Background. Previous studies, which relied on hypothetical cases and chart reviews, have questioned the inter-rater reliability of the ASA physical status (ASA-PS) scale. We therefore conducted a retrospective cohort study to evaluate its inter-rater reliability and validity in clinical practice.
The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men’s health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men’s health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men, 12 programs explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. Innovations in male-only programs that focus on masculine ideals and gender influences to engage men in increasing their physical activity hold potential for informing strategies to promote other areas of men’s health.
CME Educational Objectives
1.
Describe a cross-theoretical conceptualization of how community factors affect children’s health.
2.
Provide examples of how community conditions affect common health concerns often faced by health professionals in the clinical setting.
3.
Identify opportunities to leverage professional knowledge of community conditions and public policy to improve the health of children.
What makes us healthy? Providing guidance to families regarding prevention and diagnosing and treating illness are the foundations of clinical practice. Yet medical care directed at improving and preserving the health of the individual patient accounts for only about 15% to 20% of what makes us healthy at a population level. Community factors, such as the quality of housing, safety of neighborhoods, and availability of livable-wage jobs for adults, frequently referred to as social determinants of health, account for a much larger proportion of what makes people healthy.
1
Oral doses of L-leucine (0.2 g/kg) stimulated insulin release in obese and in acromegalic patients, but was ineffective in normal subjects, even when comparable total amounts of leucine were administered. Despite their exaggerated insulin responses, there was no change in plasma glucose levels in the obese and in the acromegalic patients. After leucine, elevated serum levels of insulin correlated with the presence of generalized hyperinsulinism as evidenced by basal hyperinsulinism and an exaggerated insulin response to an oral glucose load. These findings indicate that oral doses of leucine readily stimulate insulin release in conditions associated with islet cell hyperplasia, and may thus serve as an indicator of beta cell hyperresponsiveness. (/ Clin Endocrinol Metab 37: 431, 1973)
Conclusion: We identified that a Radiologist recommendation for LDAP referral leads to significantly faster patient referral and assessment for evaluation of suspected LC. A QI initiative is underway, consisting of knowledge sharing and regional standardization of radiologist reporting recommendations for imaging suspicious for LC in order to expedite LDAP referral.
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