Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.

Background: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses.

When a polyp is not a polyp: incidental finding of a sigmoid schwannoma at first colonoscopic screening.

Schwannomas, peripheral nerve sheath tumours arising from Schwann cells, are often associated with inherited disorders such as neurofibromatosis. Gastrointestinal schwannomas, while rare, have been reported in those without personal or family history of neurofibromatosis. Diagnoses of these lesions, however, typically follow evaluations prompted by symptomatic presentations associated with abdominal pain, rectal bleeding, change in bowel habits or positive results on faecal occult blood tests performed for colorectal cancer screening.

Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline.

Objective: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop antipsychotics; to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes.

Methods: The overall team comprised 9 clinicians (1 family physician, 1 family physician specializing in long-term care, 1 geriatric psychiatrist, 2 geriatricians, 4 pharmacists) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Health behind bars: can exploring the history of prison health systems impact future policy?

The value of history is, indeed, not scientific but moral … it prepares us to live more humanely in the present, and to meet rather than to foretell, the future - Carl Becker. Becker's quote reminds us of the importance of revealing and understanding historical practices in order to influence actions in the future. There are compelling reasons for uncovering this history, in particular to better inform government policy makers and health advocates, and to address the impacts of growing community expectations to 'make the punishment fit the crime'.

Automated Robotic Liquid Handling Assembly of Modular DNA Devices.

Recent advances in modular DNA assembly techniques have enabled synthetic biologists to test significantly more of the available "design space" represented by "devices" created as combinations of individual genetic components. However, manual assembly of such large numbers of devices is time-intensive, error-prone, and costly. The increasing sophistication and scale of synthetic biology research necessitates an efficient, reproducible way to accommodate large-scale, complex, and high throughput device construction.

Bladder dysfunction in Wolfram syndrome is highly prevalent and progresses to megacystis.

Aim: Wolfram syndrome is a rare genetic defect in WFS1 or WSF2(CISD2). It includes diabetes mellitus and insipidis, sensorineural deafness, optic atrophy, but not bladder dysfunction. However, this has appeared a common finding in our national referral clinic, and we sought to quantify this problem.

Prediction of need for intervention in posterior urethral valves: Use of urine osmolality.

Aim: Renal tubular dysfunction (RTD) causing obligate production of hypoosmolar urine in boys with posterior urethral valves (PUVs) has been described. It is not known how clinically significant this is. We hypothesize that a feedback loop is present in many PUV boys who suffer deterioration of their lower urinary tract (LUT).

Finding a Space for Women: The British Medical Association and Women Doctors in Australia, 1880-1939.

This paper examines the experiences of women in one professional organisation - the British Medical Association in Australia - during a significant period in the development of such bodies. In doing so it offers an opportunity to consider the relationship between professional societies and the construction of a gendered profession. For the medical profession in particular the time-frame of this study, from the 1880s to the 1930s, has been regarded by scholars as especially important.

Age of heart disease presentation and dysmorphic nuclei in patients with LMNA mutations.

Nuclear shape defects are a distinguishing characteristic in laminopathies, cancers, and other pathologies. Correlating these defects to the symptoms, mechanisms, and progression of disease requires unbiased, quantitative, and high-throughput means of quantifying nuclear morphology. To accomplish this, we developed a method of automatically segmenting fluorescently stained nuclei in 2D microscopy images and then classifying them as normal or dysmorphic based on three geometric features of the nucleus using a package of Matlab codes.

Dupuytren's and Ledderhose Diseases in a Family with LMNA-Related Cardiomyopathy and a Novel Variant in the ASTE1 Gene.

Dupuytren's disease (palmar fibromatosis) involves nodules in fascia of the hand that leads to flexion contractures. Ledderhose disease (plantar fibromatosis) is similar with nodules of the foot. While clinical aspects are well-described, genetic mechanisms are unknown.

Phenome-wide association study using research participants' self-reported data provides insight into the Th17 and IL-17 pathway.

A phenome-wide association study of variants in genes in the Th17 and IL-17 pathway was performed using self-reported phenotypes and genetic data from 521,000 research participants of 23andMe. Results replicated known associations with similar effect sizes for autoimmune traits illustrating self-reported traits can be a surrogate for clinically assessed conditions. Novel associations controlling for a false discovery rate of 5% included the association of the variant encoding p.

Integrating medication samples into the traditional community pharmacy supply chain: a feasibility study.

Objective: To assess the feasibility of a medication sampling program involving community pharmacists.

Methods: A community pharmacy dispensed samples after receiving a voucher given to patients by prescribers. Surveys explored prescribers' and patients' views about sampling and patients' experiences with the program.

Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals.

Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort.

Beyond Plan B: A Qualitative Study of Canadian Pharmacists' Emergency Contraception Counselling Practices.

Objective: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD).

Methods: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto.

Assessment of yoga as an adjuvant treatment for combat-related posttraumatic stress disorder.

Objectives: This study assessed yoga as an adjuvant strategy for symptoms of combat-related posttraumatic stress disorder (PTSD).

Methods: Subjects had significant, combat-related PTSD. Control data were collected during an eight-week waiting period.

Effects of semantic context on access to words of low imageability in deep-phonological dysphasia: a treatment case study.

Background: Deep dysphasia is a relatively rare subcategory of aphasia, characterised by word repetition impairment and a profound auditory-verbal short-term memory (STM) limitation. Repetition of words is better than nonwords (lexicality effect) and better for high-image than low-image words (imageability effect). Another related language impairment profile is phonological dysphasia, which includes all of the characteristics of deep dysphasia except for the occurrence of semantic errors in single word repetition.