Nursing Case Management Strategies for Adults with Serious Mental Illness Seeking Dental Services.

A university-community partnership initiated a dental screening and nursing case management program for Medicaid-insured adults with serious mental illness (SMI). Forty-three adults with SMI participated in dental screening; 72% participated in case management. Per client, an average of six case management contacts was made. After 6 months, 87% (27/31) had attended at least one dental appointment, with a 13% no-show rate; 8 completed treatment, 4 had ongoing treatment, 12 had interrupted care, and 3 were lost to follow-up. Adults with SMI experienced high unmet dental needs; nursing case management strategies aided clients to initiate and complete dental care.

Comparison of Benefit of Transcatheter Aortic Valve Implantation in Patients With Low Gradient Versus High Gradient Aortic Stenosis and Left Ventricular Dysfunction.

Patients with low gradient severe aortic stenosis (LG-AS) often exhibit significant limitations in functional status and quality of life. We aimed to evaluate the clinical effect of transcatheter aortic valve implantation (TAVI) on LG-AS patients compared to those with high transvalvular gradients and similar left ventricular dysfunction. Retrospective analysis of records for all patients with a left ventricular ejection fraction <50% who underwent TAVI at our institution was performed. Patients were grouped according to their transvalvular gradient. Data were collected from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Clinical benefit endpoints included improvements in left ventricular ejection fraction and changes in the Kansas City Cardiomyopathy Questionnaire. Additional outcomes analyzed included 1-year all-cause mortality, stroke rates, rates of rehospitalization, need for a permanent pacemaker, and hospital length of stay. Two hundred three patients met our inclusion criteria. one hundred one LG-AS patients (mean transvalvular gradient <40 mm Hg) were compared to 102 patients with high transvalvular gradients (mean transvalvular gradient >40 mm Hg). LG-AS patients yielded similar improvements in left ventricular ejection fraction (43.5% ± 63.7 vs 37.7% ± 58.7; p = 0.525) and Kansas City Cardiomyopathy Questionnaire scores (423.51% ± 1257.02 vs 266.56% ± 822.81; p = 0.352). There were no differences between the groups with respect to 1-year mortality (16.8% vs 12.7%; p = 0.412), stroke rates, hospital length of stay, need for permanent pacemaker implantation or hospital readmissions. In conclusion, we found that TAVI is associated with comparable improvement in clinical and echocardiographic outcomes in LG-AS patients as compared to those with high gradient severe aortic stenosis.

Biomarker validation of a long-chain omega-3 polyunsaturated fatty acid food frequency questionnaire.

Long-chain omega-3 PUFA (LC n-3 PUFA) are beneficial for health. To date there is no specific food frequency questionnaire (FFQ) to assess LC n-3 PUFA intakes. The objective of this study is to validate our newly developed FFQ by comparison with LC n-3 PUFA content of both red blood cells (RBC) and plasma, expressed as a percentage of total FA. Fifty-three healthy male and female subjects were recruited from Wollongong, Australia. Average LC n-3 PUFA intakes (mg/d) were estimated using the new FFQ. RBC and plasma FA were assessed using GC. Spearman correlation coefficients were used to assess the linear relationship between FFQ intakes and both RBC and plasma FA. The results show that there were significant Spearman's correlation coefficients between the FFQ intakes and RBC (and plasma) FA for total LC n-3 PUFA, EPA, and DHA (0.50 (0.54), 0.39 (0.54) and 0.40 (0.48), respectively) but not for docosapentaenoic acid. The FFQ was also an effective ranking tool. The FFQ is a valid method based on erythrocyte and plasma FA as biochemical markers. In conclusion, the new FFQ is a valid method that can be used to estimate the LC n-3 PUFA intake of adults.

Dietary validation of a new Australian food-frequency questionnaire that estimates long-chain n-3 polyunsaturated fatty acids.

Currently, there is no FFQ designed to capture the intakes of the long-chain (LC) n-3 PUFA. The objectives of this study were to validate a new LC n-3 PUFA FFQ by comparison with 3 d weighed food records (FR) and to determine its reproducibility assessed 4 to 6 weeks apart. Healthy male and female subjects (n 53) were recruited from Wollongong and the Australian Capital Territory, Australia. The FFQ and FR were analysed for LC n-3 PUFA intakes using a nutrient analysis software package and these intakes were compared using Wilcoxon signed rank tests and Spearman correlation coefficients. Bland-Altman analysis and quintile assignment assessed the agreement between the two methods and the FFQ's ability to rank individuals according to intakes, respectively. Comparison of intakes from FFQ and FR correlated significantly for total LC n-3 PUFA, EPA, docosapentaenoic acid (DPA) and DHA, 0.75, 0.64, 0.62 and 0.72, respectively (P < 0.05); hence, there is reasonable agreement between the FFQ and the FR in assessing LC n-3 PUFA intakes. Quintile assignments correctly assigned 49 % of subjects into the same quintiles and 87 % of subjects were correctly assigned either to the same or adjacent quintiles. The FFQ was reproducible for intakes of LC n-3 PUFA, EPA, DPA and DHA with Spearman correlation coefficients of 0.88, 0.88, 0.90 and 0.87, respectively. In conclusion, the new FFQ is a valid and reproducible method that can be used to estimate the LC n-3 PUFA intake of healthy adults.