risk categories and increased the numbers of persons who could benefit from more intensive cholesterol-lowering. These new definitions moved millions of people into more intensive treatment categories compared to previously published guidelines. This article focuses on the latest National Cholesterol Education Program guidelines for identification and treatment of persons with or at risk for coronary heart disease. [ABSTRACT FROM AUTHOR]

We report a spray deposition technique for patterning liquid metal alloys to form stretchable conductors, which can then be encapsulated in silicone elastomers via the same spraying procedure. While spraying has been used previously to deposit many materials, including liquid metals, this work focuses on quantifying the spraying process and combining it with silicones. Spraying generates liquid metal microparticles (~5 μm diameter) that pass through openings in a stencil to produce traces with high resolution (~300 µm resolution using stencils from a craft cutter) on a substrate. The spraying produces sufficient kinetic energy (~14 m/s) to distort the particles on impact, which allows them to merge together. This merging process depends on both particle size and velocity. Particles of similar size do not merge when cast as a film. Likewise, smaller particles (

Abstract Background Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when implemented in ethnic and low-income populations. Methods The Stanford and San Mateo Heart to Heart (HTH) project is a randomized controlled clinical trial designed to rigorously evaluate the efficacy and cost-effectiveness of a multi-risk cardiovascular case management program in low-income, primarily ethnic minority patients served by a local county health care system in California. Randomization occurred at the patient level. The primary outcome measure is the absolute CHD risk over 10 years. Secondary outcome measures include adherence to guidelines on CHD prevention practice. We documented the study design, methodology, and baseline sociodemographic, clinical and lifestyle characteristics of 419 participants. Results We achieved equal distributions of the sociodemographic, biophysical and lifestyle characteristics between the two randomization groups. HTH participants had a mean age of 56 years, 63% were Latinos/Hispanics, 65% female, 61% less educated, and 62% were not employed. Twenty percent of participants reported having a prior cardiovascular event. 10-year CHD risk averaged 18% in men and 13% in women despite a modest low-density lipoprotein cholesterol level and a high on-treatment percentage at baseline. Sixty-three percent of participants were diagnosed with diabetes and an additional 22% had metabolic syndrome. In addition, many participants had depressed high-density lipoprotein (HDL) cholesterol levels and elevated values of total cholesterol-to-HDL ratio, triglycerides, triglyceride-to-HDL ratio, and blood pressure. Furthermore, nearly 70% of participants were obese, 45% had a family history of CHD or stroke, and 16% were current smokers. Conclusion We have recruited an ethnically diverse, low-income cohort in which to implement a case management approach and test its efficacy and cost-effectiveness. HTH will advance the scientific understanding of better strategies for CHD prevention among these priority subpopulations and aid in guiding future practice that will reduce health disparities.

Combination therapy is increasingly recommended for patients with multiple lipid disorders, especially those at high risk for coronary events. We investigated the long-term safety and effectiveness of a new drug formulation containing once-daily extended-release niacin and lovastatin. A total of 814 men and women (mean age 59 years) with dyslipidemia were enrolled in a 52-week multicenter, open-label study. We used 4 escalating doses (niacin/lovastatin in milligrams): 500/10 for the first month, 1,000/20 for the second, 1,500/30 for the third, and 2,000/40 for the fourth month through week 52. Dose-dependent effects were observed for all major lipid parameters. At week 16, mean low-density lipoprotein (LDL) cholesterol and triglycerides were reduced by 47% and 41%, respectively; mean high-density lipoprotein (HDL) cholesterol was increased by 30% (all p <0.001). LDL/HDL cholesterol and total/HDL cholesterol ratios were also decreased by 58% and 48%, respectively. These effects persisted through week 52, except for the mean increase in HDL cholesterol, which had increased to 41% at 1 year. Lipoprotein (a) and C-reactive protein also decreased in a dose-related manner (by 25% and 24%, respectively, on 2,000/40 mg; p <0.01 vs baseline). Treatment was generally well tolerated. The most common adverse event was flushing, which caused 10% of patients to withdraw. Other adverse events included gastrointestinal upset, pruritus, rash, and headache. Drug-induced myopathy did not occur in any patient. The incidence of elevated liver enzymes to >3 times the upper limit of normal was 0.5%. Once-daily niacin/lovastatin exhibits substantial effects on multiple lipid risk factors and represents a significant new treatment option in the management of dyslipidemia. [ABSTRACT FROM AUTHOR]

Background: Psychosocial factors have demonstrated associations with both prognosis of patients with cardiovascular disease (CVD) as well as the development of CVD. Psychosocial distress may influence health behaviors (such as eating behavior) that increase cardiovascular risk.Method: The purpose of this research was to evaluate the role of psychosocial distress on intake of high-fat snacks and fruits and vegetables in 740 men and women, identified as high risk for cardiovascular disease, who took part in a 1-year cardiovascular risk factor reduction program.Results: Participants who were more successful at decreasing or staying at an optimal level of high-fat food intake had lower levels of baseline total psychosocial distress and worry and decreases in total psychosocial distress. A greater success rate at increasing fruit and vegetable intake or staying at an optimal level of fruit and vegetable intake was associated with changes in Type A and competing behaviors.Conclusions: Results from these analyses suggest that baseline levels and changes in psychosocial variables, particularly decreased psychosocial distress, were associated with improvements in healthful eating behaviors. Further work may provide information that could be useful in tailoring health behavior interventions to specific subgroups based on psychosocial characteristics, initial health behaviors, and demographic characteristics. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Purpose: The purpose of this paper is to discover if there is a correlation between scores on the Beck's Depression Inventory (BDI) and the Cognitive and Physical Functioning Questionnaire (CPFQ) scores of 43 patients with major depression., Design/methodology/approach: In total, 43 adult patients with major depression were evaluated during their regularly scheduled outpatient appointment in a mental health clinic., Findings: There was an R 2 value of 0.6544 between the patients' scores, a moderate-to-strong correlation which matches other observations that cognitive impairment increases in conjunction with severity of depression. This correlation lends further clinical support to the legitimacy of using the CPFQ as a simpler alternative to traditional neuropsychological testing, with further testing of the correlation between CPFQ and traditional neuropsychological testing results being a worthwhile potential field of study., Originality/value: Cognitive dysfunction is a frequent comorbidity in patients with depression, but while there is a brief and effective self- assessment for depression, the BDI, in common use, there is no equivalent test for cognitive dysfunction, and physicians are forced to rely on less accessible methods of neuropsychological testing., Competing Interests: Conflicts of interest: Authors have no conflicts of interest., (© Kishen Berra, Charles Nguyen and Peter Bota.)

The maturing of a clinical discipline necessitates the ability to document scientific advancements and state-of-the-art reviews with a focus on clinical practice. Such was the case for the field of cardiac rehabilitation in 1981. Whereas a growing body of literature was demonstrating benefits of exercise in cardiac patients with regard to clinical, psychologic, and quality-of-life outcomes,, there were still concerns about the safety of exercise and whether it could be widely adapted in clinical care. Since this was a time period when searches of online databases such as PubMed had not yet been established (began in 1996), there was a great value of concentrating much of the cardiac rehabilitation literature in a single journal.This commentary describes the conceptualization and implementation of the Journal of Cardiopulmonary Rehabilitation and Prevention from 1981 to the present and its acceptance as the official journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and later the Canadian Association of Cardiac Rehabilitation. The commentary also highlights the journal's inclusion in Index Medicus in 1995, its receipt of an impact factor from International Scientific Indexing in 2007, and its publication of many important scientific statements, often in collaboration with major scientific organizations such as the American Heart Association and the American College of Cardiology.

Metabolic equivalents, or METs, are routinely employed as a guide to exercise training and activity prescription and to categorize cardiorespiratory fitness (CRF). There are, however, inherent limitations to the concept, as well as common misapplications. CRF and the patient's capacity for physical activity are often overestimated and underestimated, respectively. Moreover, frequently cited fitness thresholds associated with the highest and lowest mortality rates may be misleading, as these are influenced by several factors, including age and gender. The conventional assumption that 1 MET = 3.5 mL O 2 /kg/min has been challenged in numerous studies that indicate a significant overestimation of actual resting energy expenditure in some populations, including coronary patients, the morbidly obese, and individuals taking β-blockers. These data have implications for classifying relative energy expenditure at submaximal and peak exercise. Heart rate may be used to approximate activity METs, resulting in a promising new fitness metric termed the "personal activity intelligence" or PAI score. Despite some limitations, the MET concept provides a useful method to quantitate CRF and define a repertoire of physical activities that are likely to be safe and therapeutic. In conclusion, for previously inactive adults, moderate-to-vigorous physical activity, which corresponds to ≥3 METs, may increase MET capacity and decrease the risk of future cardiac events., (Copyright © 2017 Elsevier Inc. All rights reserved.)