Medicine and Health Sciences Commons^™

Qualitative Methods In Pharmacy Research, Gisselle Gallego, Lotte Stig Norgaard

Medical Papers and Journal Articles

Over the past years, there has been an increase in the use of qualitative methods in health services research, including pharmacy research. Pharmacy practice researchers can use these methods to understand, explain, discover, and explore both patients’ and health care practitioners’ thoughts, perceptions, and feelings. Qualitative research can also be used for the “democratisation” of research methods through research that is inclusive, collaborative, and involves partnerships and co-production. There is a wide spectrum of qualitative research methods that might be used in pharmacy research. This Special Issue showcases five articles in different settings and countries with diverse participants that seek …

Adherence To Prescribing Restrictions For Her2-Positive Metastatic Breast Cancer In Australia: A National Population-Based Observational Study (2001-2016), Benjamin Daniels, Federico Girosi, Hanna Tervonen, Belinda E. Kiely, Sarah J. Lord, Nehmat Houssami, Sally-Anne Pearson

Medical Papers and Journal Articles

Background: Targeted cancer therapy is often complex, involving multiple agents and chemotherapeutic partners. In Australia, prescribing restrictions are put in place to reflect existing evidence of cost-effectiveness of these medicines. As therapeutic options continue to expand, these restrictions may not be perceived to align with best practice and it is not known if their use in the real-world clinic adheres to these restrictions. We examined the treatment of women receiving trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) to determine the extent to which treatment adhered to national prescribing restrictions.

Patients and methods: Our population-based, retrospective cohort study used dispensing records …

A Research And Evaluation Capacity Building Model In Western Australia, Roanna Lobo, Gemma Crawford, Jonathan Hallett, Sue Laing, Donna B. Mak, Jonine Jancey, Sally Rowell, Kahlia Mccausland, Lisa Bastian, Anne Sorenson, P.J. Matt Tilley, Simon Yam, Jude Comfort, Sean Brennan, Maryanne Doherty

Medical Papers and Journal Articles

Evaluation of public health programs, services and policies is increasingly required to demonstrate effectiveness. Funding constraints necessitate that existing programs, services and policies be evaluated and their findings disseminated. Evidence-informed practice and policy is also desirable to maximise investments in public health. Partnerships between public health researchers, service providers and policymakers can help address evaluation knowledge and skills gaps. The Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (SiREN) aims to build research and evaluation capacity in the sexual health and blood-borne virus sector in Western Australia (WA). Partners’ perspectives of the SiREN model after 2 …

Variations In The Management Of Acute Illness In Children With Congenital Adrenal Hyperplasia: An Audit Of Three Paediatric Hospitals, Georgina L. Chrisp, Ann M. Maguire, Maria Quartararo, Henrik Falhammar, Bruce R. King, Craig F. Munns, David J. Torpy, Shihab Hameed, R Louise Rushworth

Medical Papers and Journal Articles

Objective: Episodes of acute adrenal insufficiency (AI)/adrenal crises (AC) are a serious consequence of congenital adrenal hyperplasia (CAH). This study aimed to assess morbidity from acute illness in CAH and identify factors associated with use of IV hydrocortisone, admission and diagnosis of an AC.

Method: An audit of acute illness presentations among children with CAH to paediatric hospitals in New South Wales, Australia, between 2000 and 2015.

Results: There were 321 acute presentations among 74 children with CAH. Two thirds (66.7%, n=214) of these resulted in admission and 49.2% (n=158) of the patients received intravenous (IV) hydrocortisone. An AC was …

'Compassion, The First Emotion Ditched When I'M Busy'. The Struggle To Maintain Our Common Humanity, Lorna Davin, Jill Thistlethwaite, Emma Bartle

Medical Papers and Journal Articles

Introduction: A considerable body of literature has been built around the socialisation of medical students and junior doctors into the culture of medicine, yet our appreciation of how their affective learning is shaped through practice, over time, continues to challenge our understanding and subsequent educational practice. This study addresses this gap by using compassion as a lens to unpack affective learning.

Methods: This research asked interns undertaking their first year of medical practice “What have been the main influences (positive and/or negative) in how you have learned to express compassion for your patients when working in the clinical context?" Their …

Systematic Review Of Pain Medicine Content, Teaching, And Assessment In Medical School Curricula Internationally, Elspeth E. Shipton, Frank Bate, Raymond Garrick, Carole Steketee, Edward A. Shipton, Eric J. Visser

Medical Papers and Journal Articles

Introduction: Pain management is a major health care challenge in terms of the significant prevalence of pain and the negative consequences of poor management. Consequently, there have been international calls to improve pain medicine education for medical students. This systematic review examines the literature on pain medicine education at medical schools internationally, with a particular interest in studies that make reference to: a defined pain medicine curriculum, specific pain medicine learning objectives, dedicated pain education modules, core pain topics, medical specialties that teach pain medicine, elective study opportunities, hours allocated to teaching pain medicine during the curriculum, the status of …

Who Enrols And Graduates From Web-Based Pharmacy Education - Experiences From Northern Sweden, Sofia Mattsson, Maria Gustafsson, Sofia Svahn, Helena Norberg, Gisselle Gallego

Medical Papers and Journal Articles

Introduction: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umeå University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden.

Methods: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university's admissions data) and the alumni cohort …

Feedback From Activity Trackers Improves Daily Step Count After Knee And Hip Arthroplasty: A Randomized Controlled Trial, Neill Van Der Walt, Lucy J. Salmon, Benjamin Gooden, Matthew C. Lyons, Michael O'Sullivan, Kaka Martina, Leo A. Pinczewski, Justin P. Roe

Medical Papers and Journal Articles

Background: Commercial wrist-worn activity monitors have the potential to accurately assess activity levels and are being increasingly adopted in the general population. The aim of this study was to determine if feedback from a commercial activity monitor improves activity levels over the first 6 weeks after total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Methods: One hundred sixty-three consecutive subjects undergoing primary TKA or THAwere randomized into 2 groups. Subjects received an activity tracker with the step display obscured 2 weeks before surgery and completed patient-reported outcome measures (PROMs). On day 1 after surgery, participants were randomized to either …

Cultural Considerations At End Of Life In A Geriatric Inpatient Rehabilitiation Setting, Melissa J. Bloomer, Mari Botti, Fiona Runacres, Peter Poon, Jakqui Barnfield, Alison M. Hutchinson

Medical Papers and Journal Articles

Aim: To explore the impact of cultural factors on the provision of end-of-life care in a geriatric inpatient rehabilitation setting.

Background: Australia’s ageing population is now also one of the most culturally diverse. Individuals from culturally and linguistically diverse backgrounds may have specific care needs at the end of life according to various aspects of their culture.

Design: A mixed method approach using a retrospective audit of existing hospital databases, deceased patients’ medical records, and in-depth interviews with clinicians.

Findings: Patients’ and families’ cultural needs were not always recognised or facilitated in end-of-life care, resulting in missed opportunities to tailor …

The Association Between Post-Stroke Depression, Aphasia, And Physical Independence In Stroke Patients At 3-Month Follow-Up, Shuo Wang, Chun-Xue Wang, Ning Zhang, Yu-Tao Xiang, Yang Yang, Yu-Zhi Shi, Yi-Ming Deng, Mei-Fang Zhu, Fei Liu, Ping Yu, Gabor S. Ungvari, Chee H. Ng

Medical Papers and Journal Articles

Objective: Few studies have examined the association between post-stroke depression (PSD), aphasia, and physical independence in Chinese patients. This study investigated the above association in stroke patients in China at 3-month follow-up.

Methods: Altogether 270 patients within 14 days after ischemic stroke were recruited and followed up at 3 months. PSD, aphasia, and physical functional status were measured using the Stroke Aphasia Depression Questionnaire (SADQ), Western Aphasia Battery (WAB), and modified Rankin Scale (mRS), respectively. Patients with mRS total score >2 were considered as having “physical dependence.”

Results: Out of 248 patients at 3-month follow up, 119 (48%) were rated …

Management Of Amiodarone-Induced Thyrotoxicosis At A Cardiac Transplantation Centre, Michelle Isaacs, Monique Costin, Ron Bova, Helen L. Barrett, Drew Heffernan, Katherine Samaras, Jerry R. Greenfield

Medical Papers and Journal Articles

Background: Amiodarone-induced thyrotoxicosis (AIT) is associated with significant morbidity and mortality, particularly in patients with cardiac failure. The aim of the study was to evaluate the management of AIT at a tertiary hospital specialising in cardiac failure and transplantation.

Methods: Retrospective audit of 66 patients treated for AIT by Endocrinology (2007–2016), classified as type 1 (T1) or type 2 (T2) based on radiological criteria. Main outcome measurements were response rate to initial treatment, time to euthyroidism, and frequency/safety of thyroidectomy.

Results: Mean age was 60 ± 2 years; 80% were male. Sixty-four patients commenced medical treatment: thionamides (THIO) in 23, …

What’S Old Is New Again: The Sacroiliac Joint As A Cause Of Lateralizing Low Back Pain, Jennifer Saunders, Manuel Cusi, Hans Van Der Wall

Medical Papers and Journal Articles

It has not been easy to identify mechanical failure of the sacroiliac joint (SIJ) with traditional imaging. The integrated model of function (Lee and Vleeming, 1998) suggests that under normal circumstances, form and force closure combined contribute to sacral nutation and “locking” the SIJ for optimal load transfer. This model is supported by clinical evidence and scintigraphic findings that contribute to successful therapy in 80% of cases. Single-photon emission computed tomography and x-ray computed tomography (SPECT-CT), a hybrid device, was used in a study of 1200 patients (64% female and 36% male patients with an average age of 42 years; …

Progression-Free Survival As A Surrogate Endpoint For Overall Survival In Modern Ovarian Cancer Trials: A Meta-Analysis, Katrin M. Sjoquist, Sarah J. Lord, Michael L. Friedlander, Robert John Simes, Ian C. Marschner, Chee Khoon Lee

Medical Papers and Journal Articles

Background: Progression-free survival (PFS) has been adopted as the primary endpoint in many randomized controlled trials, and can be determined much earlier than overall survival (OS). We investigated whether PFS is a good surrogate endpoint for OS in trials of first-line treatment for epithelial ovarian cancer (EOC), and whether this relationship has changed with the introduction of new treatment types.

Methods: In a meta-analysis, we identified summary data [hazard ratio (HR) and median time] from published randomized controlled trials. Linear regression was used to assess the association between treatment effects on PFS and OS overall, and for subgroups defined by …

Changing Medical Student Attitudes To Patient Safety: A Multicentre Study, Kim Oates, Ian Wilson, Wendy Hu, Ben Walker, Amanda Nagle, Janice Wiley

Medical Papers and Journal Articles

Background: Although patient safety is becoming widely taught in medical schools, its effect has been less rigorously evaluated. We describe a multicentre study to evaluate student changes in patient safety attitudes using a standardized instrument, the Attitudes to Patient Safety Questionnaire3 (APSQ3).

Methods: A patient safety training package designed for medical students was delivered in the first year and second year in four Australian medical schools. It comprises eight face-to-face modules, each of two hours. Seminars start with an interactive introduction using questions, video and role play, followed by small group break-outs to discuss a relevant case study. Groups are …

'Death Is Difficult In Any Language': A Qualitative Study Of Palliative Care Professionals' Experiences When Providing End-Of-Life Care To Patients From Culturally And Linguistically Diverse Backgrounds, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Background: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care.

Aim: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture.

Design: An emergent qualitative design, informed by theoretical and procedural direction from grounded theory research.

Setting/participants: Four focus …

Identifying Systems Barriers That May Prevent Bereavement Service Access To Bereaved Carers: A Report From An Australian Specialist Palliative Care Service, Jane Phillips, Elizabeth A. Lobb, Paula Mohacsi, Nicole Heneka, David Currow

Medical Papers and Journal Articles

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers.

Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers.

Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin.

Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half …

Help-Seeking Experiences Of Bereaved Adolescents: A Qualitative Study, Karl Andriessen, Elizabeth Lobb, Jane Mowll, Michael Dudley, Brian Draper, Philip Mitchell

Medical Papers and Journal Articles

Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much needed auxiliary. Parental encouragement is important in accessing adequate professional help.

Rheumatoid Leptomeningitis Presenting With An Acute Neuropsychiatric Disorder, Michal Lubomski, Joanne Sy, Michael Buckland, Andie S. Lee, Bethan Richards, Elizabeth Thompson, Michael Fulham, Nora Breen, Kirsty Morris, G Michael Halmagyi

Medical Papers and Journal Articles

Leptomeningitis is a rare central nervous system manifestation of rheumatoid arthritis, generally in patients with established chronic rheumatoid disease. We report a 41-year-old man without previous rheumatoid arthritis or psychiatric disorder who presented with an acute neuropsychiatric disturbance and polyarthralgia. His MR scan of brain showed asymmetric bifrontal leptomeningitis, confirmed on (18F)-fluoro-D-glucose-positron emission tomography. Other investigations showed highly positive serum and cerebrospinal fluid anti-cyclic citrullinated peptide. A leptomeningeal biopsy showed necrotising leptomeningeal inflammation with ill-defined granulomas and lymphoplasmacytic infiltrate without organisms. Prolonged high-dose corticosteroids and then rituximab resulted in recovery. Chronic leptomeningitis can present with an acute neuropsychiatric disorder. We …

Culturally And Linguistically Diverse Palliative Care Patients' Journeys At The End-Of-Life, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients.

Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the …

The Effect Of Self-Selected Complementary Therapies On Cancer Patients' Quality Of Life And Symptom Distress: A Prospective Cohort Study In An Integrative Oncology Setting, N J. Stomski, A Petterson, L J. Kristjanson, Elizabeth Lobb, M B. Phillips, A Williams, P Morrison, D Joske

Medical Papers and Journal Articles

Objective: To examine the effectiveness of a multifaceted complementary therapies intervention, delivered in a systematic manner within an Australian public hospital setting, on quality of life and symptom distress outcomes for cancer patients.

Methods: Adults receiving treatment for any form of cancer were eligible to participate in this study. Self-referred participants were offered a course of six complementary therapy sessions. Measures were administered at baseline, and at the third and sixth visit. The primary outcomes were quality of life and symptom distress. Linear mixed models were used to assess change in the primary outcomes.

Results: In total, 1376 cancer patients …

Depressive Symptoms In Patients With Irritable Bowel Syndrome: A Meta-Analysis Of Comparative Studies, Qing-E Zhang, Fei Wang, Geng Qin, Wei Zheng, Chee H. Ng, Gabor S. Ungvari, Zhen Yuan, Songli Mei, Gang Wang, Yu-Tao Xiang

Medical Papers and Journal Articles

Depression is common in patients with irritable bowel syndrome (IBS), but the reported prevalence across different studies is inconsistent. This meta-analysis systematically examined the presence and severity of depressive symptoms in patients with IBS. Two investigators independently performed a literature search. The pooled depressive symptom severity was calculated using a random effects model. Subgroup, sensitivity and meta-regression analyses were conducted to examine the moderating factors of the development of depressive symptoms. Twenty four studies (n=2,837) comparing depressive symptoms between IBS patients (n=1,775) and healthy controls (n=1,062) were identified; 14 (58.3%) studies were rated as high quality. Compared to healthy controls, …

The Association Between Urinary Alzheimer-Associated Neuronal Thread Protein And Cognitive Impairment In Late-Life Depression: A Controlled Pilot Study, Qing-E Zhang, Sihai Ling, Peng Li, Saina Zhang, Chee H. Ng, Gabor S. Ungvari, Liang-Jen Wang, Sheng-Yu Lee, Gang Wang, Yu-Tao Xiang

Medical Papers and Journal Articles

Accumulation of tau protein is associated with both Alzheimer’s disease (AD) and late-life depression (LLD). Alzheimer-associated neuronal thread protein (AD7c-NTP), which is closely linked with the tau protein, is elevated in the cerebrospinal fluid and urine of AD patients. This study examined the association between urinary AD7c-NTP and late-life depression with cognitive impairment. One hundred and thirty-eight subjects were recruited into late-life depression with cognitive impairment (LLD-CI, n=52), late-life depression without cognitive impairment (LLD-NCI, n=29), AD (n=27), and healthy control (HC, n=30) groups. The level of urinary AD7c-NTP was measured using the enzyme-linked immunosorbent assay method. The Montreal Cognitive Assessment …

Protocol To Develop Sustainable Day Care For Children Aged 1-4 Years In Disadvantaged Urban Communities In Dhaka, Bangladesh, Mahua Das, Helen Elsey, Riffat A. Shawon, Joseph Hicks, J Ferdoush, Rumana Huque, Fariza Fieroze, Shammi Nasreen, Hilary Wallace, Saidur R. Mushreky

Medical Papers and Journal Articles

Introduction: Lack of safe, stimulating and health promoting environments for children under-5 hinders their physical, social and cognitive development, known as early childhood development (ECD). Improving ECD impacts on children, and can improve educational attainment for girls, who often care for younger siblings, and employment prospects for mothers. Developing and evaluating the impacts of ECD programmes within childcare needs to assess a range of social, health, educational and economic impacts, including women’s empowerment. Children living in slums are at high risk of poor early development and holistic, sustainable interventions are needed to address ECD in these contexts. This study will …

Using New And Innovative Technologies To Assess Clinical Stage In Early Intervention Youth Mental Health Services: Evaluation Study, Laura Ospina-Pinillos, Tracey A. Davenport, Frank Iorfino, Ashleigh Tickell, Shane Cross, Elizabeth M. Scott, Ian B. Hickie

Medical Papers and Journal Articles

Background: Globally there is increasing recognition that new strategies are required to reduce disability due to common mental health problems. As 75% of mental health and substance use disorders emerge during the teenage or early adulthood years, these strategies need to be readily accessible to young people. When considering how to provide such services at scale, new and innovative technologies show promise in augmenting traditional clinic-based services.

Objective: The aim of this study was to test new and innovative technologies to assess clinical stage in early intervention youth mental health services using a prototypic online system known as the Mental …

Predicting Sequential Bilateral Cochlear Implantation Performance In Postlingually Deafened Adults: A Retrospective Cohort Study, Yvette E. Smulders, Thomas Hendriks, Inge Stegeman, Robert H. Eikelboom, Cathy Sucher, Gemma Upson, Ronel Chester Browne, Dona Jayakody, Peter L. Santa Maria, Marcus D. Atlas, Peter L. Friedland

Medical Papers and Journal Articles

Objective: To identify which preoperative patient characteristics influence sequential bilateral cochlear implantation performance and to create a statistical model that predicts benefit.

Design: Multicentre retrospective cohort study.

Setting: All patients were operated in four academic teaching hospitals in Perth, Australia, and followed up by audiologists of the Ear Science Institute Australia.

Participants: A total of 92 postlingually deafened adult patients who had undergone sequential cochlear implantations between 19 June 1990 and 14 March 2016 were included. Patients were excluded if the 12-month follow-up consonant-nucleus-consonant (CNC) phoneme score was missing.

Main outcome measure: The effect of 18 preoperative factors on the …

Cortical Aav-Cntf Gene Therapy Combined With Intraspinal Mesenchymal Precursor Cell Transplantation Promotes Functional And Morphological Outcomes After Spinal Cord Injury In Adult Rats, Stuart I. Hodgetts, Jun Han Yoon, Alysia Fogliani, Emmanuel A. Akinpelu, Danii Baron-Heeris, Imke G.J Houwers, Lachlan P.G Wheeler, Bernadette T. Majda, Sreya Santhakumar, Sarah J. Lovett, Emma Duce, Margaret A. Pollett, Tylie M. Wiseman, Brooke Fehily, Alan R. Harvey

Medical Papers and Journal Articles

Ciliary neurotrophic factor (CNTF) promotes survival and enhances long-distance regeneration of injured axons in parts of the adult CNS. Here we tested whether CNTF gene therapy targeting corticospinal neurons (CSN) in motor-related regions of the cerebral cortex promotes plasticity and regrowth of axons projecting into the female adult F344 rat spinal cord after moderate thoracic (T10) contusion injury (SCI). Cortical neurons were transduced with a bicistronic adeno-associated viral vector (AAV1) expressing a secretory form of CNTF coupled to mCHERRY (AAV-CNTF^mCherry) or with control AAV only (AAV-GFP) two weeks prior to SCI. In some animals, viable or …

Educating For Indigenous Health Equity: An International Consensus Statement, Rhys Jones, Lynden Crowshoe, Papaarangi Reid, Betty Calam, Elana Curtis, Michael Green, Tania Huria, Kristen Jacklin, Martina Kamaka, Cameron Lacey, Jill Milroy, David Paul, Suzanne Pitama, Leah Walker, Gillian Webb, Shaun Ewen

Medical Papers and Journal Articles

The determinants of health inequities between Indigenous and non-Indigenous populations include factors amenable to medical education’s influence, for example, the competence of the medical workforce to provide effective and equitable care to Indigenous populations. Medical education institutions have an important role to play in eliminating these inequities. However, there is evidence that medical education is not adequately fulfilling this role, and in fact may be complicit in perpetuating inequities.

This article seeks to examine the factors underpinning medical education’s role in Indigenous health inequity, in order to inform interventions to address these factors. The authors developed a consensus statement that …

Screening For Familial Hypercholesterolaemia In Primary Care: Time For General Practice To Play Its Part, Tom Brett, Nadeem Qureshi, Samuel Gidding, Gerald F. Watts

Medical Papers and Journal Articles

Fifty per cent of first-degree relatives of index cases with familial hypercholesterolemia (FH) inherit the disorder. Despite cascade screening being the most cost-effective method for detecting new cases, only a minority of individuals with FH are currently identified. Primary care is a key target area to increase identification of new index cases and initiate cascade screening, thereby finding close relatives of all probands. Increasing public and health professional awareness about FH is essential.

In the United Kingdom and in Australia, most of the population are reviewed by a General Practitioner (GP) at least once over a three-year period, offering opportunities …

Prevalence Of Internet Addiction Disorder In Chinese University Students: A Comprehensive Meta-Analysis Of Observational Studies, Lu Li, Dan-Dan Xu, Jing-Xin Chai, Di Wang, Lin Li, Ling Zhang, Li Lu, Chee H. Ng, Gabor S. Ungvari, Song-Li Mei, Yu-Tao Xiang

Medical Papers and Journal Articles

Background and aims: Internet addiction disorder (IAD) is common in university students. A number of studies have examined the prevalence of IAD in Chinese university students, but the results have been inconsistent. This is a meta-analysis of the prevalence of IAD and its associated factors in Chinese university students.

Methods: Both English (PubMed, PsycINFO, and Embase) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until January 16, 2017.

Results: Altogether 70 studies covering 122,454 university students were included in the meta-analysis. Using the random-effects model, the pooled overall prevalence …

Cardiac Steatosis In Hiv-A Marker Or Mediator Of Disease?, Morgan Jacob, Cameron J. Holloway

Medical Papers and Journal Articles

Although people living with HIV (PLHIV) are approaching normal life expectancy, a limitation to achieving this goal is managing the higher prevalence of co-morbidities, including cardiovascular disease. Whilst ischaemic heart disease likely contributes to a large proportion of cardiac disease in the modern era of treatment, cardio-metabolic disease, including cardiac steatosis, akin to obesity-related heart disease, is also a possible mechanism of increased cardiac morbidity and mortality. HIV and other metabolic and inflammatory diseases affecting the heart, including obesity, share many cardio-metabolic abnormalities, with increased pericardial and myocardial fat content, in association with chronic systemic inflammatory changes and alterations in …