scholarly journals When to Start and Stop Bone-Protecting Medication for Preventing Glucocorticoid-Induced Osteoporosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Kaleen N. Hayes ◽  
Ulrike Baschant ◽  
Barbara Hauser ◽  
Andrea M. Burden ◽  
Elizabeth M. Winter
Keyword(s):  
Osteoporosis Treatment ◽  
Current Evidence ◽  
Future Research ◽  
Current Guideline ◽  
Patient Case ◽  
Osteoporosis Therapy ◽  
Major Barrier ◽  
Increase Fracture Risk ◽  
Clear Guideline ◽  
Areas Of Interest

Glucocorticoid-induced osteoporosis (GIOP) leads to fractures in up to 40% of patients with chronic glucocorticoid (GC) therapy when left untreated. GCs rapidly increase fracture risk, and thus many patients with anticipated chronic GC exposures should start anti-osteoporosis pharmacotherapy to prevent fractures. In addition to low awareness of the need for anti-osteoporosis therapy among clinicians treating patients with GCs, a major barrier to prevention of fractures from GIOP is a lack of clear guideline recommendations on when to start and stop anti-osteoporosis treatment in patients with GC use. The aim of this narrative review is to summarize current evidence and provide considerations for the duration of anti-osteoporosis treatment in patients taking GCs based on pre-clinical, clinical, epidemiologic, and pharmacologic evidence. We review the pathophysiology of GIOP, outline current guideline recommendations on initiating and stopping anti-osteoporosis therapy for GIOP, and present considerations for the duration of anti-osteoporosis treatment based on existing evidence. In each section, we illustrate major points through a patient case example. Finally, we conclude with proposed areas for future research and emerging areas of interest related to GIOP clinical management.

scholarly journals Probióticos en enfermedad celíaca: ¿estamos listos para su aplicación en la práctica clínica?

2021 ◽  
Vol 51 (4) ◽  
Author(s):  
Gastón H Rueda ◽  
M Inés Pinto-Sánchez
Keyword(s):  
Celiac Disease ◽  
Immune System ◽  
Gastrointestinal Symptoms ◽  
Mechanisms Of Action ◽  
Current Evidence ◽  
Future Research ◽  
Preclinical Studies ◽  
Gluten Free ◽  
Review Of The Literature ◽  
Areas Of Interest

Probiotics, live microorganisms that produce a beneficial effect on health, are a possible supplement to a gluten-free diet in the treatment of celiac disease. Several clinical studies have shown that celiac patients treated with probiotics improved their gastrointestinal symptoms. Although the mechanisms of probiotics in celiac disease are unclear, preclinical studies in mice suggest different mechanisms, such as the modulation of the intestinal microbiota and the immune system, or through the production of proteases. We conducted a review of the literature to address the current evidence on the efficacy of probiotics in the treatment of celiac disease, possible mechanisms of action, and areas of interest for future research studies.

The application of virtual reality in health professions� digital education: a narrative review (Preprint)

2018 ◽  
Author(s):  
Lorraine Tudor Car ◽  
Bhone Myint Kyaw ◽  
Josip Car
Keyword(s):  
Virtual Reality ◽  
Professional Education ◽  
Health Professions ◽  
Health Professions Education ◽  
Narrative Review ◽  
Current Evidence ◽  
Future Research ◽  
Educational Content ◽  
Potential Applications

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.

Institutions and the Embedded Entrepreneur

2019 ◽  
pp. 115-134
Author(s):  
Maryann Feldman ◽  
Paige Clayton
Keyword(s):  
Current Evidence ◽  
Future Research ◽  
Institutional Logic ◽  
The Relationship ◽  
Regional Resources

This chapter examines the relationship between entrepreneurs and the communities in which they are embedded. It argues that the actions of entrepreneurs and their firms are contextually situated in specific geographies that make their actions endogenous in the development of place and define a place-specific institutional logic. This argument is at odds with the view that industry clustering is due to the role of incumbent firms. This chapter reconciles these views by adopting a temporal view, allowing both incumbents and geography to co-occur and influence clustering. It then considers the current evidence of entrepreneurs’ effects on regional resources and capacity, and concludes with suggestions for future research.

scholarly journals The Economic, Social, and Environmental Impacts of Farmers Markets: Recent Evidence from the US

2021 ◽  
Vol 13 (6) ◽  
pp. 3423
Author(s):  
Phillip Warsaw ◽  
Steven Archambault ◽  
Arden He ◽  
Stacy Miller
Keyword(s):  
Food Systems ◽  
Food System ◽  
Agricultural Practices ◽  
The United States ◽  
Current Evidence ◽  
Farmers Markets ◽  
Future Research ◽  
Regional Food ◽  
Recent Scholarship ◽  
Fresh Food

Farmers markets are regular, recurring gatherings at a common facility or area where farmers and ranchers directly sell a variety of fresh fruits, vegetables, and other locally grown farm products to consumers. Markets rebuild and maintain local and regional food systems, leading to an outsized impact on the food system relative to their share of produce sales. Previous research has demonstrated the multifaceted impacts that farmers markets have on the communities, particularly economically. Recent scholarship in the United States has expanded inquiry into social impacts that markets have on communities, including improving access to fresh food products and increasing awareness of the sustainable agricultural practices adopted by producers, as well developing tools for producers and market stakeholders to measure their impact on both producers and communities. This paper reviews the recent scholarship on farmers markets to identify recent trends and synthesizes the current evidence describing the ways in which farmers markets contribute to the wellbeing of their communities, as well as identifying areas for additional future research.

scholarly journals Impact of Shift Work and Long Working Hours on Worker Cognitive Functions: Current Evidence and Future Research Needs

2021 ◽  
Vol 18 (12) ◽  
pp. 6540
Author(s):  
Veruscka Leso ◽  
Luca Fontana ◽  
Angela Caturano ◽  
Ilaria Vetrani ◽  
Mauro Fedele ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Cognitive Impairment ◽  
Sleep Disturbances ◽  
Working Hours ◽  
Night Work ◽  
Current Evidence ◽  
Future Research ◽  
Negative Effects ◽  
Long Working Hours ◽  
Main Determinants

Particular working conditions and/or organization of working time may cause important sleep disturbances that have been proposed to be predictive of cognitive decline. In this regard, circadian rhythm misalignment induced by exposure to night work or long working hours would be responsible for cognitive impairment. Nevertheless, evidence supporting this correlation is limited and several issues still need to be elucidated. In this regard, we conducted a systematic review to evaluate the association between shift/night work and cognitive impairment and address its main determinants. Information provided by the reviewed studies suggested that night work might have serious immediate negative effects especially on cognitive domains related to attention, memory and response inhibition. Furthermore, cognitive performance would progressively worsen over consecutive night shifts or following exposure to very long work shifts. Otherwise, conflicting results emerged regarding the possible etiological role that night work chronic exposure would have on cognitive impairment. Therefore, circadian rhythm desynchronization, lack of sleep and fatigue resulting from night work may negatively impact worker’s cognitive efficiency. However, in light of the considerable methodological variability of the reviewed studies, we proposed to develop a standardized research and evaluation strategy in order to obtain a better and comprehensive understanding of this topic.

scholarly journals Unequal impact of the COVID-19 crisis on minority ethnic groups: a framework for understanding and addressing inequalities

2021 ◽  
pp. jech-2020-216061
Author(s):  
Srinivasa Vittal Katikireddi ◽  
Sham Lal ◽  
Enitan D Carrol ◽  
Claire L Niedzwiedz ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Social Consequences ◽  
Control Measures ◽  
Current Evidence ◽  
Future Research ◽  
Complex Interplay ◽  
Structural Racism ◽  
Theoretical Understanding ◽  
Minority Ethnic Groups ◽  
Minority Ethnic

Minority ethnic groups have been disproportionately affected by the COVID-19 pandemic. While the exact reasons for this remain unclear, they are likely due to a complex interplay of factors rather than a single cause. Reducing these inequalities requires a greater understanding of the causes. Research to date, however, has been hampered by a lack of theoretical understanding of the meaning of ‘ethnicity’ (or race) and the potential pathways leading to inequalities. In particular, quantitative analyses have often adjusted away the pathways through which inequalities actually arise (ie, mediators for the effect of interest), leading to the effects of social processes, and particularly structural racism, becoming hidden. In this paper, we describe a framework for understanding the pathways that have generated ethnic (and racial) inequalities in COVID-19. We suggest that differences in health outcomes due to the pandemic could arise through six pathways: (1) differential exposure to the virus; (2) differential vulnerability to infection/disease; (3) differential health consequences of the disease; (4) differential social consequences of the disease; (5) differential effectiveness of pandemic control measures and (6) differential adverse consequences of control measures. Current research provides only a partial understanding of some of these pathways. Future research and action will require a clearer understanding of the multiple dimensions of ethnicity and an appreciation of the complex interplay of social and biological pathways through which ethnic inequalities arise. Our framework highlights the gaps in the current evidence and pathways that need further investigation in research that aims to address these inequalities.

scholarly journals Defining a research agenda for youth sport specialisation in the USA: the AMSSM Youth Early Sport Specialization Summit

2021 ◽  
Vol 55 (3) ◽  
pp. 135-143
Author(s):  
Stephanie A Kliethermes ◽  
Stephen W Marshall ◽  
Cynthia R LaBella ◽  
Andrew M Watson ◽  
Joel S Brenner ◽  
...  
Keyword(s):  
Research Agenda ◽  
Sport Participation ◽  
Youth Sport ◽  
Well Being ◽  
Medical Society ◽  
Current Evidence ◽  
Future Research ◽  
Long Term Effects ◽  
Increased Risk ◽  
The Usa

Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.

scholarly journals Creating Dementia-Friendly Communities for Social Inclusion: A Scoping Review

2021 ◽  
Vol 7 ◽  
pp. 233372142110135
Author(s):  
Lillian Hung ◽  
Allison Hudson ◽  
Mario Gregorio ◽  
Lynn Jackson ◽  
Jim Mann ◽  
...  
Keyword(s):  
Scoping Review ◽  
Social Inclusion ◽  
Search Strategy ◽  
Current Evidence ◽  
Future Research ◽  
Education Practice ◽  
Active Involvement ◽  
People With Dementia ◽  
Index Terms ◽  
Inclusion Methods

Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research.

WoCoVA consensus on the clinical use of in-line filtration during intravenous infusions: Current evidence and recommendations for future research

2021 ◽  
pp. 112972982198916
Author(s):  
Ton Van Boxtel ◽  
Mauro Pittiruti ◽  
Annemarie Arkema ◽  
Patrick Ball ◽  
Giovanni Barone ◽  
...  
Keyword(s):  
Potential Benefit ◽  
Scientific Evidence ◽  
Venous Access ◽  
Current Evidence ◽  
Future Research ◽  
Global Awareness ◽  
Current State ◽  
Intravenous Infusions ◽  
Proper Definition ◽  
Definition Of

The need for filtering intravenous infusions has long been recognized in the field of venous access, though hard scientific evidence about the actual indications for in-line filters has been scarce. In the last few years, several papers and a few clinical studies have raised again this issue, suggesting that the time has come for a proper definition of the type of filtration, of its potential benefit, and of its proper indications in clinical practice. The WoCoVA Foundation, whose goal is to increase the global awareness on the risk of intravenous access and on patients’ safety, developed the project of a consensus on intravenous filtration. A panel of experts in different aspects of intravenous infusion was chosen to express the current state of knowledge about filtration and to indicate the direction of future research in this field. The present document reports the final conclusions of the panel.

scholarly journals Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of cerebral venous sinus thrombosis

2020 ◽  
Vol 5 (2) ◽  
pp. 152-158
Author(s):  
Yuhua Fan ◽  
Jian Yu ◽  
Hongbing Chen ◽  
Jian Zhang ◽  
Jiangang Duan ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Clinical Management ◽  
Sinus Thrombosis ◽  
Cerebrovascular Disorders ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Current Evidence ◽  
Current Guideline ◽  
Venous Sinus Thrombosis ◽  
Venous Thromboembolic Events

AimCerebral venous sinus thrombosis (CVST) is a less common cerebrovascular disease that predominantly affects young patients. The incidence of CVST is 2–5/10 000 000/year, accounting for 0.5%–1% of all stroke. To reduce mortality and morbidity associated with CVST, Chinese Stroke Association commissioned the authors to write the current guideline on the management of CVST.MethodsPubMed (MEDLINE), CNKI and Wanfang database were searched for studies related to CVST from 1 January 1990 to 31 July 2019. Data were synthesised by evidence tables. Each recommendation was fully discussed by the writing group members and reviewed by Chinese Stroke Association Stroke Fellow Committees. Levels of evidence grading algorithm of Chinese Stroke Association was used to grade each recommendation.ResultsThis guideline mainly focuses on the diagnostic evaluation, therapeutic strategies and secondary prevention of CVST. CT/CTV and MRI/MRV are recommended in the initial imaging evaluation of patients with suspected CVST. Anticoagulation therapy with low-molecular weight heparin should be initiated in patients with CVST immediately. After the acute stage, warfarin is recommended for 3–6 months to prevent the recurrence of CVST and other venous thromboembolic events.ConclusionsThe guideline summarises the current evidence regarding the management of CVST, and provides references for diagnosis, treatment and secondary prevention of CVST in China.

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