Research Spotlight

Posted September 15th 2016

Cardiac Electromechanical Abnormalities in Hemodialysis Patients: Indicators of Cardiomyopathy and Future Risk.

Peter McCullough M.D.

Peter McCullough M.D.

Fallahzadeh, M. K. and P. A. McCullough (2015). “Cardiac electromechanical abnormalities in hemodialysis patients: Indicators of cardiomyopathy and future risk.” Am J Nephrol 42(3): 237-238.

Full text of this article.

Cardiovascular diseases (CVDs) are more common in chronic kidney disease and end-stage renal disease (ESRD) patients as compared with general population and are a major of cause of morbidity and mortality in this population [1,2]. CVD accounts for approximately 50% of mortality in ESRD patients. In addition to the increased chance of coronary artery disease, the chance of developing arrhythmic events and sudden cardiac death is also higher in ESRD patients [3,4]. The underlying pathophysiology behind this increased chance of arrhythmic event in hemodialysis patients is not clearly understood. Previous studies have shown that hemodialysis patients have lower left ventricular ejection fraction and higher atrial diameters as compared with general population [5,6,7]. Using the timing of electrocardiogram and tissue Doppler on echocardiography, the time from electrical activation to muscular contraction can be assessed. Atrial electromechanical delay (AEMD) times have been reported to be longer in ESRD patients and have been shown to improve after each hemodialysis session [6,7,8]. Additionally, prolonged atrial conduction times are considered as predisposing factors for atrial fibrillation [9]. In this issue of Journal, Turkmen et al. [10] from Turkey have compared the cardiac electromechanical characteristics and biochemical profile of 60 hemodialysis patients versus 44 healthy controls. They also followed the hemodialysis patients for 2 years and compared the characteristics of 19 patients who died within this 2-year period versus 41 living hemodialysis patients.


Posted September 15th 2016

Stress and burnout among gynecologic oncologists: A Society of Gynecologic Oncology Evidence-based Review and Recommendations.

Carolyn M. Matthews M.D.

Carolyn M. Matthews M.D.

Cass, I., L. R. Duska, S. V. Blank, G. Cheng, N. C. duPont, P. J. Frederick, E. K. Hill, C. M. Matthews, T. L. Pua, K. S. Rath, R. Ruskin, P. H. Thaker, A. Berchuck, B. S. Gostout, D. M. Kushner and J. M. Fowler (2016). “Stress and burnout among gynecologic oncologists: A society of gynecologic oncology evidence-based review and recommendations.” Gynecol Oncol: 2016 Aug [Epub ahead of print].

Full text of this article.

Burnout has been studied among medical oncologists and surgeons; however, there is less data specific to gynecologic oncolxogists [14] and [15]. Job satisfaction and work related stress among gynecologic oncologists have been assessed [2], but until recently, burnout was not assessed. Two large, seminal studies, a 2014 survey of 369 members of the Society of Gynecologic Oncologists (SGO) and a 2008 survey of 7900 members of the American College of Surgeons (ACS), established the high prevalence of physician burnout in gynecologic oncologists and surgeons respectively, affecting 32%–40% of responders [16] and [17]. Both works are cited throughout this paper and were driving forces motivating the Society of Gynecologic Oncology (SGO) to assemble a Wellness Task Force to address this issue. This paper represents an effort by the Task Force to acknowledge the high rate of burnout in gynecologic oncology as a specialty by bringing the subject forward for discussion, and exploring potential solutions.


Posted September 15th 2016

Designing Incentives to Change Behaviors: Examining College Student Intent Toward Healthy Diets.

Brandon Pope Ph.D.

Brandon Pope Ph.D.

McComb, S., C. Jones, A. Smith, W. Collins and B. Pope (2016). “Designing incentives to change behaviors: Examining college student intent toward healthy diets.” West J Nurs Res 38(9): 1094-1113.

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College is a time when young adults establish lifestyle habits. This research examines how personalization and limited resources might be balanced most effectively when designing incentives to shift college students’ intentions toward positive dietary changes. A randomized 2 x 2 experiment (Coaching/Coupons x Fruits and Vegetables/Low Fat) was conducted, where respondents were exposed to virtual interventions and asked pre- and post-intervention about their intent to eat healthy. Results suggest that interventions may incentivize students, but are dependent on student characteristics. On-campus students and students with more knowledge about healthy diets were more likely to increase their intent when offered coaching; students living off campus and those with less knowledge resonated with coupons. On- and off-campus students differed in their positive responses to eating fruits and vegetables versus low fat foods, respectively. Younger students may be more susceptible to interventions. Findings may be useful in designing meaningful incentives for college students.


Posted September 15th 2016

Association between dietary acid load and the risk of cardiovascular disease: nationwide surveys (KNHANES 2008-2011).

Hyun Joon Shin M.D.

Hyun Joon Shin M.D.

Han, E., G. Kim, N. Hong, Y. H. Lee, D. W. Kim, H. J. Shin, B. W. Lee, E. S. Kang, I. K. Lee and B. S. Cha (2016). “Association between dietary acid load and the risk of cardiovascular disease: Nationwide surveys (knhanes 2008-2011).” Cardiovasc Diabetol 15(1): 122.

Full text of this article.

BACKGROUND: Acid-base imbalance has been reported to increase incidence of hypertension and diabetes. However, the association between diet-induced acid load and cardiovascular disease (CVD) risk in the general population has not been fully investigated. METHODS: This was a population-based, retrospectively registered cross-sectional study using nationally representative samples of 11,601 subjects from the Korea National Health and Nutrition Examination Survey 2008-2011. Individual CVD risk was evaluated using atherosclerotic cardiovascular disease (ASCVD) risk equations according to 2013 ACC/AHA guideline assessment in subjects aged 40-79 without prior CVD. Acid-base status was assessed with both the potential renal acid load (PRAL) and the dietary acid load (DAL) scores derived from nutrient intake. RESULTS: Individuals in the highest PRAL tertile had a significant increase in 10 year ASCVD risks (9.6 vs. 8.5 %, P < 0.01) and tended to belong to the high-risk (10 year risk >10 %) group compared to those in the lowest PRAL tertile (odds ratio [OR] 1.23, 95 % confidence interval [CI] 1.22-1.35). The association between higher PRAL score and high CVD risk was stronger in the middle-aged group. Furthermore, a multiple logistic regression analysis also demonstrated this association (OR 1.20 95 % CI 1.01-1.43). Subgroup analysis stratified obesity or exercise status; individuals in unhealthy condition with lower PRAL scores had comparable ASCVD risk to people in the higher PRAL group that were in favorable physical condition. In addition, elevated PRAL scores were associated with high ASCVD risk independent of obesity, exercise, and insulin resistance, but not sarcopenia. Similar trends were observed with DAL scores. CONCLUSION: Diet-induced acid load was associated with increased risk of CVD, independent of obesity and insulin resistance.


Posted September 15th 2016

Mobile Apps for Educational Purposes.

Jobeth Pilcher Ed.D.

Jobeth Pilcher Ed.D.

Pilcher, J. (2016). “Mobile apps for educational purposes.” J Nurses Prof Dev: 2016 Aug [Epub ahead of print].

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With the growing number of mobile resources, nurse educators and professional development practitioners have the opportunity to harness mobile applications as a tool for their education toolbox. Yet, the overwhelming availability of choices can lead to questions, such as the following: How do we locate apps without spending huge amounts of our valuable time? How do we know which apps to choose? How can we evaluate apps? This article is aimed at addressing these questions.