Culture
Diabetes Patients Experiencing Empathy From Primary Care Practitioners Have Lower Risk of Mortality
Sea urchins have gotten a bad rap on the Pacific coast. The spiky sea creatures can mow down entire swaths of kelp forest, leaving behind rocky urchin barrens. An article in the New York Times went so far as to call them "cockroaches of the ocean." But new research suggests that urchins play a more complex role in their ecosystems than previously believed.
Crouching in the boot-sucking mud of the Baylands Nature Preserve in Palo Alto, Manu Prakash, associate professor of bioengineering at Stanford University, peered through his Foldscope - a $1.75 origami microscope of his own invention - scrutinizing the inhabitants of the marsh's brackish waters. With his eye trained on a large single-cell organism, called Spirostomum, he watched it do something that immediately made it his next research subject.
NUST MISIS scientists together with the colleagues from P.N. Lebedev Physical Institute of the Russian Academy of Sciences of the Russian Academy of Sciences, Skobeltsyn Institute of Nuclear Physics Lomonosov Moscow State University and Dagestan State University have published the first results of a "scan" obtained by the method of muon radiography of the underground space in the Derbent fortress of Naryn-Kala. The preliminary conclusion of the scientists -- the hypothesis of archaeologists about the use of the building as a Christian temple is most likely to be true.
A large observational cohort study examining male veterans aged over 50 years with type 2 diabetes found that metformin use was associated with a significantly lower risk of dementia in African American patients. The study included data from 73,500 patients who received care through the Veteran's Health Administration from 2000-2015 and were diabetes- and dementia-free at baseline and who subsequently developed type 2 diabetes and began treatment with either metformin or sulfonylurea.
A novel "flash mob" study finds that, in emergency care, acute coronary syndrome cannot be safely ruled out using the Marburg Heart Score or the family physicians' clinical assessment. In a period of only two weeks, researchers at Maastricht University collected data on 258 ACS-suspected patients by mobilizing one in five family physicians throughout the Netherlands to participate in the study. This mobilization was done by enlisting ambassadors among the FP community in the Netherlands who then spread the word through traditional professional and social networks.
Family physicians prescribe the greatest volume of opioids (22.9%) and number of prescriptions (31.2%) to individuals with chronic noncancer pain, making them targets for quality improvements in safer prescribing practices. Interviews with 22 family physicians in Ontario, Canada, from June to July 2017, identified key themes driving the over prescription of opioids in managing chronic pain: the contrast between doctors' training and current expectations; navigating patient and system expectations; and the duration and quality of therapeutic relationships.
CHAMPAIGN, Ill. -- A new paper co-written by a University of Illinois expert who studies labor economics says the minimum wage is an effective tool to increase the incomes of older workers who are at or near retirement and - contrary to the notion that higher minimum wages force earlier retirements - has no discernible "disemployment" effects.
In an era of rising inequality and aging populations, the effect of the minimum wage on the labor market for older workers is increasingly important, said Mark Borgschulte, a professor of economics at Illinois.
A questionnaire-based management algorithm for major depressive disorder in primary care is feasible to implement, though attrition from treatment is high. Among 25,000 patients in primary care clinics in a large metropolitan area, 4,325 (17%) screened positive for depression with 2,426 having a clinician-diagnosed depressive disorder. Of the 2,160 patients who had 18 weeks of follow-up care, 65% were treated with medication. Remission, defined as a PHQ-9 score of less than five, was more common in patients who experienced three or more follow-up visits.
The advent of the Affordable Care Act has led to millions of new patients seeking primary care. Because the number of primary care physicians has remained stable, access to care has been a concern. This "secret shopper" study performed between 2012 and 2016 showed that the proportion of primary care appointments scheduled for Medicaid patients with nonphysician advanced practitioners, like nurse practitioners and physician assistants, increased from 7.7% to 12.9% across a sample of 3,742 randomly selected primary care practices in 10 states.
In this special report, the authors argue that the current primary care team paradigm is underpowered, in that most of the administrative responsibility still falls mainly on the physician. Jobs not requiring a medical education, such as entering data into electronic health records, should not be handled by physicians and advanced practitioners.
The Astana Declaration, adopted by the World Health Organization in October 2018, acknowledges the importance of primary health care to achieve better health outcomes globally. But how, the authors ask, can physicians make this declaration work? Family physicians, the authors argue, can serve an important role in improving primary health care if they are better integrated "horizontally," translating their localized knowledge of health trends to wider populations and communities.
Gorillas have more complex social structures than previously thought, from lifetime bonds forged between distant relations, to "social tiers" with striking parallels to traditional human societies, according to a new study.
The findings suggest that the origins of our own social systems stretch back to the common ancestor of humans and gorillas, rather than arising from the "social brain" of hominins after diverging from other primates, say researchers.
Poor quality social relationships that contribute to psychosocial stress may be associated with bone loss in postmenopausal women, suggests research published online in the Journal of Epidemiology & Community Health.
Psychosocial stress is a well-established risk factor for many chronic diseases and previous research has suggested that a number of psychosocial stressors, such as increased major life events, lower levels of optimism, life satisfaction and education, and may be associated with fractures.
Most dog and cat owners are not aware of pet blood donation schemes and animal blood banks, finds a survey of pet owners published in Vet Record.
However, the majority of owners in this study said they would be willing to allow their pets to donate blood, suggesting that just like human blood donation, raising awareness could help to increase donor numbers, say the researchers.