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https://www.readbyqxmd.com/read/29454263/homeless-youth-barriers-and-facilitators-for-service-referrals
#1
Emma B Black, Izabela E Fedyszyn, Helen Mildred, Rhianna Perkin, Richard Lough, Peter Brann, Cheryl Ritter
Young people who are homeless and experiencing mental health issues are reluctant to use relevant services for numerous reasons. Youth are also at risk of disengaging from services at times of referral to additional or alternative services. This study aimed to identify barriers and facilitators for inter-service referrals for homeless youth with mental health issues who have already engaged with a service. Qualitative, semi-structured interviews were conducted with homeless youth (n = 10), homelessness support workers (n = 10), and mental health clinicians (n = 10)...
February 10, 2018: Evaluation and Program Planning
https://www.readbyqxmd.com/read/29454074/nutraceuticals-as-therapeutic-agents-for-atherosclerosis
#2
REVIEW
Joe W E Moss, Jessica O Williams, Dipak P Ramji
Atherosclerosis, a chronic inflammatory disorder of medium and large arteries and an underlying cause of cardiovascular disease (CVD), is responsible for a third of all global deaths. Current treatments for CVD, such as optimized statin therapy, are associated with considerable residual risk and several side effects in some patients. The outcome of research on the identification of alternative pharmaceutical agents for the treatment of CVD has been relatively disappointing with many promising leads failing at the clinical level...
February 14, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29453872/effect-of-dermatology-consultation-on-outcomes-for-patients-with-presumed-cellulitis-a-randomized-clinical-trial
#3
Lauren N Ko, Anna C Garza-Mayers, Jessica St John, Lauren Strazzula, Priyanka Vedak, Radhika Shah, Allison S Dobry, Sowmya R Rao, Leslie W Milne, Blair Alden Parry, Daniela Kroshinsky
Importance: Each year, cellulitis leads to 650 000 hospital admissions and is estimated to cost $3.7 billion in the United States. Previous literature has demonstrated a high misdiagnosis rate for cellulitis, which results in unnecessary antibiotic use and health care cost. Objective: To determine whether dermatologic consultation decreases duration of hospital stay or intravenous antibiotic treatment duration in patients with cellulitis. Design, Setting, and Participants: This randomized clinical trial was conducted in a large urban tertiary care hospital between October 2012 and January 2017, with 1-month follow-up duration...
February 16, 2018: JAMA Dermatology
https://www.readbyqxmd.com/read/29453552/hiv-related-stigma-social-support-and-psychological-distress-among-individuals-initiating-art-in-ethiopia
#4
Angela Parcesepe, Olga Tymejczyk, Robert Remien, Tsigereda Gadisa, Sarah Gorrell Kulkarni, Susie Hoffman, Zenebe Melaku, Batya Elul, Denis Nash
Recent World Health Organization HIV treatment guideline expansion may facilitate timely antiretroviral therapy (ART) initiation. However, large-scale success of universal treatment strategies requires a more comprehensive understanding of known barriers to early ART initiation. This work aims to advance a more comprehensive understanding of interrelationships among three known barriers to ART initiation: psychological distress, HIV-related stigma, and low social support. We analyzed cross-sectional interview data on 1175 adults initiating ART at six HIV treatment clinics in Ethiopia...
February 16, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29453417/exome-sequencing-has-higher-diagnostic-yield-compared-to-simulated-disease-specific-panels-in-children-with-suspected-monogenic-disorders
#5
Oliver James Dillon, Sebastian Lunke, Zornitza Stark, Alison Yeung, Natalie Thorne, Clara Gaff, Susan M White, Tiong Yang Tan
As test costs decline, whole-exome sequencing (WES) has become increasingly used for clinical diagnosis, and now represents the primary alternative to gene panel testing for patients with a suspected genetic disorder. We sought to compare the diagnostic yield of singleton-WES with simulated application of commercial gene panels in children suspected of having a genetically heterogeneous condition. Recruitment, singleton-WES and phenotype-driven variant analysis was completed for 145 paediatric patients. At recruitment, clinicians were required to propose commercial gene panel tests as an alternative to WES and nominate a phenotype-driven candidate gene list...
February 16, 2018: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/29453294/public-preferences-for-interventions-to-prevent-emerging-infectious-disease-threats-a-discrete-choice-experiment
#6
Alex R Cook, Xiahong Zhao, Mark I C Chen, Eric A Finkelstein
OBJECTIVE: When faced with an emergent epidemic with high mortality and morbidity potential, policy makers must decide what public health interventions to deploy at different stages of the outbreak. However, almost nothing is known about how the public view these interventions or how they trade off risks (of disease) with inconvenience (of interventions). In this paper, we aim to understand public perceptions on pandemic interventions, as well as to identify if there are any distinct respondent preference classes...
February 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29452931/identification-of-novel-uncertainty-factors-and-thresholds-of-toxicological-concern-for-health-hazard-and-risk-assessment-application-to-cleaning-product-ingredients
#7
REVIEW
Zhen Wang, W Casan Scott, E Spencer Williams, Michael Ciarlo, Paul C DeLeo, Bryan W Brooks
Uncertainty factors (UFs) are commonly used during hazard and risk assessments to address uncertainties, including extrapolations among mammals and experimental durations. In risk assessment, default values are routinely used for interspecies extrapolation and interindividual variability. Whether default UFs are sufficient for various chemical uses or specific chemical classes remains understudied, particularly for ingredients in cleaning products. Therefore, we examined publicly available acute median lethal dose (LD50), and reproductive and developmental no-observed-adverse-effect level (NOAEL) and lowest-observed-adverse-effect level (LOAEL) values for the rat model (oral)...
February 13, 2018: Environment International
https://www.readbyqxmd.com/read/29452563/code-red-the-essential-yet-neglected-role-of-emergency-care-in-health-law-reform
#8
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#9
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452051/using-the-ecological-model-to-understand-influences-on-college-student-vaping
#10
Marshall Cheney, Mary Gowin, Ashley H Clawson
Objective The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. Participants Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015- Aug 2016. Methods Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. Results College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others...
February 16, 2018: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/29451776/short-term-pulmonary-toxicity-assessment-of-pre-and-post-incinerated-organomodified-nanoclay-in-mice
#11
Todd A Stueckle, Donna C Davidson, Ray Derk, Tiffany G Kornberg, Lori Battelli, Sherri Friend, Marlene Orandle, Alixandra Wagner, Cerasela Zoica Dinu, Konstantinos A Sierros, Sushant Agarwal, Rakesh K Gupta, Yon Rojanasakul, Dale W Porter, Liying Rojanasakul
Organomodified nanoclays (ONCs) are increasingly used as filler materials to improve nanocomposite strength, wettability, flammability, and durability. However, pulmonary risks associated with exposure along their chemical lifecycle are unknown. This study's objective was to compare pre- and post-incinerated forms of uncoated and organomodified nanoclays for potential pulmonary inflammation, toxicity, and systemic blood response. Mice were exposed via aspiration to low (30 µg) and high (300 µg) doses of pre-incinerated uncoated montmorillonite nanoclay (CloisNa), ONC (Clois30B), their respective incinerated forms (I-CloisNa and I-Clois30B), and crystalline silica (CS)...
February 16, 2018: ACS Nano
https://www.readbyqxmd.com/read/29451681/verification-of-a-physiologically-based-pharmacokinetic-model-of-ritonavir-to-estimate-drug-drug-interaction-potential-of-cyp3a4-substrates
#12
Ken-Ichi Umehara, Felix Huth, Christina S Won, Tycho Heimbach, Handan He
Ritonavir is one of several ketoconazole alternatives used to evaluate strong CYP3A4 inhibition potential in clinical drug-drug interaction (DDI) studies. In this study, four physiologically-based pharmacokinetic (PBPK) models of ritonavir as an in vivo time-dependent inhibitor of CYP3A4 were created and verified for the oral doses of 20, 50, 100 and 200 mg using fraction absorbed (Fa) and oral clearance (CLoral) values reported in the literature, as transporter and CYP enzyme reaction phenotyping data were not available...
February 16, 2018: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/29451660/economic-assessment-of-postoperative-pain-control-strategies-for-treatment-of-adult-patients-with-cancer
#13
Rafael Freitas Dos Santos, Fernando Bliacheriene, Flavia Mori Sarti
OBJECTIVE: The authors performed an economic assessment of opioids currently being used for control of postoperative pain relating to the surgical treatment of cancer (fentanyl and sufentanil) within the Brazilian Unified Health System (SUS, in the Portuguese acronym). METHOD: The assessment was based on the perspective of the government, in order to collaborate with the promotion of effectiveness in public policies of health, and to optimize the allocation of public resources into health...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29450844/endobarrier%C3%A2-a-safe-and-effective-novel-treatment-for-obesity-and-type-2-diabetes
#14
Nisha Patel, Aruchuna Mohanaruban, Hutan Ashrafian, Carel Le Roux, James Byrne, John Mason, James Hopkins, Jamie Kelly, Julian Teare
BACKGROUND AND AIMS: Obesity associated with diabetes mellitus is a significant worldwide problem associated with considerable health care costs. Whilst surgical intervention is effective, it is invasive, costly and associated with complications. This study aims to evaluate the safety and efficacy of the EndoBarrier®, a duodenal-jejunal sleeve bypass as an alternative treatment of diabetes mellitus in obese patients. MATERIALS AND METHODS: This was a multi-centre, non-randomised trial recruiting obese patients with type 2 diabetes from three sites in the UK...
February 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29449500/the-cost-effectiveness-of-biannual-serum-urate-su-monitoring-after-reaching-target-in-gout-a-health-economic-analysis-comparing-su-monitoring
#15
Philip C Robinson, Nicola Dalbeth, Peter Donovan
OBJECTIVE: The 2012 American College of Rheumatology gout management guidelines recommend monitoring serum urate (SU) every 6 months after target SU has been achieved. Our objective was to determine through modeling whether this testing would be cost-effective, considering financial cost, quality of life, and estimated change in adherence. METHODS: A cost-utility analysis was completed with a 3-arm model: (1) no regular urate monitoring; (2) annual urate monitoring; and (3) biannual urate monitoring...
February 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29449152/development-of-the-health-and-weight-attitudes-scale
#16
Teresa Drake, Roberta J Ogletree
OBJECTIVE: To develop and validate an instrument to assess attitudes toward Health at Every Size (HAES) principles. METHODS: Survey items were generated based on 5 HAES principles. A panel of reviewers was recruited to establish content validity. A convenience sample of college students in health education was recruited for pilot survey administration. Internal reliability was assessed using Cronbach α and test-retest reliability was assessed with Pearson correlation...
February 12, 2018: Journal of Nutrition Education and Behavior
https://www.readbyqxmd.com/read/29448237/the-effect-of-multimorbidity-on-the-gap-between-global-and-age-comparative-self-rated-health-scores-among-the-korean-elderly
#17
Namsoo Kim, Hyun-Jun Nam, Juhwan Noh, Eun-Cheol Park
Most of the behavior change models regard perceived health status as a motivation for healthy behaviors or chronic disease self-management. The aim of this study was to examine the association between the number of chronic diseases and the difference between global and age-comparative self-rated health scores (GSRH and ASRH). We used national representative survey data pertaining to the elderly in 2011 from the Korea Institute for Health and Social Affairs. In total, 10,003 participants (≥60 years old) were selected from those who had completed the survey in 2008...
January 3, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29447995/how-effective-are-messages-and-their-characteristics-in-changing-behavioural-intentions-to-substitute-plant-based-foods-for-red-meat-the-mediating-role-of-prior-beliefs
#18
Annukka Vainio, Xavier Irz, Hanna Hartikainen
By means of a population-based survey experiment, we analysed the effectiveness of two message characteristics - message framing and the refutation of misinformation - in persuading respondents to reduce their consumption of red meat and increase that of plant-based alternatives. We also tested whether the effects of those two message characteristics were moderated by prior beliefs about the health and climate impacts of red meat consumption. The data were collected with an online survey of the adult population living in Finland (N = 1279)...
February 12, 2018: Appetite
https://www.readbyqxmd.com/read/29447730/no-163-gynaecological-and-obstetric-management-of-women-with-inherited-bleeding-disorders
#19
Christine Demers, Christine Derzko, Michele David, Joanne Douglas
OBJECTIVE: The prevalence of bleeding disorders, notably von Willebrand disease (vWD), among adult women with objectively documented menorrhagia is consistently reported to be 10% to 20% and is even higher in adolescents presenting with menorrhagia. OPTIONS: Diagnostic tools and specific medical and, where appropriate, surgical alternatives to management are reviewed and evidence-based recommendations presented. EVIDENCE: A MEDLINE search of the English literature between January 1975 and November 2003 was performed using the following key words: menorrhagia, uterine bleeding, pregnancy, von Willebrand, congenital bleeding disorder, desmopressin/DDAVP, tranexamic acid, oral contraceptives, medroxyprogesterone, therapy, hysterectomy, anesthesia, epidural, spinal...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29447716/no-186-conservative-management-of-urinary-incontinence
#20
Magali Robert, Sue Ross
OBJECTIVE: To outline the evidence for conservative management options for treating urinary incontinence. OPTIONS: Conservative management options for treating urinary incontinence include behavioural changes, lifestyle modification, pelvic floor retraining, and use of mechanical devices. OUTCOMES: To provide understanding of current available evidence concerning efficacy of conservative alternatives for managing urinary incontinence; to empower women to choose continence therapies that have benefit and that have minimal or no harm...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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