More than A1C: Types of success among adults with type-2 diabetes participating in a technology-enabled nurse coaching intervention.

Objective: Success in diabetes research and self-management is often defined as a significant decrease in glycated hemoglobin (A1C). The aim of this article is to explore different types of successes experienced by adults with type-2 diabetes participating in a health technology and nurse coaching clinical trial.

Methods: A qualitative analysis was conducted using surveys and documentation from motivational interview-based coaching sessions between study nurses and intervention participants.

Personalizing Mobile Fitness Apps using Reinforcement Learning.

Despite the vast number of mobile fitness applications (apps) and their potential advantages in promoting physical activity, many existing apps lack behavior-change features and are not able to maintain behavior change motivation. This paper describes a novel fitness app called CalFit, which implements important behavior-change features like dynamic goal setting and self-monitoring. CalFit uses a reinforcement learning algorithm to generate personalized daily step goals that are challenging but attainable.

Reduced Regional Grey Matter Volumes in Pediatric Obstructive Sleep Apnea.

Pediatric OSA is associated with cognitive risk. Since adult OSA manifests MRI evidence of brain injury, and animal models lead to regional neuronal losses, pediatric OSA patients may also be affected. We assessed the presence of neuronal injury, measured as regional grey matter volume, in 16 OSA children (8 male, 8.

Disrupted functional brain network organization in patients with obstructive sleep apnea.

Introduction: Obstructive sleep apnea (OSA) subjects show impaired autonomic, affective, executive, sensorimotor, and cognitive functions. Brain injury in OSA subjects appears in multiple sites regulating these functions, but the integrity of functional networks within the regulatory sites remains unclear. Our aim was to examine the functional interactions and the complex network organization of these interactions across the whole brain in OSA, using regional functional connectivity (FC) and brain network topological properties.

The relationship between hospital systems load and patient harm.

Objectives: The objective of this study was to describe the relationship between patient harm due to health-care errors and the stresses on the hospital systems that occur because of the patients in need of care.

Methods: Two California hospitals each provided 1 year of data to study the relationship between patient harm and Hospital Systems Load. This observational study used 2 metrics, Hospital Systems Load and patient harm.

An evidence-based guideline for unintended pregnancy prevention.

Despite the frequency of and significant costs related to unintended pregnancy, it has received less attention in research and prevention guidelines development than other important health threats. This lack of attention has resulted in a system-wide failure to provide care to reproductive aged women who are at risk of unintended pregnancy. An evidence-based blueprint for a coordinated system of primary, secondary, and tertiary prevention is proposed for health professionals who provide care for patients at risk for unintended pregnancy.

Pharmacology.

Inadequate pain relief has been identified as a common problem after coronary artery bypass surgery, Understanding the pharmacology of analgesics commonly used after cardiovascular surgery is a fundamental part of effective pain management. The pharmacologic properties for two analgesic drug classes, opioid and nonopioid, are reviewed. Major drugs in each class are discussed in terms of their pharmacodynamic and pharmacokinetic properties.

An increasing prevalence of hearing impairment and associated risk factors over three decades of the Alameda County Study.

Objectives: This study assessed changes in the prevalence of hearing impairment in persons aged 50 years and older over the past 30 years and identified risk factors.

Methods: Age-adjusted hearing impairment prevalence rates at four time intervals were calculated from the Alameda County Study (n = 5108). Logistic regression models analyzed risk factors from 1974 for 1994 incident hearing impairment.