Frostsherwood0417

Graphical Abstract.

Widespread misuse of short-acting beta-agonists (SABAs) may contribute to asthma-related morbidity and mortality. Recognizing this, the Global Initiative for Asthma neither recommends SABA monotherapy nor regards this formulation as a preferred reliever. Many health systems and healthcare professionals (HCPs) experience practical issues in implementing guidelines. Clear quality standards can drive improvements in asthma care and encourage implementation of global and national medical guidelines.

A steering group of global asthma experts came together between May and September 2019 to develop quality statements codifying the minimum elements of good quality asthma care. These statements were either evidencebased (when robust evidence was available) or reflected a consensus based on clinical expertise and experience of the group.

The quality statements (and associated essential criteria) developed emphasize key elements concerning (1) objective diagnosis specific to individual symptoms, (2) treatment apprse. In particular, the statements empower self-management by patients and encourage health-promoting behaviors, which are essential to reduce exacerbations, the primary goal of asthma management.

The steering group proposes quality statements that national and local clinical groups can implement as quantitative quality standards that are appropriate to their local circumstances, including during the coronavirus disease 2019 (Covid-19) pandemic. By translating these statements into locally relevant quality standards, primary care physicians and HCPs can encourage optimal management and reduce preventable healthcare interactions. The evidence-based evolution of care encapsulated in these statements will further engender high-quality, patient-centered holistic management that addresses asthma as an inflammatory disease. In particular, the statements empower self-management by patients and encourage health-promoting behaviors, which are essential to reduce exacerbations, the primary goal of asthma management.

Despite the increasing demand for public health measures to prevent problem gambling, few studies have examined the association between community characteristics and problem gambling. The aim of this nationally representative cross-sectional study was to investigate the relationship between a sense of community belonging and problem gambling in Canada. We also examined whether this relationship was modified by sex and marital status.

Canadian Community Health Survey (2013-2014) data from 38,968 residents of Quebec, Saskatchewan, Manitoba, and British Columbia were analyzed. Problem gambling was assessed using the Canadian Problem Gambling Index. https://www.selleckchem.com/products/lw-6.html We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for problem gambling.

The prevalence of problem gambling was 1.4% (1.9% among males; 0.9% among females). We observed an inverse dose-response relationship between a sense of community belonging and problem gambling. Compared with those with a very strong sense of community belonging, the adjusted ORs for problem gambling were 1.07 (95% CI 0.65-1.76) for a somewhat strong sense, 1.27 (95% CI 0.77-2.11) for a somewhat weak sense, and 2.32 (95% CI 1.34-4.02) for a very weak sense of community belonging. The association was more prominent among females (except for those widowed/divorced/separated), whereas no clear association was found among males, irrespective of marital status.

When implementing public health measures to reduce problem gambling, it would be useful to account for possible differential impacts of a sense of community belonging by sex and marital status, which may reflect significant social contexts among residents.

When implementing public health measures to reduce problem gambling, it would be useful to account for possible differential impacts of a sense of community belonging by sex and marital status, which may reflect significant social contexts among residents.Patients with hematological diseases often experience cerebrovascular complications including ischemic stroke, intracerebral and subarachnoid hemorrhage, microbleeds, posterior reversible encephalopathy syndrome, and dural sinus and cerebral vein thrombosis (CVT). In this update, we will review recent advances in the management of cerebrovascular diseases in the context of myeloproliferative neoplasms, leukemias, lymphomas, multiple myeloma, POEMS, paroxysmal nocturnal hemoglobinuria (PNH), thrombotic thrombocytopenic purpura (TTP), and sickle-cell disease. In acute ischemic stroke associated with hematological diseases, thrombectomy can in general be applied if there is a large vessel occlusion. Intravenous thrombolysis can be used in myeloproliferative neoplasms and sickle-cell anemia, but in other diseases, a case-by-case evaluation of the bleeding risks is mandatory. Patients with sickle-cell disease and acute stroke need very often to be transfused. In PNH, acute ischemic stroke patients must be anticoagulated. Most patients with CVT can be treated with low-molecular weight heparin (LMWH) acutely, even those with leukemias. Prevention of recurrence of cerebral thrombotic events depends on the control of the underlying disease, combined in some conditions with antithrombotic drugs. The recent introduction of specific monoclonal antibodies in the treatment of PHN and TTP has dramatically reduced the risk of arterial and venous thrombosis.

Few clinical studies evaluate interventions to reduce oral discomfort among patients in palliative care.

This study examines the efficacy of a Salvia officinalis (SO) based herbal mouth rinse compared to conventional normal saline (NS) in order to improve oral health.

A block-randomized controlled trial. Data were collected before and after a 4-day intervention with either SO (n=44) or NS (n=44). Numerical rating scales (NRS, 0-10) and 12 items from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Oral Health 17 (EORTC QLQ-OH17) measured patient-reported oral symptoms. An oral examination was performed before and after the intervention.

This study included adult patients with late-stage cancer in an inpatient hospice unit.

Of the 88 patients included (mean age=63.9 years, SD=10.6), 73 (83%) completed the study. At baseline, 78% reported dry mouth on the EORTC QLQ-OH17, and 80% rated dry mouth ≥4 on the NRS. Total oral health scores based on the 12 EORTC QLQ-OH17 items improved similarly in both groups (p<0.