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Health of the poor

Vasco Deon Kidd, Anna Maria Ocampo De Claro
The prevalence of autism in the United States has been climbing for the last 3 decades, and this comes at a time when the medical community is poorly equipped to address the various needs of individuals with autism spectrum disorder (ASD). Because busy orthopaedic surgery practices will invariably encounter more patients with ASD, they may want to develop pragmatic strategies and protocols that will promote a successful health-care interaction with these patients.
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Mohamad J Halawi, Mark P Cote, Hardeep Singh, Michael B O'Sullivan, Lawrence Savoy, Jay R Lieberman, Vincent J Williams
BACKGROUND: Depression and poor mental health are known to be negative predictors of patient-reported outcomes after total joint arthroplasty. Although previous studies have examined these risk factors in isolation to each other, they are, in reality, closely related, and yet each represents a different aspect of one's psychological well-being. The objective of this study was to investigate the association between depression and patient-reported outcomes, taking into account patients' baseline mental health...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Tateaki Naito, Shuichi Mitsunaga, Satoru Miura, Noriatsu Tatematsu, Toshimi Inano, Takako Mouri, Tetsuya Tsuji, Takashi Higashiguchi, Akio Inui, Taro Okayama, Teiko Yamaguchi, Ayumu Morikawa, Naoharu Mori, Toshiaki Takahashi, Florian Strasser, Katsuhiro Omae, Keita Mori, Koichi Takayama
BACKGROUND: Combinations of exercise and nutritional interventions might improve the functional prognosis for cachectic cancer patients. However, high attrition and poor compliance with interventions limit their efficacy. We aimed to test the feasibility of the early induction of new multimodal interventions specific for elderly patients with advanced cancer Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) programme. METHODS: This was a multicentre prospective single-arm study...
October 18, 2018: Journal of Cachexia, Sarcopenia and Muscle
Mary Hawk, Catherine Maulsby, Blessing Enobun, Suzanne Kinsky
Though housing instability is linked to poor HIV health outcomes, studies that assess the HIV treatment cascade by housing status are limited. Using data from a multi-site Retention in Care initiative we constructed HIV treatment cascades for participants (n = 463) of five grantee sites. We found no significant differences in viral suppression at follow-up among participants who were unstably housed at enrollment (49%) as compared to those who were stably housed at enrollment (54%). Among participants with available data at 6- or 12-month follow-up, 94% were engaged in care, 90% were retained in, 94% were on ART, and 71% had suppressed viral load...
October 17, 2018: AIDS and Behavior
Carolyn J Crandall, Joseph Larson, Andrea LaCroix, Jane A Cauley, Meryl S LeBoff, Wenjun Li, Erin S LeBlanc, Beatrice J Edwards, JoAnn E Manson, Kristine Ensrud
BACKGROUND: Guidelines recommend fracture risk assessment in postmenopausal women aged 50-64, but the optimal method is unknown. OBJECTIVES: To compare discrimination and calibration of the Fracture Risk Assessment Tool (FRAX) and Garvan fracture risk calculator for predicting fractures in postmenopausal women aged 50-64 at baseline. DESIGN: Prospective observational study. PARTICIPANTS: Sixty-three thousand seven hundred twenty-three postmenopausal women aged 50-64 years participating in the Women's Health Initiative Observational Study and Clinical Trials...
October 17, 2018: Journal of General Internal Medicine
Jieun Song, Marsha R Mailick, Jan S Greenberg
OBJECTIVE: Parents of individuals with developmental disorders or mental health problems often provide life-long care and support to their children, which negatively affects their health in part due to chronic stress. This study aimed to examine the experience of stigma as a source of chronic stress among parents of individuals with developmental disorders or mental health problems and the effect of stigma on parental health outcomes. METHOD: Using data from the Survey of Midlife in the United States (MIDUS 2 and 3), we constructed a sample for a longitudinal analysis including 128 parents of individuals with developmental disorders (e...
September 27, 2018: Social Science & Medicine
Wubet Worku Takele, Mekuriaw Alemayehu, Terefe Derso, Amare Tariku
OBJECTIVE: This study was aimed at determining the magnitude of prenatal iodine deficiency and its determinants among women attending antenatal care clinic at the University of Gondar Specialized Referral Hospital, Northwest Ethiopia. A cross-sectional study was conducted from March 13 to April 25/2017. Precisely, 378 pregnant women were included in the study selected via systematic random sampling technique. Urinary Iodine concentration was determined through spectrophotometer using Sandell-Kolthoff reaction...
October 17, 2018: BMC Research Notes
Obinna Ositadimma Oleribe, Deborah Udofia, Olabisi Oladipo, Temitope Arike Ishola, Simon D Taylor-Robinson
BACKGROUND: The Nigerian health system has been plagued with numerous healthcare worker strikes (industrial action) at all levels. The purpose of this study is to document physicians' views on healthcare worker-initiated strike action in Nigeria and represent a follow-on to a previous study where poor leadership and management were cited as the most common cause of strike action by healthcare workers. METHODS: A cross-sectional, descriptive study was executed between April and June 2017...
October 17, 2018: Human Resources for Health
Bianca N M Silva, Policarpo A Sales, Alvaro J Romanha, Silvane M F Murta, Camilo H S Lima, Magaly G Albuquerque, Eliane D'Elia, Jose G de Aquino, Vitor F Ferreira, Fernando C Silva, Angelo C Pinto, Barbara V Silva
BACKGROUND: Chagas disease, also known as American trypanosomiasis, is classified as one of the 17 most important neglected diseases by the World Health Organization. The only drugs with proven efficacy against Chagas disease are benznidazole and nifurtimox, however both show adverse effects, poor clinical efficacy,and the development of resistance. For these reasons, the search for new effective chemical entities is a challenge to research groups and the pharmaceutical industry. OBJECTIVE: Synthesis and antitrypanosomal activities of a series of thiosemicarbazones and semicarbazones containing the 1,2,3-1H triazole isatin scaffold...
September 12, 2018: Medicinal Chemistry
Abigail M Freeman, Rachel H Tribe, Joshua C H Stott, Stephen Pilling
OBJECTIVE: Emerging evidence for Open Dialogue (OD) has generated considerable interest. Evidence comes from a range of methodologies (case study, qualitative, and naturalistic designs), which have not been synthesized as a whole. The objective of this review was to synthesize this literature. METHODS: A systematic search of the databases PubMed, CINAHL, Scopus, Web of Science and PsycINFO included studies published until January 2018. A total of 1,777 articles were screened...
October 18, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Zhiyou Cai, Wenbo He, Feng-Juan Zhuang, Yan Chen
OBJECTIVE: Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke. METHODS: Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1st 2012 to December 30th 2016 was performed...
October 17, 2018: International Journal of Neuroscience
Richard Harding, Gao Wei, Liz Gwyther, Elvis Miti
Parental death and HIV are associated with poor mental health for orphans in sub-Saharan Africa. This study aimed to evaluate a theory-based intervention for orphaned children on treatment in Tanzania, in terms of feasibility, acceptability and preliminary outcomes. A pilot RCT with nested focus group (FGD) allocated 48 children to usual care or residential "Memory Work Therapy". Children completed outcome measures at T0 (baseline), T1 (2 weeks following intervention) and T2 (9 weeks from T0). Forty percent of eligible children assented...
October 17, 2018: AIDS Care
Rafat Hussain, Stuart Wark, Peta Ryan
Australia has one of the world's highest life expectancy rates, and there is a rapidly growing need for informal caregivers to support individuals who are ageing, have chronic illness or a lifelong disability. These informal carers themselves face numerous physical and psychological stressors in attempting to balance the provision of care with their personal life, their work commitments and family responsibilities. However, little is known about the specific challenges facing rural carers and the barriers that limit their capacity to provide ongoing support...
October 16, 2018: International Journal of Environmental Research and Public Health
M Verdecchia, K Keus, S Blankley, D Vambe, C Ssonko, T Piening, E C Casas
INTRODUCTION: Since 2011 Médecins sans Frontières together with the eSwatini Ministry of Health have been managing patients with multi-drug resistant tuberculosis (MDR-TB) at Matsapha and Mankayane in Manzini region. This analysis describes the model of care and outcomes of patients receiving a 20 months MDR-TB treatment regimen between 2011 and 2013. METHOD: We conducted a retrospective observational cohort study of MDR-TB patients enrolled for treatment between May 2011 and December 2013...
2018: PloS One
Douglas G Widman, Savanna Gornisiewicz, Sharon Shacham, Sharon Tamir
Infection of immunocompromised individuals with normally benign opportunistic viruses is a major health burden globally. Infections with viruses such as Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), Kaposi's sarcoma virus (KSHV), adenoviruses (AdV), BK virus (BKPyV), John Cunningham virus (JCPyV), and human papillomavirus (HPV) are significant concerns for the immunocompromised, including when these viruses exist as a co-infection with human immunodeficiency virus (HIV). These viral infections are more complicated in patients with a weakened immune system, and often manifest as malignancies resulting in significant morbidity and mortality...
2018: PloS One
Maria R Dahm, Andrew Georgiou, Robert Herkes, Anthony Brown, Julie Li, Robert Lindeman, Andrea R Horvath, Graham Jones, Michael Legg, Ling Li, David Greenfield, Johanna I Westbrook
Background Diagnostic testing provides integral information for the prevention, diagnosis, treatment and management of disease. Inadequate test result reporting and follow-up is a major risk to patient safety. Factors contributing to failure to follow-up test results include unclear delineation of responsibility about who is meant to act on a test result; poor coordination across different levels of care; and the absence of integrated health information systems for the efficient information communication. Methods A 2016 Australian Stakeholder Forum brought together over 30 representatives from 14 different consumer, clinical and management stakeholder organisations to discuss safe and effective test result communication, management and follow-up...
October 17, 2018: Diagnosis
Muriel Lérias-Cambeiro, Anabela Rodrigues, Inês Taborda, Filipa Lança
Postpartum haemorrhage is an important health issue worldwide, and it can be caused by uterine atony, retained placental tissue, trauma or coagulation disorders. Although coagulopathy represents a rare cause, it is a significant contributor to postpartum haemorrhage with poor outcomes. Associated with high morbidity and mortality rates, postpartum haemorrhage demands prevention, prompt diagnosis and effective management. We describe a unique case of severe coagulopathy caused by underestimated blood loss during caesarean section without postpartum bleeding, in which transfusion requirements were thromboelastometry-guided...
September 28, 2018: Acta Médica Portuguesa
João Moreira de Sousa, Cátia A Moreira, Diogo Telles-Correia
INTRODUCTION: The aim of the study is to assess the prevalence of anxiety and depressive symptoms in Portuguese medical students compared to students of other faculties, and the possible impact those symptoms have on academic performance. MATERIAL AND METHODS: A cross-sectional study was conducted in a sample of 750 students: 512 medical students and 238 nonmedical students. All students anonymously completed a socio-demographic survey and the Hospital Anxiety and Depression Scale (HADS)...
September 28, 2018: Acta Médica Portuguesa
Paul W Kline, Edward L Melanson, William J Sullivan, Patrick J Blatchford, Matthew J Miller, Jennifer E Stevens-Lapsley, Cory L Christiansen
Background: Physical activity remains low and nearly unchanged from pre-operative levels following total knee arthroplasty (TKA) and is a proposed problem underlying long-term functional limitations, secondary health problems, and higher healthcare costs after TKA. Objective: The objective is to determine whether a telehealth-based physical activity behavior-change intervention improves physical activity behavior and functional outcomes after TKA. Design: The design is a two-arm, parallel, assessor-blinded, RCT with baseline, mid-intervention, post-intervention, and 6-month follow-up assessments...
October 17, 2018: Physical Therapy
María de la Paz Maino, Susana Morales, Orietta Echávarri, Jorge Barros, Arnol García, Claudia Moya, Tita Szmulewicz, Ronit Fischman, Catalina Núñez, Alemka Tomicic
OBJECTIVE: To identify clinical and sociodemographic factors that increase or decrease suicidal risk in a clinical sample of subjects seeking mental health care. METHOD: A cross-sectional study was performed at three health centers in Santiago, Chile. The Parental Bonding Instrument (PBI), Depressive Experience Questionnaire (DEQ), Outcome Questionnaire (OQ-45.2), Reasons for Living Inventory (RFL), and State Trait Anger Expression Inventory (STAXI-2), in addition to a sociodemographic survey, were applied to 544 participants (333 with suicidal behavior and 211 without current suicidal behavior)...
October 11, 2018: Revista Brasileira de Psiquiatria
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