Involvement of Informal Caregivers in Preventing Falls in Older Adults with Cognitive Impairment: A Rapid Review.

Background: The prevalence of falls and related injuries is double in older adults with cognitive impairment compared with cognitively healthy older adults. A growing body of literature shows that falls prevention interventions in the cognitively impaired are difficult to implement and that the feasibility and adherence to interventions depend on a number of factors including informal caregiver involvement. However, no systematic review exists on the topic.

The effect of human leukocyte antigen A1 and B35-Cw4 on sustained BK polyomavirus DNAemia after renal transplantation.

Human leukocyte antigen (HLA) class I presentation pathway plays a central role in natural killer (NK) cell and cytotoxic T-cell activities against BK polyomavirus (BKPyV) DNAemia. We determined the risk of sustained BKPyV DNAemia in 175 consecutive renal transplant recipients considering the simultaneous effect of donor/recipient HLA class I antigens and pre- or post-transplant variables. Median (IQR) age was 53 (44-64) years, and 37% of patients were female.

Assessing the relationship between water and nutrition knowledge and beverage consumption habits in children.

Objective: To examine the relationship between knowledge and beverage consumption habits among children.

Design: Cross-sectional analysis. Linear regression was used to identify sociodemographic, dietary and behavioural determinants of beverage consumption and knowledge, and to describe the relationships between children's knowledge and water and sugar-sweetened beverage (SSB) consumption.

Regional cerebral cortical thickness correlates with autonomic outflow.

Dysregulation of autonomic control often develops with advancing age, favoring a chronic state of heightened sympathetic outflow with parasympathetic withdrawal. However, the mechanisms of this age-related autonomic impairment are not known. This study tested the hypothesis that inter-individual differences in autonomic outflow across the adult age-span are related to cerebral cortex thickness.

Impact of PubMed search filters on the retrieval of evidence by physicians.

Background: Physicians face challenges when searching PubMed for research evidence, and they may miss relevant articles while retrieving too many nonrelevant articles. We investigated whether the use of search filters in PubMed improves searching by physicians.

Methods: We asked a random sample of Canadian nephrologists to answer unique clinical questions derived from 100 systematic reviews of renal therapy.

Searching for medical information online: a survey of Canadian nephrologists.

Background: Physicians often search for information to improve patient care. We evaluated how nephrologists use online information sources for this purpose.

Methods: In this cross-sectional study (2008 to 2010), a random sample of Canadian nephrologists completed a survey of their online search practices.

Evaluating the impact of MEDLINE filters on evidence retrieval: study protocol.

Background: Rather than searching the entire MEDLINE database, clinicians can perform searches on a filtered set of articles where relevant information is more likely to be found. Members of our team previously developed two types of MEDLINE filters. The 'methods' filters help identify clinical research of high methodological merit.

A scale for distinguishing efficacy from effectiveness was adapted and applied to stroke rehabilitation studies.

Objectives: To apply a tool that purports to differentiate between efficacy and effectiveness studies to stroke rehabilitation trials and to evaluate its applicability and reliability.

Study Design And Setting: Three raters developed item operational definitions before independently applying the seven-item scale to 151 randomized controlled trials (RCT), published during or after 1997, that evaluated either a pharmacologic (P, n=78) or a nonpharmacologic (NP, n=73) intervention. Inter-rater reliability was assessed for both individual items and total scores, separately for P and NP trials.

Clinical manifestations of hemochromatosis in HFE C282Y homozygotes identified by screening.

Background: Patients with hemochromatosis may suffer organ damage from iron overload, often with serious clinical consequences.

Objective: To assess prevalences of self-reported symptoms and clinical signs and conditions in persons homozygous for the hemochromatosis gene (HFE) mutation (C282Y) identified by screening.

Methods: Participants were adults 25 years of age or older enrolled in the Hemochromatosis and Iron Overload Screening (HEIRS) Study.

Accuracy of family history of hemochromatosis or iron overload: the hemochromatosis and iron overload screening study.

Background & Aims: The aim of this study was to assess the analytic validity of self-reported family history of hemochromatosis or iron overload.

Methods: A total of 141 probands, 549 family members, and 641 controls participated in the primary care Hemochromatosis and Iron Overload Screening Study. Participants received a postscreening clinical examination and completed questionnaires about personal and family histories of hemochromatosis or iron overload, arthritis, diabetes, liver disease, and heart disease.

HFE C282Y homozygotes aged 25-29 years at HEIRS Study initial screening.

We characterized HFE C282Y homozygotes aged 25-29 years in the HEmochromatosis and IRon Overload Screening (HEIRS) Study using health questionnaire responses, transferrin saturation (TfSat), serum ferritin (SF), and HFE genotyping. In eight homozygotes, we used denaturing high-performance liquid chromatography and sequencing to search for HFE2 (= HJV), TFR2, HAMP, SLC40A1 (= FPN1), and FTL mutations. Sixteen of 4,008 White or Hispanic participants aged 25-29 years had C282Y homozygosity (15 White, 1 Hispanic); 15 were previously undiagnosed.

Characteristics of participants with self-reported hemochromatosis or iron overload at HEIRS study initial screening.

There are few descriptions of young adults with self-reported hemochromatosis or iron overload (H/IO). We analyzed initial screening data in 7,343 HEmochromatosis and IRon Overload Screening (HEIRS) Study participants ages 25-29 years, including race/ethnicity and health information; transferrin saturation (TS) and ferritin (SF) measurements; and HFE C282Y and H63D genotypes. We used denaturing high-pressure liquid chromatography and sequencing to detect mutations in HJV, TFR2, HAMP, SLC40A1, and FTL.

Association of ferroportin Q248H polymorphism with elevated levels of serum ferritin in African Americans in the Hemochromatosis and Iron Overload Screening (HEIRS) Study.

The ferroportin (FPN1) Q248H polymorphism has been associated with increased serum ferritin (SF) levels in sub-Saharan Africans and in African Americans (AA). AA participants of the HEIRS Study who did not have HFE C282Y or H63D who had elevated initial screening SF (> or =300 microg/L in men and >= or =200 microg/L in women) (defined as cases) were frequency-matched to AA participants with normal SF (defined as controls) to investigate the association of the Q248H with elevated SF. 10.

Geographic and racial/ethnic differences in HFE mutation frequencies in the Hemochromatosis and Iron Overload Screening (HEIRS) Study.

Objective: To assess geographic differences in the frequencies of HFE C282Y and H63D genotypes in six racial/ethnic groups recruited in the Hemochromatosis and Iron Overload Screening (HEIRS) Study.

Design: HFE C282Y and H63D genotypes of 97,551 participants, ages > or = 25 years, who reported that they belonged to one of six racial/ethnic groups, were analyzed. HFE genotype frequencies were compared among the racial/ethnic groups and among the HEIRS Study field centers within each racial/ethnic group.

Relationships of serum ferritin, transferrin saturation, and HFE mutations and self-reported diabetes in the Hemochromatosis and Iron Overload Screening (HEIRS) study.

Objective: We evaluated the associations of self-reported diabetes with serum ferritin concentration, transferrin saturation (TfSat), and HFE C282Y and H63D mutations in six racial/ethnic groups recruited at five field centers in the Hemochromatosis and Iron Overload Screening (HEIRS) study.

Research Design And Methods: Analyses were conducted on 97,470 participants. Participants who reported a previous diagnosis of diabetes and/or hemochromatosis or iron overload were compared with participants who did not report a previous diagnosis.

Estimates of quality and reliability with the physiotherapy evidence-based database scale to assess the methodology of randomized controlled trials of pharmacological and nonpharmacological interventions.

Background And Purpose: Systematic reviews and meta-analyses often include an evaluation of the methodological quality of the individual studies that have been included, and are usually conducted by at least 2 individuals. The objective of this study was to assess the methodological quality and reliability of a series of randomized controlled trials (RCTs) of both pharmacological and nonpharmacological interventions by use of the 10-item Physiotherapy Evidence-Based Database (PEDro) Scale.

Methods: Two abstractors independently reviewed 81 RCTs assessing a variety of interventions.

Initial screening transferrin saturation values, serum ferritin concentrations, and HFE genotypes in whites and blacks in the Hemochromatosis and Iron Overload Screening Study.

We compared initial screening data of 44,082 white and 27,124 black Hemochromatosis and Iron Overload Screening (HEIRS) Study participants. Each underwent serum transferrin saturation (TfSat) and ferritin (SF) measurements without regard to fasting, and HFE C282Y and H63D genotyping. Elevated measurements were defined as: TfSat more than 50% (men), more than 45% (women); and SF more than 300 ng/ml (men), more than 200 ng/ml (women).

The PEDro scale provides a more comprehensive measure of methodological quality than the Jadad scale in stroke rehabilitation literature.

Objective: To systematically compare the PEDro scale and the Jadad scale when applied to the stroke rehabilitation literature.

Study Design And Setting: A literature search of multiple databases was used to identify all trials from 1968 through 2002. Each article was reviewed and assigned quality scores according to PEDro and Jadad criteria.

Community reintegration after stroke.

A systematic review of the literature from 1970-2002 was conducted to highlight the issues facing stroke survivors and their families upon integration into the community. Areas of interests were social support, caregiver burden and depression, family interactions, family education intervention, social and leisure activities post stroke, and leisure therapy. Four studies were selected for detailed reviews of the effectiveness of social support, 10 studies for family education intervention, and 3 studies for leisure therapy post stroke.

Treatment of visual perceptual disorders post stroke.

Visual perceptual disorders are a common clinical consequence of stroke. They include unilateral neglect, which has a major impact on rehabilitation outcome. The nature of the behavioral deficits associated with neglect has suggested that behavioral modification strategies may improve performance.

Rehabilitation of aphasia: more is better.

Although the most effective means of treating aphasia post stroke has not been determined, several areas of aphasia therapy have proven to be more effective than others. A recent study had determined that intense aphasia therapy over a short period of time has greater impact on recovery than less intense therapy over a longer period of time. Building upon the idea that more is better, this article examines other spects of aphasia therapy that may be combined to facilitate recovery.

Gait retraining post stroke.

A major component of stroke rehabilitation focuses on gait restoration. The purpose of this review is to examine the efficacy of a variety of gait retraining techniques currently in clinical use, including strength training, functional electrical stimulation, treadmill training, partial body-weight support, EMG biofeedback, and splinting of the lower extremity. Forty-eight studies evaluating six gait enhancement techniques were reviewed.

Early supported discharge in stroke rehabilitation.

A systematic review of the randomized controlled trials published from 1970-2002 was conducted to assess the effectiveness of early supported discharge programs in the context of stroke rehabilitation. Ten studies, including 1,286 patients, were selected for detailed review. The methodological quality of the studies was assessed using the PEDro Scale.

The efficacy of stroke rehabilitation: a qualitative review.

A systematic review of randomized controlled trials published from 1970-2002 was conducted to assess whether specialized inpatient stroke rehabilitation is associated with improved outcomes compared to conventional care. Twelve studies involving 2,813 patients were included for detailed review. The methodological quality of the studies was assessed using the PEDro Scale.

An evidence-based review of stroke rehabilitation.

A comprehensive evidence-based review of stroke rehabilitation was created to be an up-to-date review of the current evidence in stroke rehabilitation and to provide specific conclusions based on evidence that could be used to help direct stroke care at the bedside and at home. A literature search using multiple data-bases was used to identify all trials from 1968 to 2001. Methodological quality of the individual randomized controlled trials was assessed using the Physiotherapy Evidence Database (PEDro) quality assessment scale.