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BMC Medicine

Robert D Schweitzer, Lyn Vromans, Mark Brough, Mary Asic-Kobe, Ignacio Correa-Velez, Kate Murray, Caroline Lenette
BACKGROUND: Despite increasing numbers of refugee women-at-risk being resettled and their potential vulnerability, there exists no empirical research into the psychiatric health of this unique subgroup with which to guide policy and practice. This research aimed to investigate psychiatric symptom status of a sample of refugee women-at-risk recently resettled in Australia, as well as factors contributing to symptoms of trauma, anxiety, depression, and somatization. The level of psychiatric symptomatology is compared to reference groups of women from Sudan and Burma, who entered Australia under the Humanitarian Entry Programme, and who did not meet criteria as women-at-risk...
September 18, 2018: BMC Medicine
Elizabeth Cecil, Alex Bottle, Richard Ma, Dougal S Hargreaves, Ingrid Wolfe, Arch G Mainous, Sonia Saxena
BACKGROUND: Universal health coverage (UHC) aims to improve child health through preventive primary care and vaccine coverage. Yet, in many developed countries with UHC, unplanned and ambulatory care sensitive (ACS) hospital admissions in childhood continue to rise. We investigated the relation between preventive primary care and risk of unplanned and ACS admission in children in a high-income country with UHC. METHODS: We followed 319,780 children registered from birth with 363 English practices in Clinical Practice Research Datalink linked to Hospital Episodes Statistics, born between January 2000 and March 2013...
September 17, 2018: BMC Medicine
Gillian H Stresman, Julia Mwesigwa, Jane Achan, Emanuele Giorgi, Archibald Worwui, Musa Jawara, Gian Luca Di Tanna, Teun Bousema, Jean-Pierre Van Geertruyden, Chris Drakeley, Umberto D'Alessandro
BACKGROUND: Despite the biological plausibility of hotspots fueling malaria transmission, the evidence to support this concept has been mixed. If transmission spreads from high burden to low burden households in a consistent manner, then this could have important implications for control and elimination program development. METHODS: Data from a longitudinal cohort in The Gambia was analyzed. All consenting individuals residing in 12 villages across the country were sampled monthly from June (dry season) to December 2013 (wet season), in April 2014 (mid dry season), and monthly from June to December 2014...
September 14, 2018: BMC Medicine
Hawkar Ibrahim, Verena Ertl, Claudia Catani, Azad Ali Ismail, Frank Neuner
BACKGROUND: In August 2014, the Islamic State of Iraq and Syria (ISIS), a terrorist organization, attacked the Yazidi's ancestral homeland in northwestern Iraq. Among other atrocities, they abducted thousands of women and girls and traded many of them into sexual slavery. The aim of this study is to determine the mental health of women and girl survivors of these events in relation to enslavement and experiences with genocide-related events, as well as perceived social rejection in their community...
September 13, 2018: BMC Medicine
Zobair M Younossi, Azza Karrar, Mariaelena Pierobon, Aybike Birerdinc, Maria Stepanova, Dinan Abdelatif, Zahra Younoszai, Thomas Jeffers, Sean Felix, Kianoush Jeiran, Alex Hodge, Weidong Zhou, Fanny Monge, Lakshmi Alaparthi, Vikas Chandhoke, Zachary D Goodman, Emanuel F Petricoin
BACKGROUND: Non-alcoholic steatohepatitis (NASH) is among the leading causes of liver disease worldwide. It is increasingly recognized that the phenotype of NASH may involve a number of different pathways, of which each could become important therapeutic targets. The aim of this study is to use high resolution mass spectrometry (MS) and phosphoproteomics techniques to assess the serum proteome and hepatic phosphoproteome in subjects with NASH-related fibrosis. METHODS: Sixty-seven biopsy-proven NAFLD subjects with frozen sera and liver tissue were included...
September 12, 2018: BMC Medicine
Yu-Tzu Wu, Linda Clare, John V Hindle, Sharon M Nelis, Anthony Martyr, Fiona E Matthews
BACKGROUND: The heterogeneity of symptoms across dementia subtypes has important implications for clinical practice and dementia research. Variation in subtypes and associated symptoms may influence the capability to live well for people with dementia and carers. The aim of this study is to investigate the potential impact of dementia subtypes on the capability to live well for both people with dementia and their carers. METHODS: The analysis was based on the 1283 dyads of community-dwelling people with dementia and carers in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) project, a large cohort study in Great Britain...
September 11, 2018: BMC Medicine
P Bruijning-Verhagen, J A P van Dongen, J D M Verberk, R Pijnacker, R D van Gaalen, D Klinkenberg, H E de Melker, M-J J Mangen
BACKGROUND AND OBJECTIVE: Since 2013, a biennial rotavirus pattern has emerged in the Netherlands with alternating high and low endemic years and a nearly 50% reduction in rotavirus hospitalization rates overall, while infant rotavirus vaccination has remained below 1% throughout. As the rotavirus vaccination cost-effectiveness and risk-benefit ratio in high-income settings is highly influenced by the total rotavirus disease burden, we re-evaluated two infant vaccination strategies, taking into account this recent change in rotavirus epidemiology...
September 10, 2018: BMC Medicine
Christopher Burton, Alison Elliott, Amanda Cochran, Tom Love
BACKGROUND: The science of complex systems has been proposed as a way of understanding health services and the demand for them, but there is little quantitative evidence to support this. We analysed patterns of healthcare use in different urgent care settings to see if they showed two characteristic statistical features of complex systems: heavy-tailed distributions (including the inverse power law) and generative burst patterns. METHODS: We conducted three linked studies...
September 7, 2018: BMC Medicine
Jennifer M Ross, Nathaniel J Henry, Laura A Dwyer-Lindgren, Andrea de Paula Lobo, Fatima Marinho de Souza, Molly H Biehl, Sarah E Ray, Robert C Reiner, Rebecca W Stubbs, Kirsten E Wiens, Lucas Earl, Michael J Kutz, Natalia V Bhattacharjee, Hmwe H Kyu, Mohsen Naghavi, Simon I Hay
BACKGROUND: Brazil has high burdens of tuberculosis (TB) and HIV, as previously estimated for the 26 states and the Federal District, as well as high levels of inequality in social and health indicators. We improved the geographic detail of burden estimation by modelling deaths due to TB and HIV and TB case fatality ratios for the more than 5400 municipalities in Brazil. METHODS: This ecological study used vital registration data from the national mortality information system and TB case notifications from the national communicable disease notification system from 2001 to 2015...
September 6, 2018: BMC Medicine
Minah Park, Mark Jit, Joseph T Wu
BACKGROUND: There is increasing interest in estimating the broader benefits of public health interventions beyond those captured in traditional cost-utility analyses. Cost-benefit analysis (CBA) in principle offers a way to capture such benefits, but a wide variety of methods have been used to monetise benefits in CBAs. METHODS: To understand the implications of different CBA approaches for capturing and monetising benefits and their potential impact on public health decision-making, we conducted a CBA of human papillomavirus (HPV) vaccination in the United Kingdom using eight methods for monetising health and economic benefits, valuing productivity loss using either (1) the human capital or (2) the friction cost method, including the value of unpaid work in (3) human capital or (4) friction cost approaches, (5) adjusting for hard-to-fill vacancies in the labour market, (6) using the value of a statistical life, (7) monetising quality-adjusted life years and (8) including both productivity losses and monetised quality-adjusted life years...
September 5, 2018: BMC Medicine
Winnie Lau, Derrick Silove, Ben Edwards, David Forbes, Richard Bryant, Alexander McFarlane, Dusan Hadzi-Pavlovic, Zachary Steel, Angela Nickerson, Miranda Van Hooff, Kim Felmingham, Sean Cowlishaw, Nathan Alkemade, Dzenana Kartal, Meaghan O'Donnell
BACKGROUND: High-income countries like Australia play a vital role in resettling refugees from around the world, half of whom are children and adolescents. Informed by an ecological framework, this study examined the post-migration adjustment of refugee children and adolescents 2-3 years after arrival to Australia. We aimed to estimate the overall rate of adjustment among young refugees and explore associations with adjustment and factors across individual, family, school, and community domains, using a large and broadly representative sample...
September 4, 2018: BMC Medicine
Mina Fazel
The ever-increasing number of reasons forcing people to flee from their homes to new, safer places either within their countries of origin, into neighbouring countries or across continental, conversant and cultural boundaries has led to a humanitarian crisis to which scientific enquiry must increasingly contribute. Yet, little is known about how best to support refugee adults and children in the process of resettling in high-income nations, an issue which the recent study by Lau et al. published in this journal, is attempting to address...
September 4, 2018: BMC Medicine
Gregg S Gonsalves, J Tyler Copple, Tyler Johnson, A David Paltiel, Joshua L Warren
BACKGROUND: We have previously conducted computer-based tournaments to compare the yield of alternative approaches to deploying mobile HIV testing services in settings where the prevalence of undetected infection may be characterized by 'hotspots'. We report here on three refinements to our prior assessments and their implications for decision-making. Specifically, (1) enlarging the number of geographic zones; (2) including spatial correlation in the prevalence of undetected infection; and (3) evaluating a prospective search algorithm that accounts for such correlation...
September 3, 2018: BMC Medicine
Rebecca F Goldstein, Sally K Abell, Sanjeeva Ranasinha, Marie L Misso, Jacqueline A Boyle, Cheryce L Harrison, Mary Helen Black, Nan Li, Gang Hu, Francesco Corrado, Hanne Hegaard, Young Ju Kim, Margaretha Haugen, Won O Song, Min Hyoung Kim, Annick Bogaerts, Roland Devlieger, Judith H Chung, Helena J Teede
BACKGROUND: The association between Institute of Medicine (IOM) guidelines and pregnancy outcomes across ethnicities is uncertain. We evaluated the associations of gestational weight gain (GWG) outside 2009 IOM guidelines, with maternal and infant outcomes across the USA, western Europe and east Asia, with subgroup analyses in Asia. The aim was to explore ethnic differences in maternal prepregnancy body mass index (BMI), GWG and health outcomes across these regions. METHODS: Systematic review, meta-analysis and meta-regression of observational studies were used for the study...
August 31, 2018: BMC Medicine
Sean M Moore, Quirine A Ten Bosch, Amir S Siraj, K James Soda, Guido España, Alfonso Campo, Sara Gómez, Daniela Salas, Benoit Raybaud, Edward Wenger, Philip Welkhoff, T Alex Perkins
BACKGROUND: Mathematical models of transmission dynamics are routinely fitted to epidemiological time series, which must inevitably be aggregated at some spatial scale. Weekly case reports of chikungunya have been made available nationally for numerous countries in the Western Hemisphere since late 2013, and numerous models have made use of this data set for forecasting and inferential purposes. Motivated by an abundance of literature suggesting that the transmission of this mosquito-borne pathogen is localized at scales much finer than nationally, we fitted models at three different spatial scales to weekly case reports from Colombia to explore limitations of analyses of nationally aggregated time series data...
August 30, 2018: BMC Medicine
Ankur Pandya, Tim Doran, Jinyi Zhu, Simon Walker, Emily Arntson, Andrew M Ryan
BACKGROUND: Introduced in 2004, the United Kingdom's (UK) Quality and Outcomes Framework (QOF) is the world's largest primary-care pay-for-performance programme. Given some evidence of the benefits and the substantial costs associated with the QOF, it remains unclear whether the programme is cost-effective. Therefore, we assessed the cost-effectiveness of continuing versus stopping the QOF. METHODS: We developed a lifetime simulation model to estimate quality-adjusted life years (QALYs) and costs for a UK population cohort aged 40-74 years (n = 27,070,862) exposed to the QOF and for a counterfactual scenario without exposure...
August 29, 2018: BMC Medicine
Alison F Crawshaw, Manish Pareek, John Were, Steffen Schillinger, Olga Gorbacheva, Kolitha P Wickramage, Sema Mandal, Valerie Delpech, Noel Gill, Hilary Kirkbride, Dominik Zenner
BACKGROUND: The UK, like a number of other countries, has a refugee resettlement programme. External factors, such as higher prevalence of infectious diseases in the country of origin and circumstances of travel, are likely to increase the infectious disease risk of refugees, but published data is scarce. The International Organization for Migration carries out and collates data on standardised pre-entry health assessments (HA), including testing for infectious diseases, on all UK refugee applicants as part of the resettlement programme...
August 28, 2018: BMC Medicine
Holger Fröhlich, Rudi Balling, Niko Beerenwinkel, Oliver Kohlbacher, Santosh Kumar, Thomas Lengauer, Marloes H Maathuis, Yves Moreau, Susan A Murphy, Teresa M Przytycka, Michael Rebhan, Hannes Röst, Andreas Schuppert, Matthias Schwab, Rainer Spang, Daniel Stekhoven, Jimeng Sun, Andreas Weber, Daniel Ziemek, Blaz Zupan
BACKGROUND: Personalized, precision, P4, or stratified medicine is understood as a medical approach in which patients are stratified based on their disease subtype, risk, prognosis, or treatment response using specialized diagnostic tests. The key idea is to base medical decisions on individual patient characteristics, including molecular and behavioral biomarkers, rather than on population averages. Personalized medicine is deeply connected to and dependent on data science, specifically machine learning (often named Artificial Intelligence in the mainstream media)...
August 27, 2018: BMC Medicine
I Sermet-Gaudelus, M Renouil, A Fajac, L Bidou, B Parbaille, S Pierrot, N Davy, E Bismuth, P Reinert, G Lenoir, J F Lesure, J P Rousset, A Edelman
The original article [1] contains errors in Table 1 affecting some of the presented oligonucleotide sequences and readthrough values in Table 1.
August 25, 2018: BMC Medicine
Arun J Sanyal
Non-alcoholic fatty liver disease (NAFLD) has emerged as a common cause of liver-related morbidity and mortality. Tackling this condition at a societal level will require a clear understanding of the burden of disease in the general population. However, a major limitation of such an assessment, particularly in a real-world setting, is the low rate of diagnosis of the condition, as recently identified by Alexander et al. (BMC Med 16:130, 2018). Therein, the likelihood that the condition is indeed underdiagnosed and the potential causes for such underdiagnosis are discussed...
August 24, 2018: BMC Medicine
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