Rosalesmcgregor3724
during pregnancy, one in four continued triptan treatment during pregnancy, and extended triptan use was relatively low. Triptan discontinuation during and in the year after pregnancy was common. Use of other acute migraine treatments was higher among both continuers and initiators of triptans. Women using preventive migraine treatment were most commonly triptan continuers and re-initiators after pregnancy. Prescribing to and counseling of women with migraine should be tailored to the condition severity and their information needs to promote optimal migraine management in pregnancy.
This study aims to assess medication adherence and explore its predictors in outpatients with type 2 diabetes.
This cross-sectional study collected socio-demographics, disease-related information, and different biomedical variables for type 2 diabetes patients attending a Jordanian Diabetes center. The four-item medication adherence scale (4-IMAS) and the beliefs about medications questionnaire (BMQ) which includes necessity and concerns were used. Stepwise backward quartile regression models were conducted to evaluate variables associated with the Necessity and Concerns scores. Stepwise ordinal regression was conducted to evaluate variables associated with adherence.
287 diabetic patients participated in the study. Almost half of the participants (46.5%) reported moderate adherence and 12.2% reported low adherence. Significant predictors of the adherence were necessity score (OR = 14.86, p <0.01), concern score (OR = 0.36, p <0.05), and frequency of medication administration (OR = 0.88, p- <0.01). Education was a significant predictor of Necessity and Concerns scores (β = 0.48, -0.2, respectively).
Simplifying the medication regimen, emphasizing medication necessity and overcoming medication concerns should be targeted in future diabetes intervention programs to improve medication adherence and hence glycemic control among diabetic patients.
Simplifying the medication regimen, emphasizing medication necessity and overcoming medication concerns should be targeted in future diabetes intervention programs to improve medication adherence and hence glycemic control among diabetic patients.
Antibiotic misuse is a key contributor to antimicrobial resistance and a concern in long-term aged care facilities (LTCFs). Our objectives were to i) summarise key indicators of systemic antibiotic use and appropriateness of use, and ii) examine temporal and regional variations in antibiotic use, in LTCFs (PROSPERO registration CRD42018107125).
Medline and EMBASE were searched for studies published between 1990-2021 reporting antibiotic use rates in LTCFs. Random effects meta-analysis provided pooled estimates of antibiotic use rates (percentage of residents on an antibiotic on a single day [point prevalence] and over 12 months [period prevalence]; percentage of appropriate prescriptions). Meta-regression examined associations between antibiotic use, year of measurement and region. A total of 90 articles representing 78 studies from 39 countries with data between 1985-2019 were included. Pooled estimates of point prevalence and 12-month period prevalence were 5.2% (95% CI 3.3-7.9; n = 523,171) and 62.0% (inated efforts focusing on LTCFs are required to address antibiotic misuse in LTCFs. Our analysis provides overall baseline and regional estimates for future monitoring of antibiotic use in LTCFs.
Coordinated efforts focusing on LTCFs are required to address antibiotic misuse in LTCFs. Our analysis provides overall baseline and regional estimates for future monitoring of antibiotic use in LTCFs.With globalization, the cases of Chinese enterprises' cross-border mergers and acquisitions (M&A) are increasing rapidly. The institutional environment of the host country has become an important factor influencing M&A performance, which has a profound impact on the success or failure of cross-border M&A. Based on this, for our study, we selected cases of cross-border M&A of listed companies in China from 2007 to 2018 as research samples to empirically test the impact of the host country's governance capacity on the cross-border M&A performance of acquirers. It was found that the host country's governance capacity has a negative effect on the M&A performance in the short term, but in the long term, it can effectively improve the cross-border M&A performance of acquirers. At the same time, specific to the relationship between the governmental governance capacity of six different dimensions and long-term M&A performance, the government effectiveness, regulation quality, and rule of law have the most significant promotional effect on long-term M&A performance. This implies that acquirers should focus on the long-term impact of governmental governance capacity on M&A, and consciously lean toward countries with strong governance capacity in order to obtain long-term value growth when arranging overseas M&A activities. The conclusion of this paper provides a reliable basis on which for companies to achieve sustainable growth in complex economic activities.Anthropogenic disturbance impacts the phylogenetic composition and diversity of ecological communities. While changes in diversity are known to dramatically change species interactions and alter disease dynamics, the effects of phylogenetic changes in host and vector communities on disease have been relatively poorly studied. Using a theoretical model, we investigated how phylogeny and extinction influence network structural characteristics relevant to disease transmission in disturbed environments. We modelled a multi-host, multi-vector community as a bipartite ecological network, where nodes represent host and vector species and edges represent connections among them through vector feeding, and we simulated vector preferences and threat status on host and parasite phylogenies. We then simulated loss of hosts, including phylogenetically clustered losses, to investigate how extinction influences network structure. We compared effects of phylogeny and extinction to those of host specificity, which we predicted to strongly increase network modularity and reduce disease prevalence. The simulations revealed that extinction often increased modularity, with higher modularity as species loss increased, although not as much as increasing host specificity did. These results suggest that extinction itself, all else being equal, may reduce disease prevalence in disturbed communities. However, in real communities, systematic patterns in species loss (e.g. favoring high competence species) or changes in abundance may counteract these effects. Unexpectedly, we found that effects of phylogenetic signal in host and vector traits were relatively weak, and only important when phylogenetic signal of host and vector traits were similar, or when these traits both varied.Birch belongs to the most important allergenic taxa in Europe, therefore information on the start dates of the pollen season is very important for allergists and their patients as well as for climatologists. The study examined changes in the start of the birch pollen season as well as determined the trend of these changes. Pollen monitoring was performed in Lublin (eastern Poland) in the period 2001-2019 using the volumetric method. The Makra-test was used to detect periods with significantly higher or lower average of the onset than the average for the whole dataset. Two significant falls in the average of the pollen season start were found in 2007 and 2014. Besides, taking into account the 2-3-year rhythm of high and low concentrations of birch pollen in the atmospheric air, linear trends were fitted for the subsets of high and low abundance seasons. Significant changes in Betula pollen season start dates were only determined for the highly abundance seasons, while the results for seasons with a low concentration did not allow rejecting the hypothesis about the lack of a linear trend in the changes in the studied parameter. Moreover, a significant polynomial relationship was found between the beginning of a pollen season and the average values of monthly temperatures preceded a season. AV-951 These analyses show that the start dates of the Betula pollen season are getting significantly earlier. The dynamics of changes differ between seasons with high and low concentrations of pollen.Tree pruning is carried out to reduce conflict with infrastructure, buildings, and any other human activity. However, heavy pruning may result in a diminished tree crown capacity for sugar production and exposure to fungal infection. This risk leads to a decrease in tree stability or vigour. In this work, we analysed the effect of heavy pruning of roadside trees on the photosynthetic performance process compared to neighbouring unpruned trees. Four years of tree crown growth was studied by terrestrial imaging. Tree vitality (Roloff's classification) and risk (Visual Tree Assessment) were evaluated. Over-pruned trees showed intensified photosynthetic efficiency during the growing season following pruning. Particularly ET0/TR0 and PIABS tended to increase in pruned trees while higher Fv/Fm was noted only in late October, suggesting delayed leaf senescence. After four years, pruned trees rebuilt their crowns, however not in their entirety. Results obtained from biometric, vitality, and risk assessment showed high differentiation in pruned tree crown recovery. Our results revealed that despite the intensified efforts of trees to recover from wounding effects, severe pruning evokes dieback occurrence and a higher risk of failure in mature trees.
Low functional capacity may lead to the loss of independence and institutionalization of older adults. A nutritional intervention within a rehabilitation program may attenuate loss of muscle function in this understudied population.
This pilot study assessed the feasibility for a larger RCT of a nutritional supplementation in older adults referred to an outpatient assessment and rehabilitation program.
Participants were randomized to receive a supplement (EXP 2g fish oil with 1500 IU vitamin D3 1x/d + 20-30g whey protein powder with 3g leucine 2x/d) or isocaloric placebo (CTR corn oil + maltodextrin powder) for 16 weeks. Handgrip and knee extension strength (using dynamometry), physical performance tests and plasma phospholipid n-3 fatty acids (using GCMS) were evaluated at weeks 0, 8 and 16; and lean soft tissue mass (using DXA), at weeks 0 and 16.
Over 2 years, 244 patients were screened, 46 were eligible (18.9%), 20 were randomized, 10 completed the study (6 CTR, 4 EXP). Median age was 87 y (77-94 y; 75% women) and gait speed was 0.69 m/s; 55% had low strength, and all performed under 420m on the 6-minute walk test, at baseline. Overall self-reported compliance to powder and oil was high (96% and 85%) but declined at 16 weeks for fish oil (55%). The EXP median protein intake surpassed the target 1.2-1.5 g/kg/d, without altering usual diet. Proportions of plasma phospholipid EPA and DHA increased significantly 3- and 1.5-fold respectively, at week 8 in EXP, with no change in CTR. Participants were able to complete most assessments with sustained guidance.
Because of low eligibility, the pilot study was interrupted and deemed non-feasible; adherence to rigorous study assessments and to supplements was adequate except for long-term fish oil. The non-amended protocol may be applied to populations with greater functional capacity.
ClinicalTrials.gov NCT04454359.
ClinicalTrials.gov NCT04454359.
