Pivotal (Canada)

Purpose: Health care disparities exist for people from culturally and linguistically diverse (CALD) communities. Addressing the cultural competence of health care providers could limit these disparities. The aim of this study was to improve cultural knowledge of and humility regarding pain in a CALD community. Method: This interpretive description qualitative study used focus group discussions (FGDs) to generate ideas about how South Asian culture could influence how health care providers manage pain. A total of 14 people with pain and of South Asian background (6 women and 8 men, aged 28-70 y) participated. Two investigators independently analyzed the data. This process involved repeatedly reading the transcripts, then manually sorting the key messages into categories. The investigators compared their categorizations and resolved differences through discussion. Next, similar categories and concepts were grouped into ideas (potential themes). These ideas, along with supporting categories and verbatim quotes, were presented to the full research team for feedback. After compiling the feedback, the ideas formed the thematic representation of the data. Results: The data from the FGDs revealed how pain management could be culturally adapted. The FGDs generated four themes about South Asian cultural perspectives that could influence the pain management experience for people living with pain: (1) cultural and linguistic impediments to communication, (2) understanding of pain in terms of the extent to which it interferes with function and work, (3) nurturing or personal attention as a marker of good care, and (4) value attributed to traditional ideas of illness and treatment. Conclusion: This study demonstrates how engaging with CALD people living with pain can lead to improved cultural knowledge and humility that can form the basis for adapting pain management. Through this process, it is more likely that a meaningful and client-centred pain management plan can be developed.

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Enterprises perceive a huge opportunity in mining information that can be found in big data. New storage systems and processing paradigms are allowing for ever larger data sets to be collected and analyzed. The high demand for data analytics and rapid development in technologies has led to a sizable ecosystem of big data processing systems. However, the lack of established, standardized benchmarks makes it difficult for users to choose the appropriate systems that suit their requirements. To address this problem, we have developed the BigBench benchmark specification. BigBench is the first end-to-end big data analytics benchmark suite. In this paper, we present the BigBench benchmark and analyze the workload from technical as well as business point of view. We characterize the queries in the workload along different dimensions, according to their functional characteristics, and also analyze their runtime behavior. Finally, we evaluate the suitability and relevance of the workload from the point of view of enterprise applications, and discuss potential extensions to the proposed specification in order to cover typical big data processing use cases.

Purpose: Severe Omega-3 (OM3) nutritional deficiency has been previously correlated to an increased of sudden death and based upon plasma OM3 levels, risk quartiles have been defined. However, studies that monitor the correction of OM3 deficiency (measured as Omega-Score, OS) with treatment with an OM3 formulation, and improvement of Cardiovascular Disease (CVD) factors have not been systematically evaluated. The purpose of this study was to determine the extent of OM3 deficiency in the general and CVD populace and to investigate how treatment with a unique OM3 formulation comprised of >90% pure OM3, with a 6:1 EPA: DHA ratio (eicosapentaenoic acid: docosapentaenoic acid, 6:1-OM3) corrects this deficiency, and improves CVD factors. Methods: The primary endpoints of this randomized, double blind, placebo-controlled trial were the change in the OS (plasma EPA + DHA + docosapentaenoic acid) with secondary endpoints including the change in serum TG, lipoprotein cholesterol (VLDL, LDL, HDL, ApoB, and subfractions), and hsCRP. 655 subjects were screened, and 110 subjects that met all study criteria (including OS <6.1%) were randomized and stratified by baseline TG levels (Cohort 1: 90-199 mg/dL, and Cohort 2: 200-500mg/dL). Treatment included placebo (4g/day corn oil, n=54) and 6:1-OM3 (4g/day; n=56) for an 8-week study period. Results: 89% of screened (n=655) CVD subjects were found to be nutritionally deficient in OM3 (OS <6.1%). The median baseline OS was 3.64% for Cohort 1, and 3.15% for Cohort 2. After 8 weeks of treatment, a significant (p<0.0001) increase was observed for both Cohorts, resulting in an OS increase of 134% for Cohort 1 and 120% for Cohort 2. In normal and mildly hypertriglyceridemic subjects (90-199 mg TG/dL), no significant changes in lipid profiles were observed. However in moderately hypertriglyceridemic subjects (200-500 mg TG/dL), a placebo-corrected TG reduction of 48% (p=0.0005), VLDL-C reduction of 30% (p=0.0023) and HDL-C increase of 9% (p=0.0069) without significantly affecting LDL-C, ApoB or hsCRP levels was observed. Conclusions: This study confirms that OM3 deficiency is highly prevalent in patients with CVD. In patients with moderate hypertriglyceridemia, treatment with 6:1-OM3 corrects the deficiency and results in a concomitant and significant placebo-corrected reduction in TG and VLDL, and increase in HDL-C without adversely affecting LDL-C.