Fla. EMS supervisor buys crash victim new bicycle

By EMS1 Staff

PINELLAS PARK, Fla. — An EMS supervisor's random act of kindness was recognized by police officers last week.

FOX13News reported that the Pinellas Park Police Department thanked Sunstar EMS Supervisor Josh Brumwell on their Facebook page for going above and beyond the call of duty. Brumwell, who was working a vehicle vs. bicyclist crash at a mall exit, said the bicyclist was not injured in the crash.

However, the man's bike was a total loss. Brumwell said the man broke down, saying the bike was his only means of transportation. Brumwell went to a nearby store and bought the man a new bicycle.

"This was an amazing act of goodwill during the holiday season," the Facebook post said.

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Seroprevalence of Hepatitis B Infection Among Immigrants in a Primary Care Clinic: A Case for Granular Ethnicity and Language Data Collection

Abstract

Chronic hepatitis B virus (HBV) infection is highly prevalent worldwide and is most often diagnosed through screening efforts. In order to identify the specific ethnic groups at greatest risk, it is necessary to go beyond traditional categories. We conducted a retrospective case series in a primary care clinic serving non-English speaking immigrants to determine the prevalence of HBV among patients of various primary spoken languages (used as a proxy for ethnicity). Among the 1378 patients, the overall prevalence of current infection was 8%. HBV infection was markedly higher among Somali, Oromo and Khmer speakerscompared to other groups. This study illustrates the use of granular language data in describing the serologic profiles of HBV infection among non-English speaking patients in primary care setting. The variations in prevalence by language have implications for public health HBV screening efforts, in addition to suggesting potential risk factors for transmission.

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Offending Behavior, Drug Use, and Mental Health Among Foreign-Born versus U.S. Born Latino Criminal Justice Clients

Abstract

Little is known about the offending behavior and recidivism factors of Latinos by nativity (U.S. born, foreign-born). The present study focused on Latinos in community corrections (n = 201) in Miami, Florida, and examined differences in criminal activity, drug use, and mental health by nativity. Data were collected utilizing convenience sampling between June 2014 and December 2015. The research question was: what are the offending, drug use, and mental health histories of Latinos involved in community corrections? Participants were mostly male (n = 120; 59.7%), White (n = 105; 52.2%), and Cuban (n = 97; 48.3%). U.S. born community corrections clients (n = 141) were more likely to report more lifetime and recent criminal activity; and more likely to report lifetime and recent drug use behavior than foreign-born Latinos (n = 60). No differences were found in recent mental health. Correctional healthcare should tailor services such as substance abuse treatment differently toward U.S. born and foreign-born Latinos.

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Neck disability index, Visual analog scale, and Likert scale in patients receiving pharmacotherapy for neck pain: How good do they correlate?

2016-12-30T07-12-19Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Liya Roslin Joseph, Dhanya Sasidharan Palappallil.
Background: Neck disability index (NDI) is a patient self-assessed outcome measurement tool to assess disability due to neck pain. Improvement in pain severity score by a pain intensity numerical rating scale may not necessarily produce a significant change in NDI after treatment. Aims and Objectives: This study was undertaken to study the correlation between the pain status rated by the patient using qualitative scales with the NDI in patients with neck related problems. Materials and Methods: It was prospective observational study conducted in Physical Medicine and Rehabilitation Department of Tertiary care Teaching Hospital in Kerala for duration of 6 months. 170 patients, with M: F ratio-1:2.9, having neck pain were included and treated with centrally acting muscle relaxants and analgesics for 2 weeks. Patients were assessed on their initial visit and followed up after 2 weeks. Patient rating of pain status was measured using visual analog scale (VAS) and a 5-item Likert scale varying from excellent to bad. Disability level due to neck pain was determined using NDI. Analysis was done with correlation coefficient, paired t-test and Wilcoxon signed ranks test using SPSS 20. Results: VAS and Likert scale rating showed a positive correlation with NDI, both before (correlation coefficient = 0.663, 0.589) and after (correlation coefficient = 0.845, 0.776) pharmacotherapy. Significant changes in NDI (t = 28.199, P

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Network properties of ICC affect intestinal pacemaker activity and motor patterns, according to a mathematical model of weakly coupled oscillators

Abstract

Interstitial cells of Cajal (ICC) are the pacemaker cells of gut motility and are associated with motility disorders. ICC form a network, but the contributions of its network properties to gut physiology and dysfunction are poorly understood. We modeled an ICC network as a two-dimensional network of weakly coupled oscillators with a frequency gradient and showed changes over time in video and graphical formats. Model parameters were obtained from slow wave driven contraction patterns in the mouse intestine and pacemaker slow wave activities from the cat intestine. Marked changes in propagating oscillation patterns (including changes from propagation to non-propagating) were observed by changing network parameters (coupling strength between oscillators, the frequency gradient and frequency noise) which affected synchronization, propagation velocity and occurrence of dislocations (termination of an oscillation). Complete uncoupling of a circumferential ring of oscillators caused the proximal and distal section to de-synchronize but complete synchronization was maintained with only a single oscillator connecting the sections with high enough coupling. The network of oscillators could withstand loss; even with 40% of oscillators lost randomly within the network, significant synchronization and antegrade propagation remained. Local increase in pacemaker frequency diminished antegrade propagation; the effects were strongly dependent on location, frequency gradient and coupling strength. In summary, the model puts forth the hypothesis that fundamental changes in oscillation patterns (ICC slow wave activity or circular muscle contractions) can occur through physiological modulation of network properties. Strong evidence is provided to understand the ICC network as a system of coupled oscillators.

This article is protected by copyright. All rights reserved

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Associations of pain intensity and pain-related disability with psychological and socio-demographic factors in patients with temporomandibular disorders: a cross-sectional study at a specialized dental clinic

Abstract

The study assessed whether psychological and socio-demographic factors, including somatization, depression, stress, anxiety, daytime sleepiness, optimism, gender and age are associated with pain intensity and pain-related disability in patients with temporomandibular disorders (TMD). In total, 320 TMD patients were involved in the study. The psychological status of each patient was assessed with questionnaires, including the Symptom Checklist-90 (SCL-90), Epworth Sleeping Scale (ESS), stress questionnaire, and Life Orientation Test-Revised (LOT-R). TMD pain, including pain intensity and pain-related disability, was assessed with characteristic pain intensity (CPI) and disability points scales. The associations of psychological and socio-demographic factors with pain intensity and pain-related disability were assessed through logistic regression analyses. Higher pain intensity was significantly associated with more severe anxiety (P = 0.004), more severe somatization (P < 0.001), more severe depression (P < 0.001), more severe stress (P = 0.001), and lower optimism (P = 0.025) in univariate regression analyses. However, multiple regression analysis showed that only somatization was significantly associated with pain intensity (P < 0.001). Higher pain-related disability was significantly associated with more severe anxiety (P < 0.001), more severe somatization (P < 0.001), more severe depression (P < 0.001), more severe stress (P < 0.001) and lower optimism (P = 0.003) in univariate regression analyses. However, multiple regression analysis showed that only depression was significantly associated with pain-related disability (P = 0.003). Among the psychological and socio-demographic factors in the present study, somatization was the best predictor for pain intensity, while depression was the best predictor for pain-related disability.

This article is protected by copyright. All rights reserved.

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Hepatic Encephalopathy Is Associated with Persistent Learning Impairments Despite Adequate Medical Treatment: A Multicenter, International Study

Abstract

Background

Hepatic encephalopathy (HE) is considered reversible regarding mental status but may not be cognitively in single-center studies.

Aim

To evaluate persistence of learning impairment in prior HE compared to those who never experienced HE (no-HE) in a multicenter study.

Methods

A total of 174 outpatient cirrhotics from three centers (94 Virginia, 30 Ohio, and 50 Rome; 36 prior HE) underwent psychometric hepatic encephalopathy score (PHES) and inhibitory control (ICT) testing at baseline and then at least 7 days apart. ICT learning (change in 2nd half lures compared to 1st half) was compared between patient groups at both visits. Change in the PHES individual sub-tests and total score between visits was compared in both groups. US versus Italian trends were also analyzed.

Results

HE patients had worse PHES and ICT results compared to no-HE patients at baseline. Significant improvement (1st half 7.1 vs. 2nd half 6.2, p < 0.0001) was observed in no-HE, but not in HE (1st half 7.9 vs. 2nd half 7.8, p = 0.1) at baseline. At retesting (median 20 days later), no-HE patients continued with significant learning (1st half 6.0 vs. 2nd half 5.4, p < 0.0001), while HE patients again did not improve (1st half 7.8 vs. 2nd half 6.9, p = 0.37). Between visits, no-HE patients improved significantly on four PHES sub-tests and overall score, while HE patients only improved on two sub-tests with similar overall PHES score. Trends were similar between US and Italian subjects.

Conclusion

In this multicenter study, prior HE patients showed persistent significant learning impairment compared to those without prior HE, despite adequate medical therapy. This persistent change should increase efforts to reduce the first HE episode.

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