Homing

INTRODUCTION: Epilepsy is frequent in children and often requires complex healthcare interventions. There is a paucity of recent and detailed healthcare expenditures among children with epilepsy in the United States (US). METHODS: Data on children (aged ≤17years) from the Medical Expenditure Panel Survey-Household Component (MEPS-HC) from 2003 to 2014 were analyzed. Unadjusted overall and specific cost components were compared between children with epilepsy and those without epilepsy...

Out-of-hospital cardiac arrest (OHCA) is considered an important public health issue but its incidence has not been examined in France. The aim of this study is to define the incidence of OHCA in France and to compare this to other neighbouring countries. Data were extracted from the French OHCA registry. Only exhaustive centres during the period from January 1, 2013, to September 30, 2014 were included. All patients were included, regardless of their age and cause of OHCA. The participating centres covered about 10% of the French population...

Smallpox is regarded as an ancient and lethal disease of humans, however very little is known about the prevalence and impact of smallpox before the advent of vaccination (c.1800). Here we use evidence from English burial records covering the period 1650-1799 to confirm a striking geography to smallpox patterns. Smallpox apparently circulated as a childhood disease in northern England and Sweden, even where population densities were low and settlement patterns dispersed. However, smallpox was a relatively rare epidemic disease in southern England outside the largest cities, despite its commercialised economy and the growing spatial interconnectedness of its settlements...

BACKGROUND: Pets are major contributors of endotoxin in homes, but whether they influence endotoxin association with respiratory outcomes is unclear. OBJECTIVE: To examine whether exposure and sensitization to dog and cat modify the relationship between endotoxin exposure and asthma and wheeze. METHODS: We analyzed data from 6,051 participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES). House dust from bedroom floor and bedding was evaluated for endotoxin and for dog (Canis familiaris 1) and cat (Feline domesticus 1) allergens...

We report a proof-of-concept for the development of mitochondria-targeting nanoparticles (NPs) loaded with geranylgeranylacetone (GGA) to protect against a wide range of gentamicin-induced ototoxicity symptoms in a zebrafish model. The polymeric NPs were functionalized with a mitochondrial-homing peptide (d‑Arg‑Dmt‑Orn‑Phe‑NH2 ) and exhibited greater mitochondrial uptake and lower gentamicin uptake in hair cells via mechanotransduction (MET) channels and tuned machinery in the hair bundle than the ordinary NPs did...

BACKGROUND: We aimed to present trends in practice as our experience has grown, and report the postoperative morbidity and its associated factors following tracheobronchoplasty. METHODS: Retrospective cohort study conducted in 161 patients who underwent tracheobronchoplasty from October 2002-September 2016. The main outcome was development of a postoperative complication within 30 days of surgery. Postoperative complication events were graded using the Clavien-Dindo system...

OBJECTIVE: To validate the Brazilian Portuguese version of the Family Environment Assessment questionnaire (Inventaire du Milieu Familial). METHODS: The validation process was carried out in two stages. First, translation and back-translation were performed, and in the second phase, the questionnaire was applied in 72 families of children between 0 and 24 months for the validation process. The tool consists of the following domains: mother's communication ability; behavior; organization of the physical and temporal environment; collection/quantity of toys; maternal attitude of constant attention toward her baby; diversification of stimuli; baby's behavior...

The world's smallest fishes belong to the genus Paedocypris. These miniature fishes are endemic to an extreme habitat: the peat swamp forests in Southeast Asia, characterized by highly acidic blackwater. This threatened habitat is home to a large array of fishes, including a number of miniaturized but also developmentally truncated species. Especially the genus Paedocypris is characterized by profound, organism-wide developmental truncation, resulting in sexually mature individuals of <8 mm in length with a larval phenotype...

OBJECTIVE: Polypharmacy is common in older patients but relationships between polypharmacy and common co-morbid conditions have not been elucidated. Our goal was to determine relationships between daily oral medication use and common co-morbid disease dyads and triads using comprehensive medication and diagnostic data from a national sample of nursing homes (NH). DESIGN: Retrospective, cross-sectional study. SETTING: Nationally representative sample of U...

The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. It is recommended that all women have contact with their obstetrician-gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth...

The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. It is recommended that all women have contact with their obstetrician-gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth...

BACKGROUND: The Patient-centered Medical Home (PCMH) uses team-based care to improve patient outcomes, including satisfaction. The quality of patients' communication with their primary care providers (PCPs) is a key determinant of patient satisfaction. A shift to team-based care could disrupt the therapeutic relationship between patients and their PCPs and reduce patient satisfaction if communication and coordination among primary care team members is poor. Little is known about the relationship between intrateam communication within a PCMH and patient satisfaction with PCPs, and whether patient-provider communication might mediate this relationship...

Background Stroke patients transferred in for endovascular treatment (ET) may have lower chances for favorable outcomes compared to those who presented directly to a ET-capable hospital. We describe our real-world experience of ET in AIS, especially among patients transferred in. Materials and methods AIS patients receiving ET from January 2015 to November 2016 were reviewed. We calculated median onset to groin puncture (OTP) and groin puncture to recanalization times (PTR), location of target vessel treated, rate of concurrent intravenous (IV) alteplase use, and rate of successful recanalization as defined by TICI ≥ 2b...

Use of intravenous devices for the delivery of medical treatment spans all healthcare facilities ranging from hospitals to clinics and home care. Clinical pathways are processes used by healthcare providers to integrate and illustrate the best evidence and approach to care for a specific area of practice. The Vessel Health and Preservation (VHP) model is a framework and pathway process, consisting of four quadrants, to guide initiation and management of treatment requiring intravenous access. The pathway is designed to promote preservation of the vasculature of patients from admission through discharge with a focus on acute care...

OBJECTIVES: To investigate if high-dosed folate supplements might diminish the efficacy of malaria intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) in a cohort of pregnant women in Benin, where malaria is holoendemic. METHODS: We followed 318 women during the entire pregnancy and analyzed hematological and P.falciparum indicators in the context of an intermittent preventive treatment trial in Benin. During the follow-up women received two-dose IPTp (1500/75 mg of SP per dose) at the maternity clinic, and 600 mg of albendazole, 200 mg ferrous sulfate and 5 mg folic acid per day for home treatment...

BACKGROUND: Conventional photodynamic therapy (PDT) is associated with side effects, primarily related to the waiting time between pre-treatment with application of photosensitizer and illumination. Pain during illumination is a major issue for the patients and options for effective pain relief are limited. Post-treatment inflammation can often be severe and cause inconvenient down-time for the patients and their employers. METHODS: To avoid the problems of pain and patients crowding in the clinic we eliminated red light treatment of high PpIX concentration and introduced illumination in daylight which may be performed at home...

The ability to inexpensively monitor PM2.5 to identify sources and enable controls would advance residential indoor air quality (IAQ) management. Consumer IAQ monitors incorporating low-cost optical particle sensors and connections with smart home platforms could provide this service if they reliably detect PM2.5 in homes. In this study, particles from typical residential sources were generated in a 120 m3 laboratory and time-concentration profiles were measured with seven consumer monitors (2-3 units each), two research monitors (Thermo pDR-1500, MetOne BT-645), a Grimm Mini Wide-Range Aerosol Spectrometer (GRM), and a Tapered Element Oscillating Microbalance with Filter Dynamic Measurement System (FDMS), a federal equivalent method (FEM) for PM2...

It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support the setting of health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified three eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK...

OBJECTIVES: To investigate clinical oral disease and its association with cognitive function and dependency among older New Zealanders in residential aged care. MATERIAL AND METHODS: National survey of oral health in aged residential care throughout New Zealand. We classified residents into 1 of 3 levels of care: "low dependency care (or assisted living)"; "high dependency care"; or "specialist dementia care/psychogeriatric care." The Abbreviated Mental Test characterised cognitive function as "unimpaired" (scores of 7-10), "moderately impaired" (4-6) or "severely impaired" (0-3)...

BACKGROUND: Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS). OBJECTIVE: To determine the variables that affect continuation or discontinuation of the use of CIC. METHODS: A three-part mixed-method study (prospective longitudinal cohort ( n = 56), longitudinal qualitative interviews ( n = 20) and retrospective survey ( n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation...