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Mol Psychiatry ; 2018 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-29988085


Macronutrient intake, the proportion of calories consumed from carbohydrate, fat, and protein, is an important risk factor for metabolic diseases with significant familial aggregation. Previous studies have identified two genetic loci for macronutrient intake, but incomplete coverage of genetic variation and modest sample sizes have hindered the discovery of additional loci. Here, we expanded the genetic landscape of macronutrient intake, identifying 12 suggestively significant loci (P < 1 × 10-6) associated with intake of any macronutrient in 91,114 European ancestry participants. Four loci replicated and reached genome-wide significance in a combined meta-analysis including 123,659 European descent participants, unraveling two novel loci; a common variant in RARB locus for carbohydrate intake and a rare variant in DRAM1 locus for protein intake, and corroborating earlier FGF21 and FTO findings. In additional analysis of 144,770 participants from the UK Biobank, all identified associations from the two-stage analysis were confirmed except for DRAM1. Identified loci might have implications in brain and adipose tissue biology and have clinical impact in obesity-related phenotypes. Our findings provide new insight into biological functions related to macronutrient intake.

Stroke ; 47(1): 255-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26556821


BACKGROUND AND PURPOSE: Little is known about whether sex differences exist in the presentation, management, and outcomes of transient ischemic attack. METHODS: We conducted a cohort study of 5991 consecutive patients with transient ischemic attack admitted to 11 stroke centers in Ontario, Canada, between July 1, 2003, and March 31, 2008 and compared presenting symptoms, processes of care, and outcomes in women and men. We used linkages to administrative databases to evaluate mortality and recurrent vascular events within 30 days and 1 year of the initial presentation, with multivariable analyses to assess whether sex differences persisted after adjustment for age and comorbid conditions. RESULTS: The most common presenting symptoms for both sexes were weakness, speech impairment, and sensory deficit, with headache being slightly more frequent in women. Women were less likely than men to undergo carotid imaging, carotid endarterectomy, or receive lipid-lowering therapy. One-year mortality was slightly lower in women than in men (adjusted hazard ratio, 0.77; 95% confidence interval, 0.63-0.94). CONCLUSIONS: We found only minor sex differences in the presentation and management of transient ischemic attack, suggesting that current public awareness campaigns focusing on classic warning signs are appropriate for both women and men. Future work should focus on evaluating whether lower rates of carotid imaging, endarterectomy, and lipid-lowering therapy in women reflect undertreatment of women or are appropriate based on patient eligibility.

Ataque Isquêmico Transitório/diagnóstico , Ataque Isquêmico Transitório/mortalidade , Sistema de Registros , Caracteres Sexuais , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Estudos de Coortes , Feminino , Humanos , Masculino , Mortalidade/tendências , Ontário/epidemiologia
AAOHN J ; 57(9): 374-80, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19842612


Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the "year" variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.

Remoção , Satisfação do Paciente , Transferência de Pacientes/métodos , Prevenção de Acidentes , Desenho de Equipamento , Equipamentos e Provisões Hospitalares , Ergonomia , Humanos , Entrevistas como Assunto , Qualidade da Assistência à Saúde
Injury ; 40(9): 987-92, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19486965


Mechanical lifting devices have been developed to reduce healthcare worker injuries related to patient handling. The purpose of this study was to evaluate ceiling lifts in comparison to floor lifts based on transfer time, patient comfort and staff perceptions in three long-term care facilities with varying ceiling lift coverage. The time required to transfer or reposition patients along with patient comfort levels were recorded for 119 transfers. Transfers performed with ceiling lifts required on average less time (bed to chair transfers: 156.9 seconds for ceiling lift, 273.6 seconds for floor lift) and were found to be more comfortable for patients. In the three facilities, 143 healthcare workers were surveyed on their perceptions of patient handling tasks and equipment. For both transferring and repositioning tasks, staff preferred to use ceiling lifts and also found them to be less physically demanding. Further investigation is needed on repositioning tasks to ensure safe practice.

Atitude do Pessoal de Saúde , Equipamentos e Provisões Hospitalares/normas , Movimentação e Reposicionamento de Pacientes/instrumentação , Satisfação do Paciente , Adulto , Idoso , Colúmbia Britânica , Desenho de Equipamento , Feminino , Humanos , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade , Movimentação e Reposicionamento de Pacientes/psicologia , Movimentação e Reposicionamento de Pacientes/normas , Dor/etiologia , Dor/prevenção & controle , Percepção , Projetos Piloto , Fatores de Tempo , Adulto Jovem