Urban American Indian Experiences Living with Type 2 Diabetes Mellitus

This qualitative interpretive study aimed to describe the experiences of 13 American Indians living in urban settings and their use of traditional healing and biomedical health services for type 2 diabetes. Urban American Indian adults living in the United States who used traditional healing and biomedical health services for type 2 diabetes were recruited for the study through purposive sampling, including snowball sampling. Thirteen participants completed semi-structured interviews. Participants reported positive experiences and barriers to traditional healing and Western biomedical services. They also discussed feelings of disorientation when diagnosed at a young age with type 2 diabetes but self-empowerment as an adult. Participants felt disconnected from their tribal community and identified inaccessibility and lack of communication as barriers to using traditional healing practices. Participants noted access and convenience to biomedicine as a reason to use it and the services provided within the system. They also identified barriers to biomedicine, such as short consultation time, costs, and lack of rapport or communication. Implications for positive social change include improving awareness and understanding of healthcare providers and educators regarding urban American Indian populations’ health needs and being able to implement better-informed health programs for them

Psychometric Properties of the SymptoMScreen Questionnaire in a Mild Disability Population of Patients with Relapsing–Remitting Multiple Sclerosis: Quantifying the Patient’s Perspective

Crucial elements for achieving optimal long-term outcomes in multiple sclerosis (MS) are patient confidence and effective physician-patient communication. Patient-reported instruments may provide the means to fill the gap in currently available clinician-rated measures. The SymptoMScreen (SMSS) is a brief self-assessment tool for measuring symptom severity in 12 neurologic domains commonly affected by MS. We conducted a non-interventional study to assess the dimensional structure and item characteristics of the SMSS. A total of 218 patients with relapsing-remitting MS and mild disability (median Expanded Disability Status Scale score 2.0) were studied. Symptom severity was low (SMSS score 13.5, interquartile range 4.2-27), fatigue being the domain with the highest impact. A non-parametric item response theory, i.e., Mokken analysis, found that the SMSS is a robust one-dimensional scale (overall scalability index H 0.60) with high reliability (Cronbach's alpha 0.94). The confirmatory factor analysis model confirmed the unidimensional structure (comparative fit index 1.0, root-mean-square error of approximation 0.001). Samejima's model fitted well an unconstrained model with different item difficulties. The SMSS shows appropriate psychometric characteristics and may constitute a valuable and easy-to-implement addition to measure the symptom severity in clinical practice.This study was funded by the Medical Department of Roche Farma Spain. The sponsor also funded the journals Rapid Service fe

Título en español.

A total of 102 dairy-beef bulls were slaughtered at 18 months of age, and the tenderness of their beef determined by the Warner-Bratzler shear method. The bulls were crossbreds of Brahman, Charolaise or Angus bulls and cull dairy cows. The comparisons indicated that the Angus crossbreds were significantly more tender in the rib roasts than the two other crosses. No significant difference was found in the tenderness of the top rounds between this cross and the Charolaise. Both had a more tender top round than the Brahman crossbreds. The Angus crossbreds had a lower average, or more tenderness, than the Charolaise. A highly significant difference was shown to exist between the rib roasts and the top rounds, definitely establishing that top round cuts were more tender than rib roast cuts.Se sacrificaron 102 toros de 18 meses de edad, y se determinó la blandura de su carne mediante el método Warner-Bratzler. Estos animales representaban cruces entre toros Brahman, Charolesa o Angus y vacas lecheras desechadas. Las comparaciones demostraron que los asados de costilla de los cruces con Angus eran más blandos que los de los otros dos cruces. No hubo diferencia significativa en cuanto a la blandura de la "gallina" entre los animales del cruce con Angus y los de cruce con Charolesa, aunque el promedio de la medida de blandura favoreció a los primeros. Se demostró definitivamente en todos los cruces comparados que la "gallina" es más tierna que el asado de costilla

Medical help-seeking intentions among patients with early Alzheimer’s disease.

Background: Limited information is available on the active process of seeking medical help in patients with Alzheimer's disease (AD) at early stages. The aim of this study was to assess the phenomenon of medical help-seeking in early AD and to identify associated factors. Methods: A multicenter, non-interventional study was conducted including patients of 50-90 years of age with prodromal or mild AD (National Institute on Aging/Alzheimer's Association criteria), a Mini-Mental State Examination (MMSE) score ≥ 22, and a Clinical Dementia Rating-Global score (CDR-GS) of 0.5-1.0. A multivariate logistic regression analysis was conducted. Results: A total of 149 patients were included. Mean age (SD) was 72.3 (7.0) years, 50.3% were female, and 87.2% had a CDR-GS score of 0.5. Mean disease duration was 1.4 (1.8) years. Ninety-four (63.1%) patients sought medical help, mostly from neurologists. Patients with help-seeking intentions were mostly female (60.6%) with a CDR-GS score of 0.5 (91.5%) and had a greater awareness of diagnosis, poorer quality of life, more depressive symptoms, and a more severe perception of their condition than their counterparts. Lack of help-seeking intentions was associated with male sex (p = 0.003), fewer years of education (p = 0.005), a low awareness of diagnosis (p = 0.005), and a low emotional consequence of the condition (p = 0.016). Conclusion: Understanding the phenomenon of active medical help-seeking may facilitate the design of specific strategies to improve the detection of cognitive impairment, especially in patients with a lower level of educational attainment and poor awareness of their condition.Depto. de MedicinaFac. de MedicinaTRUEpu

Título en español.

Se sacrificaron 102 toros de 18 meses de edad, y se determinó la blandura de su carne mediante el método Warner-Bratzler. Estos animales representaban cruces entre toros Brahman, Charolesa o Angus y vacas lecheras desechadas. Las comparaciones demostraron que los asados de costilla de los cruces con Angus eran más blandos que los de los otros dos cruces. No hubo diferencia significativa en cuanto a la blandura de la "gallina" entre los animales del cruce con Angus y los de cruce con Charolesa, aunque el promedio de la medida de blandura favoreció a los primeros. Se demostró definitivamente en todos los cruces comparados que la "gallina" es más tierna que el asado de costilla.</jats:p