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Nashville, TN, United States

Tome D.,Bernard Health
British Journal of Nutrition | Year: 2012

Dietary proteins are found in animal products, plant products and single-cell organisms. Proteins are present in variable proportions in these different food sources and the different proteins also differ in their amino acid composition, dietary indispensable amino acid content and physico-chemical properties. Different criteria can be used to define dietary protein requirements and different markers can be used to assess nutritional protein quality according to the criteria used for protein requirement estimation. The current approach to determining protein requirements is related to nitrogen balance and the dietary indispensable amino acid score approach relates protein quality to the capacity of protein to allow reaching nitrogen balance by providing nitrogen and indispensable amino acids. A second approach considers more directly protein nitrogen utilization by the body and includes measurement of protein digestibility and of the efficiency of dietary nitrogen retention at maintenance or for protein deposition at the whole body level or in more specific body areas. Another approach is related to protein turnover and protein synthesis in relation to maintenance and/or efficiency for deposition or development (growth) at the whole body level or for different and more specific target tissues such as muscle or bone. Lastly, protein quality can also be evaluated from different markers used as risk factors for metabolic dysfunction and disorders related for instance to insulin resistance, diabetes and obesity or cardio-vascular disease. The accuracy and relevance of these different approaches is discussed regarding the capacity of the different protein sources (i.e. animal as meat, milk or eggs, legume as soya or pea, or cereal as wheat or rice) to satisfy protein requirements according to these different criteria and markers. © 2012 The Author.

Drewes A.M.,Aarhus University Hospital | Drewes A.M.,University of Aalborg | Jensen R.D.,Bernard Health | Nielsen L.M.,Aarhus University Hospital | And 5 more authors.
British Journal of Clinical Pharmacology | Year: 2013

Clinical studies comparing the response and side effects of various opioids have not been able to show robust differences between drugs. Hence, recommendations of the regulatory authorities have been driven by costs with a general tendency in many countries to restrict physician's use of opioids to morphine. Although this approach is recognized as cost-effective in most cases there is solid evidence that, on an individual patient basis, opioids are not all equal. Therefore it is important to have an armamentarium of strong analgesics in clinical practice to ensure a personalized approach in patients who do not respond to standard treatment. In this review we highlight differences between opioids in human studies from a pharmacological, experimental, clinical and health economics point of view. We provide evidence that individuals respond differently to opioids, and that general differences between classes of opioids exist. We recommend that this recognition is used to individualize treatment in difficult cases allowing physicians to have a wide range of treatment options. In the end this will reduce pain and side effects, leading to improved quality of life for the patient and reduce the exploding pain related costs. © 2012 The British Pharmacological Society.

Cohen S.-Y.,Center Ophtalmologique Dimagerie Et Of Laser | Souied E.H.,Creteil University Eye Clinic | Weber M.,University of Nantes | Dupeyron G.,University of Nimes | And 3 more authors.
Graefe's Archive for Clinical and Experimental Ophthalmology | Year: 2011

Background: Age-related macular degeneration is the primary cause of blindness in developed countries. Current treatments of this degenerative disease mainly include laser, photodynamic therapy with verteporfin and administration of anti-vascular endothelial growth factors. The LUEUR (LUcentis® En Utilisation Réelle) study is composed of a cross-sectional part (LUEUR1), which examined the current management of wet AMD in France, and a follow-up part (LUEUR2), which will assess the development of patients treated for wet AMD over 4 years. Here we describe the results of LUEUR1. Methods: Patients with wet AMD were enrolled during a routine medical examination in LUEUR1, a cross-sectional, observational, prospective, multicentre study. Investigators recorded patient demographics, visual acuity, characteristics of wet AMD lesions, date of AMD diagnosis, comorbidities, previous treatments, treatments prescribed at inclusion, and low vision rehabilitation. Results: A total of 72 investigators recruited 1,019 patients with wet AMD, corresponding to 1,405 eyes affected by the disease. The mean age of patients was 78.7±7.3 years. Most were female (62.3%) and non-smokers (66.9%). The mean visual acuity was 49.12±24.18 Early Treatment Diabetic Retinopathy Study letters. Most eyes showed occult (52.8%) and subfoveal (84.6%) choroidal neovascularisation. Bilateral wet AMD affected 37.9% of patients. The median time since diagnosis was 12 months. Ranibizumab-based therapy (67.3%) and photodynamic therapy (29.8%) were the most frequent previous treatments. Prior to inclusion, 5.6% of patients had low vision rehabilitation. When a treatment was prescribed on the day of inclusion, it was most often ranibizumab (89.0% of all treatments at inclusion). Conclusions: The results of this study illustrate the impact of anti-vascular endothelial growth factor therapies on the treatment of wet AMD in a real-life context. Specifically, ranibizumab-based therapy appears to have largely replaced laser photocoagulation and verteporfin-based photodynamic therapy. © 2010 Springer-Verlag.

Jourdan D.,University Blaise Pascal | Stirling J.,University Blaise Pascal | Mannix McNamara P.,University of Limerick | Pommier J.,Bernard Health | Pommier J.,Health Education in Schools Research Unit
Health Promotion International | Year: 2011

The objectives of the study were to identify the professional issues that teachers perceived as important in their commitment to a health promotion (HP) programme launched in their schools and to understand their perceptions of the impact of the programme on themselves as professionals, individuals, on students, on school staff and on the relationship with students' families. A mixed methods design was used. An anonymous questionnaire was distributed to 54 participating teachers exploring their practices and perceptions of the programme and 26 semi-structured interviews were conducted which examined their professional commitment to the programme. The main factors that teachers identified as shaping their commitment were (1) their perceptions of the programme, specifically, its congruence with their own role and practice and also their perceived impact of the programme upon whole staff relations and (2) the specific school environment including school organization, quality of the relationships with parents and student behaviour. If HP programmes are to be successfully developed in schools, it is necessary to anchor them within the schools' mission. HP programmes need to make sense to teachers' educational perspectives. They need to be responsive to school needs. They also need to be cognisant of the internal tensions that programme implementation can engender among the whole staff, some of whom may be committed to HP in their school, while others, may not value HP in the same way. Therefore, implementation processes that are respectful of the challenges schools encounter and of the differing ontological perspectives that teachers may hold with regard to HP is important. © The Author (2011).

News Article | April 23, 2015
Site: www.bernardhealth.com

Up to six million Americans are expected to pay a tax penalty this year for not having health insurance coverage in 2014. To help families avoid future penalties, a special enrollment period for the Health Insurance Marketplace opened on March 15, 2015, and will close April 30, 2015. This special enrollment period is an additional time outside of open enrollment during which you and your family have a right to sign up for health coverage. This will be your last chance this year to receive health coverage through the Health Insurance Marketplace and avoid a tax penalty for next year. Health coverage helps cover the cost of medical services, tests and treatments that assist you in getting and staying healthy. The required basic level of coverage includes preventive care, health screenings, well woman and prenatal care, immunizations for adults and children, treatment for pre-existing conditions, and the cost of some prescription medications. Surveys have shown that nearly half of uninsured adults are unaware of the penalty associated with not having health coverage. In 2014, the penalty for not having the required minimum level of health coverage was up to $95 per uninsured person or 1% of a household’s income. For 2015, this amount will more than double, with the penalty per uninsured person reaching $325 or 2% of a household’s income. There are exemptions available to those who cannot afford coverage or who have experienced hardship. Consult Healthcare.gov or an Bernard Health advisor to see if you qualify for an exemption. The special enrollment period is designed for the following: Macon County General Hospital can help you learn more about the special enrollment period, what tax penalties you may face for not having health coverage and what health plans are available to you. We have an advisor onsite to support you in the application process. “We’re offering this service to individuals and families. Health insurance is confusing,” said Bernard Health Team Member Mallory Jones. “It’s more like filing taxes than buying car insurance and people need help with it. We have an advisor set up at MCGH. Her name is Rachel Hesson. She is there 5 days a week to meet with either people that come through the ER, or people in the community that make an appointment with her.” “It is a free service when you come into the hospital. It’s an awesome opportunity to get this advice,” she said. Contact them today. You can call 615-666-2147. Rachel Hesson is available for phone or in-person appointments. Don’t be caught off guard by not being covered. Learn the value of health insurance and get covered today. Bernard Health was featured in the Macon County Times this past week. The article, written by Reporter Stacey Morgan, touches on the importance of having healthcare coverage and she gives the readers the basic facts about the March 15th-April 30th Special Enrollment Period for Marketplace coverage. This column originally appeared in the March 30th edition of the Macon County Times. If you enjoyed this post, you may like Top 5 Ways Hospitals are Helping Patients Find Health Insurance.

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