Credibility, Accuracy, and Comprehensiveness of Readily Available Internet-Based Information on Treatment and Management of Peripheral Artery Disease and Intermittent Claudication: Review.

BACKGROUND: Peripheral artery disease (PAD) affects millions of people worldwide, and a core component of management of the condition is self-management. The internet is an important source of health information for many people. However, the content of websites regarding treatment recommendations for PAD has not been fully evaluated. OBJECTIVE: This study aimed to assess the credibility, accuracy, and comprehensiveness of websites found via a common search engine, by comparing the content to current guidelines for treatment and management of PAD and intermittent claudication (IC). METHODS: A review of websites from hospitals, universities, governments, consumer organizations, and professional associations in the United States and the United Kingdom was conducted. Website recommendations for the treatment of PAD and IC were coded in accordance with the guidelines of the National Institute for Health and Care Excellence (NICE) and the American Heart Association (AHA). Primary outcomes were website credibility (4-item Journal of the American Medical Association benchmark), website accuracy (in terms of the percentage of accurate recommendations), and comprehensiveness of website recommendations (in terms of the percentage of guideline recommendations that were appropriately covered). Secondary outcomes were readability (Flesch-Kincaid grade level) and website quality (Health On the Net Foundation's code of conduct). RESULTS: After screening, 62 websites were included in this analysis. Only 45% (28/62) of websites met the credibility requirement by stating they were updated after the NICE guidelines were published. Declaration of authorship and funding and the presence of reference lists were less commonly reported. Regarding accuracy, 81% (556/685) of website recommendations were deemed accurate on following NICE's and the AHA's recommendations. Comprehensiveness was low, with an average of 40% (25/62) of guideline treatment recommendations being appropriately covered by websites. In most cases, readability scores revealed that the websites were too complex for web-based consumer health information. CONCLUSIONS: Web-based information from reputable sources about the treatment and management of PAD and IC are generally accurate but have low comprehensiveness, credibility, and readability.

Recognizing animal personhood in compassionate conservation.

Compassionate conservation is based on the ethical position that actions taken to protect biodiversity should be guided by compassion for all sentient beings. Critics argue that there are 3 core reasons harming animals is acceptable in conservation programs: the primary purpose of conservation is biodiversity protection; conservation is already compassionate to animals; and conservation should prioritize compassion to humans. We used argument analysis to clarify the values and logics underlying the debate around compassionate conservation. We found that objections to compassionate conservation are expressions of human exceptionalism, the view that humans are of a categorically separate and higher moral status than all other species. In contrast, compassionate conservationists believe that conservation should expand its moral community by recognizing all sentient beings as persons. Personhood, in an ethical sense, implies the individual is owed respect and should not be treated merely as a means to other ends. On scientific and ethical grounds, there are good reasons to extend personhood to sentient animals, particularly in conservation. The moral exclusion or subordination of members of other species legitimates the ongoing manipulation and exploitation of the living worlds, the very reason conservation was needed in the first place. Embracing compassion can help dismantle human exceptionalism, recognize nonhuman personhood, and navigate a more expansive moral space.

Reconocimiento de la Calidad de Persona en los Animales dentro de la Conservación Compasiva Resumen La conservación compasiva está basada en la posición ética que parte de que las acciones tomadas para proteger a la biodiversidad deberían estar dirigidas por la compasión por todos los seres sintientes. Los críticos de esta postura argumentan que hay tres razones nucleares por las que el daño a los animales es aceptable dentro de los programas de conservación: el principal motivo de la conservación es la protección de la biodiversidad; la conservación ya es compasiva con los animales; y la conservación debería priorizar la compasión hacia los humanos. Usamos un análisis de argumentos para aclarar los valores y la lógica subyacentes al debate en torno a la conservación compasiva. Encontramos que el rechazo a la conservación compasiva es una expresión de la excepcionalidad humana, la visión de que los humanos están en un nivel categóricamente separado y de mayor moral que todas las demás especies. Por el contrario, los conservacionistas compasivos creen que la conservación debería expandir su comunidad moral al reconocer a todos los seres sintientes como personas. La calidad de persona, en un sentido ético, implica que el individuo merece respeto y no debería ser tratado solamente como un medio para otros fines. Si hablamos desde fundamentos científicos y éticos, existen muy buenas razones para extender la calidad de persona a todos los animales sintientes, particularmente en la conservación. La exclusión moral o la subordinación de los miembros de otras especies justifica la continua manipulación y explotación de los seres vivos, la justa razón por la que necesitamos de la conservación desde el principio. La aceptación de la compasión nos puede ayudar a desmantelar la excepcionalidad humana, a reconocer la calidad de persona no humana y a navegar un espacio moral más expansivo.

An Analysis of Spatial Clustering of Stroke Types, In-hospital Mortality, and Reported Risk Factors in Alberta, Canada, Using Geographic Information Systems.

BACKGROUND: Despite advances in the quality and delivery of stroke care, regional disparities in stroke incidence and outcome persist. Spatial analysis using geographic information systems (GIS) can assist in identifying high-risk populations and regional differences in efficacy of stroke care. The aim of this study was to identify and locate geographic clusters of high or low rates of stroke, risk factors, and in-hospital mortality across a provincial health care network in Alberta, Canada. METHODS: This study employed a spatial epidemiological approach using population-based hospital administrative data. Getis-Ord Gi* and Spatial Scan statistics were used to identify and locate statistically significant "hot" and "cold" spots of stroke occurrence by type, risk factors, and in-hospital mortality. RESULTS: Marked regional variations were found. East central Alberta was a significant hot spot for ischemic stroke (relative risk [RR] 1.43, p<0.001), transient ischemic attack (RR 2.25, p<0.05), and in-hospital mortality (RR 1.50, p<0.05). Hot spots of intracerebral hemorrhage (RR 1.80, p<0.05) and subarachnoid hemorrhage (RR 1.64, p<0.05) were identified in a major urban centre. Unexpectedly, stroke risk factor hot spots (RR 2.58, p<0.001) were not spatially associated (did not overlap) with hot spots of ischemic stroke, transient ischemic attack, or in-hospital mortality. CONCLUSIONS: Integration of health care administrative data sets with geographic information systems contributes valuable information by identifying the existence and location of regional disparities in the spatial distribution of stroke occurrence and outcomes. Findings from this study raise important questions regarding why regional differences exist and how disparities might be mitigated.

Urbanization, Grassland, and Diet Influence Coyote (Canis latrans) Parasitism Structure.

Land use change can alter the ecological mechanisms that influence infectious disease exposure in animal populations. However, few studies have empirically integrated the environmental, spatial, and dietary patterns of wildlife epidemiology. We investigate how urbanization, habitat type, and dietary behavior are associated with coyote (Canis latrans) parasitism structure along a gradient of rural to urban land cover using multivariate redundancy analyses. Coyote fecal samples were collected in eight urban and six rural sites in Calgary, Alberta, Canada. Parasite and diet components were identified using common flotation procedures and fecal dietary analysis, respectively. Redundancy analysis was used to identify the best land cover, connectivity, and dietary predictors. We tested for significance using multiple permutation tests and ANOVAs. Significant factors affecting enteric parasite prevalence included dietary and land cover factors (R (2) = 0.4130, P < 0.05). Variation in dietary behavior was observed between urban and rural sites (R (2) = 0.4712, P < 0.05), as anthropogenic diet items (i.e., garbage, crabapples) were strongly influenced by urbanization. Our research supports that developed habitat, grassland cover, and dietary choice interact to possibly influence the exposure of coyote hosts to enteric parasites and pioneers future investigation of disease ecology for natural populations in anthropogenic landscapes.