Background There is no universally accepted age cut‐off for defining young strokes. Aims We aimed to determine, based on the profile of young stroke patients in our regional centre, an appropriate age cut‐off for young strokes. Methods A retrospective analysis of all ischaemic stroke patients admitted to our centre from 2015 to 2017. We identified 391 ischaemic stroke patients; 30 patients between the ages of ≤50, 40 between 51–60 inclusive and 321 ≥ 61 years of age. We collected data on demographic profiles, risk factors and stroke classification using the Trial of Org 10 172 in Acute Stroke Treatment criteria. Results We found significant differences between the ≤50 and ≥61 age groups for most of the risk factors and similarities between the 51–60 inclusive and ≥ 61 age groups. At least one of the six risk factors assessed in the study was present in 86.7% of the youngest group, 97.5% of the intermediate age group and 97.2% in the oldest group. In terms of the mechanisms of stroke, the youngest and oldest age groups in our study differed in the prevalence of cryptogenic, cardioembolic and other causes of stroke. The middle and older age groups had similar mechanisms of stroke. Conclusions The prevalence of vascular risk factors and mechanisms of stroke likewise differed significantly across age groups. This study suggests that 50 years is an appropriate age cut‐off for defining young strokes and reinforces the importance of primary prevention in all age groups.
This study shows LSG is a safe and successful management strategy for morbid obesity. In addition to the direct effects of sustained weight loss, it highlights indirect effects that LSG has on obesity-related health issues, with substantial reduction in diabetic and anti-hypertensive medications. Our results reaffirm international studies of the beneficial effects of LSG on Type II diabetes and hypertension.
BackgroundMaternal obesity is an important comorbidity in contemporary obstetrics practice and is associated with significantly increased perinatal complications. Obstetric anal sphincter injury (OASIS) sustained during labour can lead to faecal incontinence, chronic pain and effects on quality of life. Currently, it is unclear if maternal body mass index (BMI) influences the risk of sustaining OASIS.AimTo investigate the impact of increased BMI on the rate of OASIS among nulliparous women.Materials and MethodsA retrospective cohort study was conducted, which included nulliparous women with singleton, vaginal deliveries ≥37 weeks gestation at a Victorian regional centre between 2007 and 2017 (n = 3335). Logistic regression was performed to calculate unadjusted and adjusted odds ratios (aOR). Women were grouped by World Health Organization BMI categories, and the rates of OASIS were evaluated.ResultsWomen with a BMI ≥ 25 were significantly less likely to develop OASIS compared to women with a BMI < 25 (aOR 0.60, 95% CI 0.41–0.89). Women with a BMI ≥ 35 had significantly decreased odds of OASIS compared to normal weight women (aOR 0.27, 0.10–0.78). While not statistically significant, the odds of OASIS decreased with each increase in BMI class. Other statistically significant risk factors were maternal age, birth weight, forceps delivery, non‐smokers (aOR 4.03, 1.46–11.1) and diabetes mellitus (aOR 9.48, 2.1–41.4).ConclusionWomen with a BMI ≥ 25 were less likely to sustain OASIS compared to women with a BMI < 25. Furthermore, the odds of OASIS decreased for each increase in BMI category. These findings warrant further investigation into the mechanism of this protective effect.
Background Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population. Aims We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including subanalyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS). Methods We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016. Demographic data, cardiovascular risk factors, aetiology/territory of IS, pre‐morbid DM status, indicators of glycaemic control and renal impairment were recorded. Results DM was present in 28.5% of IS and TIA patients, including 4% being newly diagnosed. Among diabetic IS patients, 45.3% had poor glycaemic control (HbA1c ≥7.0%) while 16% had moderate to severe renal impairment (estimated glomerular filtration rate of <30). The majority of IS were partial anterior circulation stroke (53.4%) and cardioembolism was the commonest mechanism (43.5%). We found no significant association between DM and a specific stroke location or mechanism. Conclusions Almost one‐third of IS/TIA patients had DM, with a significant proportion showing poor glycaemic control. The DM prevalence in our cohort was comparable with reported rates from other developed countries. Although we found no association between DM and a particular stroke type or mechanism, it is likely a reflection of our cohort size. Our study demonstrated that DM, as a significant risk factor in IS, warrants early detection and better management strategies.
Abstract-In the context of asynchronous online learning, formative assessments can offer amazing flexibility and support a wide range of learning strategies. While some versions do involve a considerable investment in time and cost, effective formative assessments need not be expensive. Many cost-effective strategies for developing formative assessments exist, and these can be employed quickly and effectively in online workplace training.These strategies allow learners to assess their progress and accomplishments before the risks of decreased motivation, confidence and understanding become unfortunate realities that negatively impact instructional outcomes, on-the-job performance and online learning ROI.
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