Napiercampbell2875

OBJECTIVES The aim of the present study was to test a before-school physical activity intervention (Active-Start intervention) on blood pressure in children and examine whether sedentary time moderates the effect of the intervention on blood pressure. DESIGN Randomized controlled trial. METHODS The Active-Start intervention comprising 170 children (8-10 years old) from three public schools with low socioeconomic status in Santiago (Chile). The exercise intervention was delivered daily, before starting the first school-class (800-830 a.m.), for 8 weeks. The intervention was mainly a program of cooperative physical games at moderate-vigorous intensity. Resting systolic and diastolic blood pressure was determined from the average of two measurements at baseline and at the end of intervention. Moderate-to-vigorous physical activity and sedentary time was assessed using a GENEActiv tri-axial accelerometer prior to the program intervention. RESULTS The Active-Start intervention decreased blood pressure levels in children (p less then 0.01) but did not change relative to the control group. Johnson-Neyman analysis revealed a significant relationship between the effect of intervention on systolic blood pressure and mean arterial pressure when sedentary time was below, but not at or above, 657 and 659min per day (i.e., the effect of physical exercise disappears), respectively. CONCLUSIONS The effect of physical activity on blood pressure could disappear in children with excessive sedentary time, which highlights the need to reduce total levels of sedentary time in the day-to-day life of young people in and out of schools. OBJECTIVES This study describes the development and patients' perceptions of a community pharmacist-led, statin-prescribing service for patients with diabetes and aims to identify why patients indicated for statin therapy were not prescribed therapy at the time of pharmacist consultation. SETTING This pilot service began in 4 community-based Albertsons Companies pharmacies located in western Idaho. Patients eligible for the statin-prescribing service had a current diagnosis of type 2 diabetes, were aged between 40 and 75 years, were currently taking medications to manage their diabetes and had no contraindications to statin therapy. PRACTICE DESCRIPTION Due to recent law changes in Idaho, pharmacists can now prescribe statins and certain other medications without oversight from a medical provider or the need for a collaborative practice agreement. PRACTIVE INNOVATION Patients were identified and contacted by their local community pharmacist to discuss the statin-prescribing service. Once statin therapy was inould target an important health initiative. Published by Elsevier Inc.PURPOSE To validate the predictive and prognostic role of the De Ritis ratio in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy in a large multi-institutional cohort. MATERIALS AND METHODS The preoperative De Ritis ratio was assessed in a multi-institutional cohort of 2,492 patients. An altered De Ritis ratio was defined as a ratio >1.35. Logistic regression analyses were performed to assess the association of the De Ritis ratio with advanced disease. The association of the De Ritis ratio with survival outcomes was evaluated using Cox proportional hazards regression models. RESULTS An altered De Ritis ratio was observed in 985 (41.5%) patients; it was associated with a more advanced pathological features. In a preoperative model, the De Ritis ratio was an independent predictive factor for the presence of lymph node metastasis and muscle-invasive and nonorgan-confined disease (P less then 0.05). Compared to patients with a normal De Ritis ratio, those with an altered De Ritis ratio had worse recurrence free (P less then 0.0001), cancer specific (P = 0.0003), and overall survival (P = 0.0014) in the Kaplan-Meier analyses. In the multivariable analyses that was adjusted for the effects of standard clinicopathologic features, the De Ritis ratio did not retain its independent prognostic value. CONCLUSIONS In UTUC, the preoperative De Ritis ratio is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC. Therefore, it might be useful to incorporate the De Ritis ratio into prognostic tools in selecting appropriate treatment strategies. INTRODUCTION Operative procedures near the distal femoral physis can result in iatrogenic damage if one is not familiar with the complex anatomy of the growth plate. The purpose of this study was to use physeal-specific MRI sequences to delineate the anatomic dimensions of the distal femoral physis. MATERIALS AND METHODS Sixty patients underwent physeal-specific spoiled gradient 3-D fat saturated (SPGR) MRI analysis of a single knee. Three age groups (eight to 10, 11-13, and 14-16 years) comprised of equal numbers (n = 20) of boys and girls were evaluated. Using the SPGR coronal sequence, the distance of the physis to the femoral articular cartilage was recorded at the medial, mid-medial, notch, mid-lateral and lateral margins of the knee. Coronal measurements were recorded at four locations along the sagittal sequence, as the anteroposterior dimension of the knee was divided into equal quartiles. RESULTS While little variation in shape was observed in the anterior quartile, the remaining quartiles demonstrated significant variability that increased moving posteriorly (p  less then  .001), therefore reflecting a more concave shape in the posterior aspect of the femur. These observations were statistically significant for age at the posterior two quartiles. CONCLUSION These MRI data suggest that while the physis is linear in the anterior part of the femur, it possesses a more concave shape in the posterior aspect of the medial and lateral condyles. Findings were preserved across gender and age. Ultimately, these data can aid in preoperative planning and should be considered when performing operative procedures in the skeletally immature knee. PURPOSE We examined (1) if child maltreatment (CM) is associated with lower health-related quality of life (HRQoL) and fewer quality-adjusted life years (QALY) over a 9-year follow-up of midlife women and (2) if adulthood psychosocial mediators could explain these associations. Leukadherin1 METHODS Women (n = 342) completed the Childhood Trauma Questionnaire. Longitudinal HRQoL and QALY outcomes measured at five study visits include 36-item Short-Form Health Survey mental component score and physical component score and the Short Form-6 Dimension health index. Aims 1 and 2 were investigated by generalized estimating equations and sequential structural nested mean models, respectively. RESULTS Twenty percent reported 2+ CM types. Compared with women without CM, women who experienced 2+ CM types reported 5- and 4-points lower scores in mental component score and physical component score, respectively, and 28 fewer healthy days per year in QALY. Low optimism, sleep problems, and low social support each explained greater than 10% of the relationship between 2+ CM and HRQoL and QALY over time.