Healthy lifestyle effect on stroke severity | Increasing physical activity in the preschool setting | Severity of mental health symptoms in LGBQ youth
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July 21, 2016
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Healthy lifestyle effect on stroke severity
While a healthy lifestyle has been associated with reduced risk of developing ischemic stroke, less is known about its effect on stroke severity.
The American Journal of Medicine (7/2016) 
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Free CME - Shedding Light on Shingles: The Power of Prevention
Shingles, or herpes zoster (HZ), is a common secondary infection caused by a reactivated varicella zoster virus. This CME activity will review the clinical presentations and complications of HZ as well as discuss strategies for prevention. Upon completion, you may receive up to 1.00 AMA PRA Category 1 Credit(s). Click here to begin this activity!
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Clinical Updates
Increasing physical activity in the preschool setting
A majority of preschool-aged children spend a significant portion of every weekday in a preschool or child care setting. This randomized controlled trial determined whether an ecologic physical activity intervention in preschools increases children's moderate-to-vigorous intensity physical activity (MVPA). Researchers trained preschool teachers to integrate physical activity into instructional practices. Children in the intervention schools engaged in significantly more MVPA than children in control schools, even after adjusting for parent education and length of the school day. In the sex-specific analyses, the difference was significant for girls but not for boys.
American Journal of Preventive Medicine (7/2016) 
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Severity of mental health symptoms in LGBQ youth
There may be differences in severity of mental health symptoms across lesbian, gay, bisexual, and questioning (LGBQ) youth, in addition to differences between LGBQ and heterosexual youth. These findings underscore the importance of asking about sexual orientation and behavioral health symptoms in primary care settings.
Journal of Adolescent Health (7/2016) 
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Links between asthma and obstructive sleep apnea
There are strong epidemiologic and pathophysiological associations between obstructive sleep apnea (OSA) and asthma, with growing evidence that they not only commonly coexist but also have clinically significant bidirectional interactions that impact symptoms and therapeutic responses. Understanding the pathophysiological mechanisms linking OSA and asthma is critical to reducing morbidity related to these conditions. This report outlines the current evidence for the link between asthma and OSA in the pediatric population, summarizes the pathophysiological mechanisms linking the two conditions, and discusses diagnostic and therapeutic strategies for coexisting asthma and OSA in children.
The Journal of Pediatrics (7/2016) 
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Distress intolerance and opioid misuse
The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. Identification of those at greater risk for misuse is needed to facilitate closer monitoring of high-risk subgroups and may help identify therapeutic targets for mitigation. This study examined whether distress intolerance -- the perceived or actual inability to manage negative emotional and somatic states -- was associated with opioid misuse. The results indicate that distress intolerance may be a relevant marker of misuse among chronic pain patients. This may be a useful identifier and may help reduce risk, the authors conclude.
The Journal of Pain (7/2016) 
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Observed blood pressure and mortality
What are optimal blood pressure readings for older persons in order to prevent all-cause and cardiovascular mortality? Researchers in Taiwan studied data from 128,765 annual health examination participants aged 65+ from 2001 to 2010. Best outcomes were found to be in those who maintained a blood pressure reading on the systolic side of 110-139 mm Hg and on the diastolic side of 40-79 mm Hg. Blood pressure readings outside of those values indicated worse outcomes for the participants.
Journal of the American Medical Directors Association (7/2016) 
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Competing risks model for preeclampsia
Combined screening by maternal factors and biomarkers in the early third-trimester predicts nearly all cases of preterm preeclampsia and half of term preeclampsia.
American Journal of Obstetrics & Gynecology (7/2016) 
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Continuing Medical Education
Complimentary Elsevier CME: Recent advances to improve outcomes for patients with dyslipidemia
This activity will cover data presented at the American College of Cardiology 65th Annual Scientific Session and Expo held in Chicago, Ill. Upon completion, you may receive up to 1.0 AMA PRA Category 1 Credits™. Begin the activity.
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Medical News
Study examines prevalence of adolescent diabetes, prediabetes
A study of 2,606 adolescents ages 12 to 19 showed almost 1% had diabetes, with almost one-third undiagnosed, and 20% had prediabetes. The study in the Journal of the American Medical Association said blacks and Hispanics were more likely to have prediabetes or undiagnosed diabetes, compared with whites.
HealthDay News (7/19) 
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Data show diets rich in healthy fats may boost blood glucose control
Analysis of data from 102 studies indicated a diet with more monounsaturated or polyunsaturated fats, instead of carbohydrates or saturated fat, may increase blood glucose control, researchers reported in PLOS Medicine. The studies overall found increasing polyunsaturated fat to replace carbohydrates or saturated fat showed the most consistent benefits, researchers said.
HealthDay News (7/19) 
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Business Practice News
Report: Health care quality improving, but geographical disparities persist
A report from the Commonwealth Fund found that health care quality and access have improved in US communities, with care quality highest in San Francisco, some Midwestern states, Hawaii and New England. Most communities have reduced 30-day mortality, hospital readmissions and risky medication use among seniors, but progress is uneven and has improved more rapidly in areas where more people have health insurance.
Health IT Analytics (7/15) 
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Health systems open "microhospitals" with limited inpatient beds
Health care systems in at least four states are opening "microhospitals" that are full-service and contain an emergency department but have fewer than a dozen inpatient beds. The idea is to help health systems get a foothold in attractive markets without the cost of building a large hospital, but Priya Bathija of the American Hospital Association said microhospitals potentially could be used in communities that lack access to health care.
Kaiser Health News (7/19) 
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Patient's Perspective
Alliance develops training materials for family caregivers
Laws in 31 US states and territories require hospitals to notify a designated caregiver before discharging a patient and to allow that caregiver to ask questions about care the patient will need at home. A new coalition called the Home Alone Alliance is developing free materials, including video tutorials and online courses, to teach caregivers how to change dressings, administer medications and perform other tasks.
The Wall Street Journal (tiered subscription model) (7/18) 
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The art of leadership is saying no, not yes. It is very easy to say yes.
Tony Blair,
prime minister
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