Extrapulmonary manifestations of asthma, including fatty infiltration in tissues, may reflect systemic inflammation and influence lung function and disease severity.
Abstract Background Several studies have shown the importance of establishing trust in supporting an individual’s willingness to participate in research; yet evidence is limited regarding systematic studies testing the effectiveness of various methods used to build trust. Our pilot study examined two methods of building trust in communities of color by measuring willingness to participate in research pre‐ and post‐intervention. We hypothesized that a more personalized intervention would be more effective than a non‐personalized one in changing attitudes about research participation. Methods 97 non‐randomized African American participants, without self‐reported cognitive impairment, completed the research attitudes questionnaire (RAQ) before and after participating in two different community engagement (CE) activities: 1) personalized medication review (MR), n = 48; and/or 2) a less personalized public community talk (Talk), n = 49. Numeric comparisons were conducted using student t‐tests. We used chi‐square and Fisher’s exact test for categorical comparisons. Pre‐ and post‐Talk and MR outcomes were tested for significant changes using the paired Wilcoxon non‐parametric sign rank test. Results In this predominantly female sample (80% female), mean age was 64 (standard deviation = 9.9). Study participant characteristics provided in Table 1 . There were no significant differences in RAQ or trust questions in the pre‐ and post‐Talk session. However, during the MR session, significant changes were seen on the question “I have a positive view about medical research in general” (P = 0.007). During the pre‐MR, 16.7% strongly agreed with this statement, while 39.6% strongly agreed at the post‐MR. Similarly, agreement with the statements “Medical researchers treat people from my racial group as guinea pigs” (p = 0.004) and “Medical researchers work hard to keep participants’ information private and secure” (P = 0.01) were also significantly different following the intervention (see Figure 5 ). Conclusions These findings support our hypothesis that a more personalized community engagement approach would have a greater influence on participant’s research attitudes. Compared to individuals with ≤ 1 co‐morbidities at baseline, those with ≥2 co‐morbidities had positive responses prior to an intervention and felt less responsibility to volunteer post med review. Additional studies are needed to further investigate these findings and the role of trust in association with research attitudes.
Background The most common intervention performed by physicians is the writing of a prescription. All elements in the complex process of prescribing and administering drugs are susceptible to error. Aims To measure the extent to which information recorded on prescription cards conforms to basic standards of prescription writing. To improve prescribing, recording and staff knowledge. To identify common prescribing errors and focus on the same to improve our standard of practice. Methods An audit tool was designed to collect data and standard was set 100%. Results In the initial audit, there was significant deficiency in prescription writing, which was presented at the internal teaching to all doctors and recommendations were made. This audit was repeated after a month, which showed improvement in prescription writing and recording. Recommendations Write all drugs in CAPITALS ensuring correct spelling, dose, route of administration and frequency. Complete all fields on front of the prescription card legibly. Document any change in prescription card in clinical notes. All doctors to go through their current clients medication cards and ensure any gaps filled and errors corrected. Audit report will be kept in audit folder as a reference for any rotating doctor to repeat the audit every six months in the services. Conclusion Doctors should continue to improve prescription writing and reduce any adverse events or errors. Disclosure of interest The authors have not supplied their declaration of competing interest.
Dysphagia is common in older adults. However, there are no current estimates of dysphagia in community-dwelling older adults those receiving meal support. It is unknown whether dysphagia is associated with other measures of physical function (activities of daily living [ADL] ability or nutrition status). The study purposes were to determine the prevalence of self-reported dysphagia and to identify factors associated with self-reported dysphagia in community-dwelling older adults receiving meal support. A cross-sectional study. 476 community-dwelling older adults (78.5±0.51 years) across five Elder Nutrition Program meal services in Wisconsin participated in the study. Data were collected through administration of validated ADL and nutrition questionnaires (nutritional status, functional status with ADLs, chewing ability, dental conditions, and prior diagnoses of dysphagia, pneumonia, and dementia). For self-reported dysphagia, the validated 10-item eating assessment tool (EAT-10) was used. The prevalence of self-reported dysphagia (EAT-10 score of ≥ 3) was 20.4%. Multivariate logistic regression results indicated that poor nutritional status (OR=3.1, p=0.04), difficulty chewing (OR=2.2, p=0.03), prior dysphagia diagnosis (OR=34.8, p<0.001), prior pneumonia diagnosis (OR=2.1, p=0.04), and meal service site (OR=2.68, p=0.02) were associated with self-reported dysphagia. Approximately one in five community-dwelling older adults receiving meal support had self-reported dysphagia. Increased risk for poor nutrition, reduced chewing ability, prior dysphagia and pneumonia diagnosis, and meal service site were identified as factors associated with dysphagia on the EAT-10. Results highlight the need for further studies across more sites to identify dysphagia risk indicators in community-dwelling older adults receiving meal support state-wide.
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