Selected Morphotic Parameters Differentiating Ulcerative Colitis from Crohn’s Disease

This paper presents a method that binds statistical and data mining techniques, which aims to support the decision-making process in selected diseases of the digestive system. Currently, there is no precise diagnosis for ulcerative colitis (UC) and Crohn’s disease (CD). Specialist physicians must exclude many other diseases occurring in the colon. The first goal of this study is a retrospective analysis of medical data of patients hospitalised in the Department of Gastroenterology and Internal Diseases, Bialystok, and finding the symptoms differentiating the two analysed diseases. The second goal is to build a system that clearly points to one of the two diseases UC or CD, which shortens the time of diagnosis and facilitates the future treatment of patients. The work focuses on building a model that can be the basis for the construction of action rules, which are one of the basic elements in the medical recommendation system. Generated action rules indicated differentiating factors, such as mean corpuscular volume, platelets (PLTs), neutrophils, monocytes, eosinophils, basophils, alanine aminotransferase (ALAT), creatinine, sodium and potassium. Other important parameters were smoking and blood in stool.

Exploring Inequalities in HPV Vaccine Uptake among Cape Verdean Immigrant and Portuguese Native Women

Based on data from the FEMINA study, this communication aims to explore inequalities in HPV vaccine uptake. Results highlighted differences between the Portuguese and the Cape Verdean women: 97% vs. 67% had heard about the HPV vaccine; 30% vs. 9% had been vaccinated, and 71% vs. 82% had reported a lack of medical recommendation as a major reason for not having been vaccinated. Further research on the mechanisms that operate in the production of health disparities is needed to promote equity-focused interventions.

Audit of delays in the diversion of mentally disordered defendants under the Mental Health Act 1983/2007 at a liaison and diversion service in North West London

AimsTo ascertain the length of time defendants wait for a Mental Health Act assessment (MHAA) and where necessary, how long they are waiting for a hospital bed.BackgroundThe Liaison and Diversion Service in North West London (the Service) is provided by Central North West London Foundation NHS Trust (CNWL), Barnet Enfield Haringey (BEH) and Together to Willesden Magistrates Court in North West London.One of the core activities of the Service is diverting individuals from the criminal justice system to hospital under the Mental Health Act (MHA).The Code of Practice allows for a period of 14 days between the medical recommendation and conveyance to hospital. Defendants needing admission under MHA are remanded to custody if a bed is not available. This prevents them from receiving the assessment and care they need. We consider that all defendants found to be liable to detention under the MHA should be admitted to a hospital bed on the same day.MethodData were collected between October 2018 and February 2019. All patients referred for a MHAA were included. The time a MHAA was requested, took place as well as how long the defendant waited for a bed was noted.ResultA total of 42 MHAA were requested. 25 individuals were detained under Section 2 of the MHA 1983.The time between referral for a MHAA and the MHAA taking place was obtained in 25 of the 42 referrals. The range of times between a referral being made and the assessment taking placed varied between 1.5 hours and 22 hours. Two defendants were remanded overnight in prison as the MHAA could not take place on the same day as the referral.In the 25 cases where an application for detention under Section 2 of the MHA was made, beds were not available on the same day in 7 cases. In 4 cases defendants required remand in prison custody due to beds not being available.ConclusionThere were some limitations to this audit as data were not available for all 42 individuals referred for a MHAA.Individuals referred for MHAA by the Service had both medical recommendations completed within 5 days and those who required admission to hospital were admitted within 14 days of the recommendations being completed.Whilst these standards are being met, individuals referred for MHAA and those requiring admission to hospital are still facing remand to custody.

Deep Personalized Medical Recommendations Based on the Integration of Rating Features and Review Sentiment Analysis

To comply with the rapid development of big data in mobile services, an increasing number of websites have begun to provide users with recommendation decisions in various areas, like shopping, tourism, food, and medical treatment. However, there are still some challenges in the field of medical recommendation systems, such as the lack of personalized medical recommendations and the problem of data sparseness, which seriously restricts the effectiveness of such recommendations. In this paper, we propose a personalized medical recommendation method based on a convolutional neural network that integrates revised ratings and review text, called revised rating and review based on a convolutional neural network (RR&R-CNN). First, the review text is divided into user and doctor datasets, and BERT vectorized representations are performed on them. Moreover, the original rating features are revised by adding the sentiment analysis values of the review text. Then, the vectorized review text and the revised rating features are spliced together and input into the convolutional neural network to extract the deep nonlinear feature vectors of both users and doctors. Finally, we use a factorization machine for feature interaction. We conduct comparison experiments based on a Yelp dataset in the “Health & Medical” category. The experimental results confirm the conclusion that RR&R-CNN has a better effect compared to a traditional method.

The Effect of Infant Formulas With 4 or 8 g/L GOS/FOS on Growth, Gastrointestinal Symptoms, and Behavioral Patterns: A Prospective Cohort Study

There is a lack of studies investigating the clinical benefits of prebiotic-supplemented infant formula. In this study, healthy infants that started, on medical recommendation, artificial feeding with one of 2 infant formulas containing 4 g/L of GOS/FOS (9:1) (IF4 group; n = 60) or 8 g/L of GOS/FOS (9:1) (IF8 group; n = 60) were followed for 30 days to the evaluation of growth and gastrointestinal symptoms. Exclusively breastfed infants (EBF; n = 60) were followed up as a reference. Both infant formulas supported adequate weight gain, however, IF4 formula promotes growth more similar to breastfed infants. There was no additional benefit of a dose higher than 4 g/L of GOS/FOS on gastrointestinal symptoms.

Factors Related to Sports Participation in Brazil: An Analysis Based on the 2015 National Household Survey

The academic interest in analyzing the correlates of sports participation in several countries has increased recently. Nevertheless, in developing countries, which do not monitor sportive data, this type of investigation is still scarce. This study aims to analyze socioeconomic, motivational, and supportive factors related to sports participation in Brazil. Data from the 2015 National Household Survey—Supplementary Questionnaire of Sports and Physical Activities are examined. In the survey, 71,142 individuals older than 15 years were interviewed (mean age 43.12 years; 53.83% women and 46.17% men). Logistic regression is used for analyzing the data. Results demonstrate a low participation in sports (23.38%). Sports participation declines with increasing age (2% less per year), increases with higher educational level (graduated 5.9 times more), and males prevail in the sporting context (2.3 times more). The main obstacle to women’s participation is the lack of sports facilities, and for men the lack of time and health problems. Men practice sports mainly due to socialization, fun, and competition, and women due to medical recommendation. Soccer was the most practiced sport (28.1%), predominating among men. Public policies on sports promotion for fun and socialization may increase male participation, and investments in sports facilities may increase female participation.

The Use of Pedometer as a Stimulus to the Physical Activity in the Hypertensive Patients with Difficult-to- Control Hypertension: A Controlled Randomized Study

Regular physical activity contributes to better control of hypertension in addition to other dietary measures and medications. The practice of physical activity and long term adherence to it is not consistently observed in a hypertensive population. We evaluated the possible role of the use of a pedometer as a stimulus to enhance the physical activity in a selected hypertensive population.We performed a prospective, randomized trial in a difficult-to-control hypertensive population that had been followed in the hypertensive clinic of the Hospital Santa Izabel of Santa Casa de Misericórdia da Bahia. This study compared two groups: Pedometer Group, which uses a pocket digital pedometer (Omron HJ-321) in addition to the usual medical recommendation; and Control Group, which was submitted to the regular medical recommendation without a pedometer. The performance was analyzed by the number of steps during 12 weeks observation period with the primary endpoint at first week. Forty-two patients were studied. Patients had largely low-income and low-education characteristics. Their initial number of steps at week 1 were: 6,191.7 (667.3), and 5,249.1 (549.5) for the Control and Pedometer Groups (p=0.28), respectively. At the end of a 12-week observation, the results were: 6,097.6 (547.0), and 5,913.0 (730.6) (p=0.84) for the Control and Pedometer Groups, respectively. In a population of difficult-to-control hypertension, which already had a relatively high number of steps to perform its regular activities of day-life at the beginning of the study, the use of a pedometer does not seem to enhance the level of physical activity beyond what is accomplished by the structured information that is provided in the hypertension clinic.

Meaningful futility: requests for resuscitation against medical recommendation

‘Futility’ is a contentious term that has eluded clear definition, with proposed descriptions either too strict or too vague to encompass the many facets of medical care. Requests for futile care are often surrogates for requests of a more existential character, covering the whole range of personal, emotional, cultural and spiritual needs. Physicians and other practitioners can use requests for futile care as a valuable opportunity to connect with their patients at a deeper level than the mere biomedical diagnosis. Current debate around Canada’s changing regulatory and legal framework highlights challenges in appropriately balancing the benefits and burdens created by requests for futile care.