Combination of Psychiatric and Psychological Approaches in the Assessment and Treatment of Sexual Offenders

This review discusses the association between mental disorders and sexual offending, and provides an overview of the combination of psychiatric and psychological approaches to assess and treat sexual offenders at the Sex Offender Evaluation and Treatment Unit in Siu Lam Psychiatric Centre in Hong Kong.

Addressing Prescription Discrepancies in Renal Patients: A Prospective Audit

Background

Management of chronic renal failure requires complex medication regimens to manage hypertension, hyperlipidaemia, diabetes, phosphate, anaemia and acidosis. Patient engagement in medicine management is essential to avoid potential harm.

Methods

We prospectively audited the rate of discrepancies between our hospital record of patient medications and their current prescription. We investigated whether changes to appointment letters reduced the number of discrepancies.

Results

The proportion of patients attending renal outpatient clinics failing to bring a list or unable to recall their medications fell over a 3-year period following changes to appointment letters (median proportion: 0.45 in 2014, 0.36 in 2015, 0.30 in 2016, Chi-sq = 46.94, p < 0.001); percentage of patients forgetting to bring a list with significant prescription discrepancies fell from 10.9% in 2014 to 3.9% in 2016).

Conclusion

Changes to appointment letters can potentially improve prescribing safety in an outpatient setting.

Does physical activity protect against the development of gastroesophageal reflux disease, Barrett's esophagus, and esophageal adenocarcinoma? A review of the literature with a meta-analysis

Physical activity affects the functioning of the gastrointestinal system through both local and systemic effects and may play an important role in reducing the risk of esophageal adenocarcinoma. This review assesses the biological mechanisms and epidemiological evidence for the relationship between physical activity and the development of esophageal adenocarcinoma and its precursor diseases: gastroesophageal reflux disease (GORD) and Barrett's esophagus. A search of PubMed, Medline, Embase, and CINAHL was conducted from their inceptions to 25th March 2017 for analytical studies that examined associations between recreational and/or occupational levels of physical activity and the risk of GORD, Barrett's esophagus, and esophageal adenocarcinoma. Where appropriate, a meta-analysis of effects was undertaken. Seven studies were included (2 cohort, 5 case control). For GORD, there were three case-control studies with 10 200 cases among 78 034 participants, with a pooled estimated OR of 0.67 (95% CI 0.57-0.78) for high versus low levels of recreational physical activity. In Barrett's esophagus, there was a single case-control study, which reported no association, OR 1.19 (95% CI 0.82-1.73). For esophageal adenocarcinoma, there were three studies (two prospective cohort, one case control) with 666 cases among 910 376 participants. The largest cohort study reported an inverse association for high versus low levels of recreational physical activity, RR 0.68, 95% CI 0.48-0.96. The remaining two studies reported no associations with either occupational or combined recreational and occupational activity. Heterogeneity in the measurement of exposure (recreational, occupational, and both) made a pooled estimate for esophageal adenocarcinoma inappropriate. Although limited, there is some evidence that higher levels of recreational physical activity may reduce the risk of both GORD and esophageal adenocarcinoma, but further large cohort studies examining the type, intensity and duration of activities that may be beneficial are needed.

American Diabetes Association - 77th Scientific Sessions (June 9-13, 2017 - San Diego, California, USA)

The 77th American Diabetes Association (ADA) Sci-entific Sessions took place in San Diego, California. The meeting brought together scientists and professionals from a wide range of disciplines in the field of diabetes and provided a platform for networking, allowing experts and researchers to share ideas and learn about the significant advances in diabetes research, treatment and care. Over the course of the 5 days, participants received exclusive access to more than 2,500 original research presentations.