Plos One
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Randomized Controlled Trial
The cost-effectiveness of a 20% price discount on fruit, vegetables, diet drinks and water, trialled in remote Australia to improve Indigenous health.
This paper estimates the cost-effectiveness of a 20% price discount on healthy food and beverages with and without consumer nutrition education, as trialled in remote Northern Australia. Changes in actual store sales, from the pre-discount baseline period, were analysed for population impact on consumption of fruit and vegetables, water and artificially sweetened soft drinks, in addition with total dietary weight (grams), energy (Mega Joules), and sodium (milligrams). Disability Adjusted Life Years (DALYs), arising from changes in dietary risk factor prevalence in the population, were estimated as the primary health outcome in a multi health-state Markov model. ⋯ However, the discount strategy, with or without consumer education led to a net loss of population health -36 95%CI (-47,-25) or -21(-28, -15) DALYs respectively, at increased cost to the retail and health sectors, of AUD860000 95%CI (710000, 1million) or AUD500000 (410000, 590000). The strategies trialled were thereby categorised as dominated by current practice while acknowledging considerable uncertainty surrounding the health outcome estimates. The 20% discount on limited targeted products appeared to need to be considered in conjunction with other marketing strategies to support healthy food choices, if remote Australian Indigenous population health is to be improved.
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Randomized Controlled Trial
The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial.
Previous evidence suggests that mindfulness training may improve aspects of psychosocial well-being. Whilst mindfulness is traditionally taught in person, consumers are increasingly turning to mindfulness-based smartphone apps as an alternative delivery medium for training. Despite this growing trend, few studies have explored whether mindfulness delivered via a smartphone app can enhance psychosocial well-being within the general public. ⋯ This pilot randomised controlled trial shows that self-reported improvements in psychosocial outcomes can be achieved at low cost through short-term engagement with a mindfulness-based smartphone app, and should be followed up with more substantive studies.
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Traumatic brain injuries (TBI) are a significant cause of mortality and morbidity for children globally. Adherence to evidence-based treatment guidelines have been shown to improve TBI outcomes. To inform the creation of a pediatric TBI management guideline for a low and middle income country context, we assessed the quality of available clinical practice guidelines (CPGs) for the acute management pediatric TBI. ⋯ To our knowledge, this is the first systematic review and guideline appraisal for pediatric CPGs concerning the acute management of TBI. Targeted guideline creation specific to the pediatric population has the potential to improve the quality of acute TBI CPGs. Furthermore, it is crucial to address the applicability of a guideline to translate the CPG from a published manuscript into clinically relevant local practice tools and for resource limited practice settings.
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Preoperative anemia occurs in about one third of patients who undergo elective surgery and is associated with an impaired outcome. Therefore, screening of preoperative anemia was established in the context of a multidisciplinary Patient Blood Management (PBM) program at the University Hospital of Muenster, Germany. Anemic patients without contraindications were treated with intravenous (IV) iron (ferric carboxymaltose) to increase their hemoglobin (Hgb) levels and hence to treat anemia prior to surgery. ⋯ Serum hepcidin levels were higher in the group of non-responders (10.6ng/ml [3.93, 34.77]) compared to responders (2.1ng/ml [0.25, 7.97], *p = 0.04). To conclude, the data of this retrospective pilot study indicate that hepcidin might be a promising biomarker to predict a patient`s responsiveness to IV iron in preoperative anemia treatment. Prospective studies have to investigate serum hepcidin levels as a biomarker to guide physician`s decision on IV iron substitution.
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Observational Study
Relationship of spinal alignment with muscular volume and fat infiltration of lumbar trunk muscles.
Fat infiltration and atrophy of lumbar muscles are related to spinal degenerative conditions and may cause functional deficits. Spinal alignment exerts biomechanical influence on lumbar intervertebral discs and joints. Our objective was to evaluate if spinopelvic parameters correlate with the lumbar muscle volume and fat infiltration. ⋯ Psoas volume correlated with TK (R = 0.21), TL (R = 0.27) and SVA (R = -0.23). The lumbar muscle volumes showed a moderated correlation with T1S1 length (R = 0.55 to 0.62). Spinopelvic parameters showed correlation with lumbar muscle volumes but not with muscle fat infiltration on asymptomatic young adults.