This study implicates five genetic loci in bone mineral density. Two of these loci are new; three implicate genes known to be involved in bone remodeling, such as the receptor activator of nuclear ...factor-κB ligand gene (
RANKL
). Analyses showed that three of the loci are associated with osteoporotic fracture.
This study implicates five genetic loci in bone mineral density. Two of these loci are new; three implicate genes known to be involved in bone remodeling.
Osteoporosis confers substantive morbidity and mortality and associated costs and predisposes people to fragility fractures at the hip, spine, forearm, or other skeletal sites.
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It is a common disease affecting both sexes in populations of various ancestries, although elderly women of European descent are at the highest risk.
2
Bone density is the single best predictor of osteoporotic fractures and is a valuable tool in evaluation of the risk of fractures.
3
,
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There is abundant evidence for a genetic contribution to variation in bone mineral density, with heritability estimates between 0.6 and 0.8.
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Bone mineral density is also influenced by environmental . . .
We have previously reported suggestive linkage of type 2 diabetes mellitus to chromosome 10q. We genotyped 228 microsatellite markers in Icelandic individuals with type 2 diabetes and controls ...throughout a 10.5-Mb interval on 10q. A microsatellite, DG10S478, within intron 3 of the transcription factor 7-like 2 gene (TCF7L2; formerly TCF4) was associated with type 2 diabetes (P = 2.1 × 10−9). This was replicated in a Danish cohort (P = 4.8 × 10−3) and in a US cohort (P = 3.3 × 10−9). Compared with non-carriers, heterozygous and homozygous carriers of the at-risk alleles (38% and 7% of the population, respectively) have relative risks of 1.45 and 2.41. This corresponds to a population attributable risk of 21%. The TCF7L2 gene product is a high mobility group box-containing transcription factor previously implicated in blood glucose homeostasis. It is thought to act through regulation of proglucagon gene expression in enteroendocrine cells via the Wnt signaling pathway.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Pain is underrecognized and undertreated in patients with dementia. It has been suggested that nurses’ attitudinal barriers may contribute to the challenges surrounding pain assessment and management ...in dementia.
This integrative literature review aims to identify and explore nurses’ knowledge and attitudes towards pain assessment in older people with dementia and how it may affect pain management in this patient group.
Electronic searches were conducted in Web of Science, MEDLINE, Scopus, ProQuest, PubMed, and EBSCOhost from January 2008 to December 2018 for articles specifically focusing on nurses’ knowledge and attitudes towards pain assessment in older patients with dementia.
Ten studies were included in the review after meeting the inclusion criteria. Data extracted from each study included study design, aims and objectives, setting/sample, findings, and limitations. Patients with dementia are at greater risk of experiencing underassessment, undertreatment, and delayed treatment of pain due to nurses’ knowledge deficits and uncertainty in the decision-making process. Nurses see providing comfort and reducing pain as ethical obligation. However, they find pain assessment a challenge due to the complexity of recognizing painful behaviors, and difficulty differentiating between pain and behavioral disturbances in dementia. Poor multidisciplinary communication, time constraints, and workload pressure, as well as uncertainty about opioid use, are important barriers to effective pain assessment and management among patients with dementia.
It is essential that nurses gain confidence in distinguishing signs and symptoms of pain from behavioral changes in dementia. It is important to improve interdisciplinary communication and to get physicians to listen and prioritize pain assessment and management.
•Cognitive impairment is a significant risk factor for delayed pain treatment.•Nurses experience challenges in managing pain in patients suffering dementia.•Nurses need training and education in effective assessment and management of pain in older adults with dementia.•Interdisciplinary communication around pain assessment and management in patients with dementia needs to be improved.
BACKGROUNDTelehealth, or healthcare offered through the internet, computers, and other devices for communication, is rapidly increasing with changing times and technological advancement. For quality ...and security of such services, it is crucial that professionals are competent in offering such service. Still, lack of professionals' training has been identified as one of the barriers to implementation of telehealth. Thus, to improve such training, it is crucial to identify professionals' knowledge, experience, and perspectives towards challenges and opportunities of using telehealth. OBJECTIVEThe review's objective was to answer the research question: what is known in the literature about challenges and opportunities of telehealth service provision from the perspective of health professionals? METHODSArksey and O'Malley's five-stage approach for scoping studies was used for the review. Studies were collected across four databases: Scopus, PubMed, ProQuest and EBSCOhost. The data from the 22 included studies were reported by using frequency counts and categorization of health professionals' experiences. RESULTSThe findings of the review led to three categories: (1) study demographics, (2) challenges for telehealth, and (3) opportunities for telehealth. The most frequently reported challenges were issues related to communications, inadequate technology, or support, and need for training and knowledge to use the technology. The most frequent categories of opportunities related to improved access to services, benefits related to sharing of information sharing and experience and training of using technology. DISCUSSIONFurther research is needed to explore health professionals' experience of training, and to understand the type of support, resources, and training content they need to enhance their competency in telehealth provision.
Chronic pain is a health problem that is one of leading cause of disability. Studies have shown that various aspects of a person's history, such as difficult experiences in early life, can affect ...lifestyle and health later. The aim of this study was to examine the relationship between chronic pain, adverse childhood experience (ACE) and violence in adulthood in the general population of Iceland. MATERIAL AND METHODS: A retrospective cross-sectional study. The sample was 12.400 individuals, 18-80 years of age, randomly selected from respondents' group of the data collection company MASKINA (National Portal). Data on chronic pain, ACE and experience of violence in adulthood were examined. Statistical processing was carried out in IBM SPSS Statistics 28th edition. RESULTS: Response rate was 44.8% (female 57.1%, M=56 years). Prevalence of chronic pain (≥3 months) was 40.1%. A total of 91.1% of participants answered questions about ACE, of which 16.1% ≥4 ACE-scores. There was a positive relationship between ACE and chronic pain (OR = 1.675, 95% CI: 1.420 - 1.977). Those who had ≥4 ACE-scores were more likely to have experienced violence in adulthood. CSONCLUSION: The results of this study show that chronic pain and violence in adulthood can be associated with psychological childhood trauma. People who experience psychological childhood trauma and violence in adulthood are more likely to suffer from chronic pain. It is important to be aware of experiences of childhood psychological trauma and violence when people seek healthcare for chronic pain.
The global endemic of cardiovascular diseases calls for improved risk assessment and treatment. Here, we describe an association between myocardial infarction (MI) and a common sequence variant on ...chromosome 9p21. This study included a total of 4587 cases and 12,767 controls. The identified variant, adjacent to the tumor suppressor genes CDKN2A and CDKN2B, was associated with the disease with high significance. Approximately 21% of individuals in the population are homozygous for this variant, and their estimated risk of suffering myocardial infarction is 1.64 times as great as that of noncarriers. The corresponding risk is 2.02 times as great for early-onset cases. The population attributable risk is 21% for MI in general and 31% for early-onset cases.
Background
Individuals with chronic pain are among the most frequent users of health care. Still, a significant percentage does not utilize health care for pain. A range of factors predict chronic ...pain‐related health care utilization.
Design
A cross‐sectional study aimed at identifying predictors of chronic pain‐related health care utilization and comparing predictors between men and women.
Methods
A postal questionnaire measuring sociodemographic variables, pain characteristics, health‐related quality of life (HRQoL) and pain‐related health care utilization, was sent to a sample of 4500 individuals randomly drawn from the national population of Iceland. The relationships between sociodemographic and pain‐related factors and pain‐related health care utilization among participants reporting chronic pain (≥3 months) were tested by using bivariate and multivariate statistical analysis.
Results
Among participants reporting chronic pain, 53.2% had consulted a health care provider for pain during the previous 6 months. Predictors for chronic pain‐related health care utilization differed between men and women. Interference with life and pain pattern was the strongest predictors among women, as compared with interference with life and the physical components of HRQoL for men. Pain‐related health care utilization was not linked to sociodemographic factors.
Conclusions
Pain‐related variables are better predictors of chronic pain‐related health care utilization than sociodemographic factors. Even though gender does not predict chronic pain‐related health care utilization, there are gender differences in the relationships between pain‐related variables and health care utilization. Men tend to postpone health care consultations for chronic pain longer than women.
In an extended genome-wide association study of bone mineral density among 6,865 Icelanders and a follow-up in 8,510 subjects of European descent, we identified four new genome-wide significant loci. ...These are near the SOST gene at 17q21, the MARK3 gene at 14q32, the SP7 gene at 12q13 and the TNFRSF11A (RANK) gene at 18q21. Furthermore, nonsynonymous SNPs in the C17orf53, LRP4, ADAM19 and IBSP genes were suggestively associated with bone density.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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