1,720,974 research outputs found
Will social media banish the bleep? An analysis of hospital pager activity and instant messaging patterns.
No full textPagers or ‘bleeps’ have been used for intra-hospital communication for over 30 years but are time inefficient and antiquated. We compared pager activity with instant messaging patterns over a 6-month period in a large, UK, teaching hospital. We found that instant messaging was widely used for clinical communication, yet the introduction of an intra-hospital instant messaging platform only led to a modest reduction in pager activity, suggesting that phasing-out of pagers will require a managed transition to alternative messaging technologies. Social network analysis from instant messaging logs also provided insight into patterns of communication that could be used to optimise clinical care
What impact does osteoarthritis have on ability to self-care and receipt of care in older adults? Findings from the Hertfordshire Cohort Study
No full textOBJECTIVES: Living independently remains the aim of older adults, but musculoskeletal conditions and frailty may hamper this. We examined relationships between osteoarthritis with ability to self-care and access to formal/informal care among community-dwelling older adults, comparing results to relationships between other musculoskeletal conditions of ageing (frailty, sarcopenia, osteoporosis) and these outcomes. DESIGN: Data from the Hertfordshire Cohort Study were used. Osteoarthritis (hand, hip or knee) was defined by clinical examination. Osteoporosis was assessed using dual-energy X-ray absorptiometry and medication use. Sarcopenia was assessed using EWSGOP2 criteria, frailty using Fried criteria. Ability to self-care and access to formal/informal care were self-reported. RESULTS: 443 men and women aged approximately 75 years participated. Osteoarthritis was reported by 26.8% participants; 11.8% had low grip strength; 21.4% had osteoporosis; 8.6% had sarcopenia; 7.6% were identified as frail. Most participants (90.7%) reported no problems with self-care, but more than one-fifth (21.4%) reported having received formal or informal care at home in the previous year. Odds of reporting difficulties with self-care were significantly greater (p < 0.05) for participants with osteoarthritis and for those with frailty, but not for those with osteoporosis or sarcopenia. Odds of receiving care at home in the past year were significantly greater among participants with osteoarthritis and among those with frailty, but not among those with osteoporosis or sarcopenia. CONCLUSIONS: Frailty and osteoarthritis were associated with both difficulties with self-care and receipt of care; osteoporosis and sarcopenia were not. These results highlight the contribution of clinical osteoarthritis to ability to live independently in later life, and the need to actively manage the condition in older adults
Executive summary: treatment of osteoporosis and osteoarthritis in the oldest old
No full textThis is the executive summary of a work by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) (Nicholas Fuggle et al. in Drugs, 2024).</p
PTH1 receptor agonists for fracture risk: a systematic review and network meta-analysis
Full text linkOsteoporosis, defined by reduced bone mineral density and macro- and micro-architectural degradation, leads to increased fracture risk, particularly in aging populations. While randomized controlled trials (RCTs) demonstrate that PTH1 receptor agonists, teriparatide and abaloparatide, are effective at reducing fracture risk, real-world evidence (RWE) remains sparse. This study reviews and compares the anti-fracture efficacy of these agents, against each other and against other osteoporosis treatments using both RCTs and RWE. We systematically searched Medline, Embase, and Cochrane up to May 2024, focusing on RCTs and RWE studies reporting reduction in vertebral, non-vertebral, hip, or all fractures as primary endpoint. A network meta-analysis (NMA) was conducted, first through pairwise meta-analyses of teriparatide versus abaloparatide, then a Bayesian NMA comparing each to other treatments. Safety assessments included adverse events classified by MedDRA, with a particular attention to hypercalcemia and cardiac events. Seventeen studies (11 RCTs, 6 RWE) met inclusion criteria. Teriparatide and abaloparatide were effective in reducing vertebral and non-vertebral fractures in all pairwise meta-analyses versus placebo. Abaloparatide showed an advantage over teriparatide for non-vertebral fractures (OR: 0.87, 95% CI: 0.80-0.95) and hip fractures (OR: 0.81, 95% CI: 0.71-0.93). In the NMA model, teriparatide and abaloparatide were superior to placebo, raloxifene, and calcitonin in reducing vertebral fracture while teriparatide was further superior to denosumab and risedronate. For non-vertebral fracture, abaloparatide was better than any other treatment while teriparatide was only superior to alendronate or placebo. PTH1 analogs were better than placebo at reducing all fractures while no difference was observed for the risk of hip fracture. Both abaloparatide and teriparatide demonstrate comparable safety to other osteoporosis treatments, with no increased cardiovascular risk. This review highlights that PTH1 receptor agonists effectively reduce fracture risk, with abaloparatide offering enhanced benefits for non-vertebral and hip fractures compared to teriparatide. Both agents exhibit acceptable safety profiles, suggesting their valuable role in managing osteoporosis, particularly for high-risk patients.</p
Fracture prediction, imaging and screening in osteoporosis
No full textOsteoporosis is associated with increased fragility of bone and a subsequent increased risk of fracture. The diagnosis of osteoporosis is intimately linked with the imaging and quantification of bone and BMD. Scanning modalities, such as dual-energy X-ray absorptiometry or quantitative CT, have been developed and honed over the past half century to provide measures of BMD and bone microarchitecture for the purposes of clinical practice and research. Combined with fracture prediction tools such as Fracture Risk Assessment Tool (FRAX) (which use a combination of clinical risk factors for fracture to provide a measure of risk), these elements have led to a paradigm shift in the ability to diagnose osteoporosis and predict individuals who are at risk of fragility fracture. Despite these developments, a treatment gap exists between individuals who are at risk of osteoporotic fracture and those who are receiving therapy. In this Review, we summarize the epidemiology of osteoporosis, the history of scanning modalities, fracture prediction tools and future directions, including the most recent developments in prediction of fractures.</p
Do lifestyle, anthropometric and demographic factors associated with muscle strength differ in a UK and Japanese cohort? An exploratory analysis
No full textBackground: Muscle weakness is associated with adverse clinical outcomes including disability and mortality. We report demographic, anthropometric and lifestyle correlates of grip strength in UK and Japanese population-based cohorts. Aim: To report prevalence of low grip strength according to 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and 2019 Asian Working Group for Sarcopenia (AWGS 2019) thresholds and to consider correlates of grip strength in Eastern and Western populations. Methods: UK (1572 men; 1415 women) and Japanese (519 men; 1027 women) participants were recruited from two cohorts harmonised by consensus. Muscle strength was measured by grip strength dynamometry. Potential correlates of grip strength were examined using sex-stratified linear regression; univariate correlates (p < 0.05) were included in mutually adjusted models. Results: Mean (SD) age was 66.2 (2.8) and 65.8 (12.3) in UK and Japanese cohorts, respectively. Prevalence of low grip strength was higher in Japanese participants (EWGSOP2 5.4% versus 2.4%, AWGS 2019 9.0% versus 3.7%). In both cohorts and sexes, univariate correlates of lower grip strength were older age, shorter height, not consuming alcohol, leaving education earlier and greater comorbidity. Apart from older age and shorter height, the only factors related to lower grip strength in mutually adjusted analyses were greater comorbidity among UK participants (kg difference in grip strength (95%CI) per additional comorbidity − 0.60(− 0.98, − 0.21) among men and − 0.50(− 0.86, − 0.13) among women) and not consuming alcohol among Japanese men (− 1.33(− 2.51, − 0.15)). Discussion: Correlates of muscle strength were similar in both cohorts. Conclusions: A global approach to age-related muscle weakness prevention may be appropriate.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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