Search

In this scoping review, "weight-related evidence" is an umbrella for various terms, phrases, and ways in which weight, body size, fatness, and/or obesity present in research and dietetic practice. Canadian Registered Dietitians' perceptions of, experiences with, and/or knowledge of weight-related evidence in nutrition care was identified and mapped. Implementing JBI scoping review methodology, four databases were searched: ( i ) CINAHL (EBSCO); ( ii ) Medline (Ovid); ( iii ) Embase (Elsevier); and ( iv ) Scopus (Elsevier). Google and Bing were searched for grey literature. Three JBI-trained independent reviewers completed screening to extraction. Community consultation was conducted using the Delphi Method. Of 2217 results, 67 were included in the review (29 peer-reviewed; 38 grey). Identified frequencies were 67 examples of perception, 54 of experience, and 51 of knowledge. This review identified diverse definitions/perspectives of weight-related evidence, highlighting the benefits of continuing to discuss and explore this topic within and beyond dietetics. Weight-related evidence was identified in nutrition care in various settings, representing nutrition assessment, diagnoses, interventions, monitoring, and evaluation. Focused on dietetic research and practice, this work provides a foundation for future evaluation of dietitian-led intervention fidelity, utility, and effectiveness, using systematic review or other research designs. These Canadian findings can serve as a foundation for a global/international review.

This paper describes a stroke quality improvement (QI) project in a primary stroke centre in a 431-bed hospital serving a local population of 114 000 people. Approximately 170 acute strokes are treated each year in a seven-bed stroke unit managed by three geriatricians with a subspecialty interest in stroke. 24-hour CT radiology service is available. Endovascular thrombectomy (EVT) is performed by neuro-interventional radiology at one of two comprehensive stroke centres located 90-120 min away.In 2018, as part of a national collaborative QI initiative a new national thrombectomy referral pathway was introduced with an aim that all eligible patients be referred for EVT. This initiative included maximising timely access to CT and thrombolysis. Review of local data highlighted significant deficits in these areas.A local QI team convened and a multidisciplinary approach was employed to map the existing process for CT access and time to thrombolysis decision.We describe how focused timesaving interventions such as; new emergency and radiology department 'pre-alerts', dedicated acute stroke pagers, new 'FAST' registration by clerical staff, new CT ordering codes and new 'FAST packs' (including tissue plasminogen activator, paper National Institute of Health Stroke Scale scoring tools, consent forms and EVT patient selection tools) were created and incorporated into a multidisciplinary detailed clinical stroke care pathway.We describe how we achieved our SMART aims; to reduce our door to CT time and to reduce our door to needle time to the national target of less than 30 min. A third aim was to increase the number of patients referred for EVT from our centre.This project is an accurate description of how a multidisciplinary approach combined with teamwork and effective communication can create sustainable improved patient care and is generalisable to all institutions that require timely referral to external centres for EVT., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The survival of incident dialysis patients' end-stage kidney disease in some European and American has been reported to improve in modern era compared to earlier periods. However, in Ireland, this has not been well documented., Aim: To investigate the survival outcomes of incident end-stage kidney failure dialysis patients in a tertiary center over a 24-year period, 1993-2017., Methods: A retrospective analysis was carried out utilizing the Beaumont Hospital Renal Database. Consecutive adults with incident dialysis were analyzed. Kaplan-Meier methods and the estimated mean survival times were used to evaluate survival at successive 4-year periods of time., Results: In total, 2106 patients were included, of whom 830 underwent subsequent renal transplantation during follow-up. During the study period, from 1993 up to 2017, the mean patients' age increased from 56.3 ± 17.4 in 1993-1996 to 60.6 ± 18.3 in 2014-2017. There was an overall decrement in mortality over successive time intervals which were mirrored by the improvements in median survival after commencement of dialysis treatment from 6.14 years during 1993-1996 to 8.01 years during 2009-2012. Patients' survival has steadily improved, with the 5-year survival has risen over time, by almost 15%. This positive signal persisted and became more pronounced after adjusting Kaplan-Meier curve to age, where the 5-year survival estimates were exceeding 80% in 2014-2017., Conclusion: Survival rates among incident dialysis patients have improved progressively between 1993 and 2017 in Beaumont Hospital in Dublin, Ireland. The factors which led to this improvement are not entirely clear, but likely to be multifactorial., (© 2020. Royal Academy of Medicine in Ireland.)

Coronavirus disease 2019 (COVID-19) continues to affect millions of people around the globe. As data emerge, it is becoming more evident that extrapulmonary organ involvement, particularly the kidneys, highly influence mortality. The incidence of acute kidney injury has been estimated to be 30% in COVID-19 non-survivors. Current evidence suggests four broad mechanisms of renal injury: Hypovolaemia, acute respiratory distress syndrome related, cytokine storm and direct viral invasion as seen on renal autopsy findings. We look to critically assess the epidemiology, pathophysiology and management of kidney injury in COVID-19., Competing Interests: Conflict-of-interest statement: No potential conflicts of interest., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Journal clubs have existed since William Osler started them in the 19th century, and serve as an important avenue for critical appraisal of medical research in academia. In the past decade, particularly the past 5 years, there has been a proliferation of online journal clubs on Twitter (Twitter Inc, San Francisco, CA). These Twitter-based journal clubs have used the conversational nature of the medium and the focus allowed by specifying a hashtag to bring critical appraisal to the wider community. Currently, there are 27 active Twitter-based journal clubs. NephJC is one such online, Twitter-based, nephrology-focused journal club. NephJC has been active since April 2014. We describe elements of NephJC and the participation over the past 135 sessions. Apart from critical appraisal, these journal clubs allow for archived and searchable postpublication peer-review, and are a crucial element of building an online community. They are one of the myriad ways in which social media is changing medicine and medical education., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Acoustic analysis of cough both in the time and frequency domain has been reported using voluntary and spontaneous cough. The main aim of this study was to discover whether such analysis of capsaicin-induced cough enables differences between normal subjects to be recognized. We present data from 13 healthy subjects (with normal lung function and no history of respiratory disease) using a new method of acoustic analysis, which presents the data in three graphical forms: 1) spectrogram; 2) overall spectral energy, 3) root mean square (RMS) pressure plots. Using the RMS sound pressure traces, different subjects had either two peaks, a single peak or multiple peaks. The occurrence of single and multiple peaks has previously been associated with disease states but we found them in normal subjects. The number of peaks and the visual pattern of the spectrogram was reproducible within and specific to each individual over time. During a peal of coughs in a single expiration, the peak amplitude of successive coughs decreased as lung volume reduced. Despite similarities in the overall spectral energy between individuals, there were marked differences in the small visual details of the spectrograms. However, in an individual, these small details were remarkably constant both within and between days, and can be regarded as a "cough signature". This type of spectrographic analysis provides a new approach to the analysis both of normal and abnormal cough sounds, and has identified similarities and differences in capsaicin-induced cough in normal individuals. It has potential as a tool with which to study the pathophysiology of cough.