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https://www.readbyqxmd.com/read/29040948/a-prospective-cohort-study-of-community-functioning-among-psychiatric-outpatients
#1
Alan H L Chan, Samuel Y S Wong, Wai-Tong Chien
The present study analyzed the community functioning among Chinese people with common mental disorders and their relationships with different factors under the framework of Model of Human Occupation. The research team followed up a stratified random sample of 238 patients in three public psychiatric specialist outpatient clinics in Hong Kong in one year. The patients completed assessments at baseline and 12-month follow-up in four areas of community functioning (i.e., self-care, independent living skills, social skills, and work skills), self-esteem, self-efficacy, physical functioning, behavioral regulation, mental states, family expressed emotion, and perceived social stigma...
October 10, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29040715/the-integrated-pain-team-a-mixed-methods-evaluation-of-the-impact-of-an-embedded-interdisciplinary-pain-care-intervention-on-primary-care-team-satisfaction-confidence-and-perceptions-of-care-effectiveness
#2
Natalie Purcell, Kara Zamora, Jenny Tighe, Yongmei Li, Mathew Douraghi, Karen Seal
OBJECTIVE:  To evaluate the impact of the Integrated Pain Team (IPT)-an interdisciplinary chronic pain care intervention embedded in primary care at a large Veterans Affairs health care system. Outcomes evaluated included IPT's impact on the perceived effectiveness of chronic pain care; provider self-confidence; and primary care team satisfaction, stress, and burnout. METHOD:  This mixed-methods quality-improvement study employed: 1) qualitative semistructured interviews of 61 primary care providers, other primary care team members, and organizational stakeholders; and 2) a supplementary quantitative survey of 65 providers, comparing those who had referred patients to IPT with those who had not...
October 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29040678/extended-models-for-nosocomial-infection-parameter-estimation-and-model-selection
#3
Alun Thomas, Karim Khader, Andrew Redd, Molly Leecaster, Yue Zhang, Makoto Jones, Tom Greene, Matthew Samore
We consider extensions to previous models for patient level nosocomial infection in several ways, provide a specification of the likelihoods for these new models, specify new update steps required for stochastic integration, and provide programs that implement these methods to obtain parameter estimates and model choice statistics. Previous susceptible-infected models are extended to allow for a latent period between initial exposure to the pathogen and the patient becoming themselves infectious, and the possibility of decolonization...
October 12, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/29040596/high-fidelity-phenotyping-richness-and-freedom-from-bias
#4
George Hripcsak, David J Albers
Electronic health record phenotyping is the use of raw electronic health record data to assert characterizations about patients. Researchers have been doing it since the beginning of biomedical informatics, under different names. Phenotyping will benefit from an increasing focus on fidelity, both in the sense of increasing richness, such as measured levels, degree or severity, timing, probability, or conceptual relationships, and in the sense of reducing bias. Research agendas should shift from merely improving binary assignment to studying and improving richer representations...
October 12, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29040531/survival-analysis-of-the-association-between-antenatal-care-attendance-and-neonatal-mortality-in-57-low-and-middle-income-countries
#5
David T Doku, Subas Neupane
Background: Neonatal mortality is unacceptably high in most low- and middle-income countries (LMICs). In these countries, where access to emergency obstetric services is limited, antenatal care (ANC) utilization offers improved maternal health and birth outcomes. However, evidence for this is scanty and mixed. We explored the association between attendance for ANC and survival of neonates in 57 LMICs. Methods: Employing standardized protocols to ensure comparison across countries, we used nationally representative cross-sectional data from 57 LMICs ( N  = 464 728) to investigate the association between ANC visits and neonatal mortality...
July 13, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29040498/genome-stability-of-bovine-in-vivo-conceived-cleavage-stage-embryos-is-higher-compared-to-invitro-produced-embryos
#6
Olga Tšuiko, Maaike Catteeuw, Masoud Zamani Esteki, Aspasia Destouni, Osvaldo Bogado Pascottini, Urban Besenfelder, Vitezslav Havlicek, Katrien Smits, Ants Kurg, Andres Salumets, Thomas D'Hooghe, Thierry Voet, Ann Van Soom, Joris Robert Vermeesch
STUDY QUESTION: Is the rate and nature of chromosome instability (CIN) similar between bovine in vivo-derived and in vitro-cultured cleavage-stage embryos? SUMMARY ANSWER: There is a major difference regarding chromosome stability of in vivo-derived and in vitro-cultured embryos, as CIN is significantly lower in in vivo-derived cleavage-stage embryos compared to in vitro-cultured embryos. WHAT IS KNOWN ALREADY: CIN is common during in vitro embryogenesis and is associated with early embryonic loss in humans, but the stability of in vivo-conceived cleavage-stage embryos remains largely unknown...
September 23, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29040497/the-association-between-fall-frequency-injury-risk-and-characteristics-of-falls-in-older-residents-of-long-term-care-do-recurrent-fallers-fall-more-safely
#7
Kimberley S van Schooten, Yijian Yang, Fabio Feldman, Ming Leung, Heather McKay, Joanie Sims-Gould, Stephen N Robinovitch
Background: Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. Methods: We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82±9 yrs) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip...
October 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29040431/prevention-of-breast-cancer-induced-osteolytic-bone-resorption-by-benzyl-isothiocyanate
#8
Subrata K Pore, Eun-Ryeong Hahm, Joseph D Latoche, Carolyn J Anderson, Yongli Shuai, Shivendra V Singh
Osteolytic bone resorption is the primary cause of pain and suffering (e.g., pathological bone fracture) in women with metastatic breast cancer. The current standard of care for patients with bone metastasis for reducing the incidence of skeletal complications includes bisphosphonates and a humanized antibody (denosumab). However, a subset of patients on these therapies still develops new bone metastasis or experience adverse effects. Moreover, some bisphosphonates have poor oral bioavailability. Therefore, orally-bioavailable and non-toxic inhibitors of breast cancer-induced osteolytic bone resorption are still clinically desirable...
October 11, 2017: Carcinogenesis
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#9
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29040321/co-delivery-of-micronized-urinary-bladder-matrix-damps-regenerative-capacity-of-minced-muscle-grafts-in-the-treatment-of-volumetric-muscle-loss-injuries
#10
Stephen M Goldman, Benjamin T Corona
Minced muscle grafts (MG) promote de novo muscle fiber regeneration and neuromuscular strength recovery in small and large animal models of volumetric muscle loss. The most noteworthy limitation of this approach is its reliance on a finite supply of donor tissue. To address this shortcoming, this study sought to evaluate micronized acellular urinary bladder matrix (UBM) as a scaffolding to promote in vivo expansion of this MG therapy in a rat model. Rats received volumetric muscle loss injuries to the tibialis anterior muscle of their left hind limb which were either left untreated or repaired with minced muscle graft at dosages of 50% and 100% of the defect mass, urinary bladder matrix in isolation, or a with an expansion product consisting of a combination of the two putative therapies in which the minced graft is delivered at a dosage of 50% of the defect mass...
2017: PloS One
https://www.readbyqxmd.com/read/29040316/rising-trends-and-inequalities-in-cesarean-section-rates-in-pakistan-evidence-from-pakistan-demographic-and-health-surveys-1990-2013
#11
Sarwat Mumtaz, Jinwook Bahk, Young-Ho Khang
Despite global efforts to improve maternal health, many developing countries including Pakistan have failed to achieve the target of a 75% reduction in maternal deaths by 2015. Addressing socioeconomic inequalities in access to emergency obstetric care is crucial for reducing the maternal mortality rate. This study was done to examine the time trends and socioeconomic inequalities in the utilization of cesarean section (C-section) in Pakistan during 1990-2013. We used data from the Pakistan Demographic and Health Surveys (PDHS) conducted during 1990 to 2013...
2017: PloS One
https://www.readbyqxmd.com/read/29040269/elevated-blood-pressure-and-risk-of-mitral-regurgitation-a-longitudinal-cohort-study-of-5-5-million-united-kingdom-adults
#12
Kazem Rahimi, Hamid Mohseni, Catherine M Otto, Nathalie Conrad, Jenny Tran, Milad Nazarzadeh, Mark Woodward, Terence Dwyer, Stephen MacMahon
BACKGROUND: Mitral regurgitation in people without prior cardiac disease is considered a degenerative disease with no established risk factors for its prevention. We aimed to test the hypothesis that elevated systolic blood pressure (SBP) across its usual spectrum is associated with higher risk of mitral regurgitation. METHODS AND FINDINGS: We used linked electronic health records from the United Kingdom Clinical Practice Research Datalink (CPRD) from 1 January 1990 to 31 December 2015...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29040127/double-row-arthroscopic-rotator-cuff-repair-is-more-cost-effective-than-single-row-repair
#13
Adrian L Huang, Kednapa Thavorn, Sasha van Katwyk, Peter MacDonald, Peter Lapner
BACKGROUND: The optimal technique for arthroscopic rotator cuff repair is controversial, and both single and double-row techniques are commonly used. In the current era of increasing costs, health-care delivery models are focusing on the value of care. In this study, we compared the cost-effectiveness of single-row and double-row reconstructions in patients undergoing arthroscopic rotator cuff repair. METHODS: A cost-utility analysis was performed from the perspective of a publicly funded health-care system...
October 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29040004/building-bridges-a-case-for-community-health-worker-provision-of-misoprostol-only-abortion-in-the-first-trimester
#14
Claire Tebbets, Diana Santana, José Ros Silvestre, Dee Redwine
INTRODUCTION: The consequences of unsafe abortion are devastating to women, their families, and their communities. Medication abortion presents an important alternative to harmful self-induction practices and surgical intervention under questionable circumstances. In settings where mifepristone is unavailable, the use of misoprostol alone is a safe and effective option for terminating an unwanted pregnancy. Studies have demonstrated the safety and efficacy of administration of misoprostol by community health workers (CHW) for indications such as postpartum hemorrhage and treatment of incomplete abortion...
October 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29036995/-association-of-alcohol-use-and-incidence-of-type-2-diabetes-mellitus-in-the-middle-aged-and-elderly-male-population-a-prospective-cohort-study
#15
Y Z Zhang, Y Q Yu, Y Yuan, M A He, T C Wu
Objective: To investigate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM) in the middle-aged and elderly male population. Methods: All participants were from Dongfeng-Tongji cohort, 27 009 retired employees from Dongfeng Motor Corporation in Hubei Province were enrolled in the Dongfeng-Tongji cohort baseline survey in 2008. In baseline study, information of alcohol use and other covariates were collected by semi-structured questionnaire and all participants completed physical examination including the test of fasting glucose and blood lipid levels...
October 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/29036703/spiritual-religious-distress-is-associated-with-pain-catastrophizing-and-interference-in-veterans-with-chronic-pain
#16
J Irene Harris, Timothy Usset, Laura Krause, Damien Schill, Berdette Reuer, Rhonda Donahue, Crystal L Park
Objective: Few studies have examined relations between one important aspect of spiritual/religious functioning-spiritual distress-and pain-related outcomes, and none has examined how spiritual distress and depression conjointly relate to chronic pain. The goal of the present study, then, was to examine veterans' spiritual distress as a predictor of two aspects of chronic pain, catastrophizing and interference, testing a mediational model of depression. Design: Four hundred thirty-six patients seeking treatment in a chronic pain management clinic responded to a mailed survey assessing demographics, spiritual distress, depression, pain catastrophizing, and pain interference...
September 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29036503/implementing-electronic-health-records-ehrs-health-care-provider-perceptions-before-and-after-transition-from-a-local-basic-ehr-to-a-commercial-comprehensive-ehr
#17
Marie Krousel-Wood, Allison B McCoy, Chad Ahia, Elizabeth W Holt, Donnalee N Trapani, Qingyang Luo, Eboni G Price-Haywood, Eric J Thomas, Dean F Sittig, Richard V Milani
Objective: We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Methods: Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036489/training-community-health-workers-to-promote-breast-cancer-screening-in-brazil
#18
Lorna Bittencourt, Isabel C Scarinci
Although it has been show that early detection through mammograms is the most effective way to reduce breast cancer mortality, breast cancer is the leading cause of cancer deaths among women worldwide with survival rates being even lower in low- and middle-income countries as compared to high-income countries. Despite the availability of breast cancer screening programs in Brazil through the public health system, some women do not participate in these programs due to structural and/or inter/intrapersonal barriers...
September 26, 2017: Health Promotion International
https://www.readbyqxmd.com/read/29036412/radiomic-subtyping-improves-disease-stratification-beyond-key-molecular-clinical-and-standard-imaging-characteristics-in-patients-with-glioblastoma
#19
Philipp Kickingereder, Ulf Neuberger, David Bonekamp, Paula L Piechotta, Michael Götz, Antje Wick, Martin Sill, Annekathrin Kratz, Russell T Shinohara, David T W Jones, Alexander Radbruch, John Muschelli, Andreas Unterberg, Jürgen Debus, Heinz-Peter Schlemmer, Christel Herold-Mende, Stefan Pfister, Andreas von Deimling, Wolfgang Wick, David Capper, Klaus H Maier-Hein, Martin Bendszus
Background: To analyze the potential of radiomics for disease stratification beyond key molecular, clinical and standard imaging features in patients with glioblastoma. Methods: Quantitative imaging features (n=1043) were extracted from the multiparametric MRI of 181 patients with newly-diagnosed glioblastoma prior to standard-of-care treatment (allocated to a discovery and validation set, 2:1 ratio). A subset of 386/1043 features were identified as reproducible (in an independent MRI-test-retest cohort) and selected for analysis...
September 28, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#20
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
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