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https://www.readbyqxmd.com/read/28432662/targeting-ldl-cholesterol-beyond-absolute-goals-toward-personalized-risk
#1
REVIEW
Morton Leibowitz, Chandra Cohen-Stavi, Sanjay Basu, Ran D Balicer
PURPOSE OF REVIEW: The aim of this study was to review and assess the evidence for low-density lipoprotein cholesterol (LDL-C) treatment goals as presented in current guidelines for primary and secondary prevention of cardiovascular disease. RECENT FINDINGS: Different sets of guidelines and clinical studies for secondary prevention have centered on lower absolute LDL-C targets [<70 mg/dL (<1.8 mmol/L)], greater percent reductions of LDL-C (≥50%), or more intense treatment to achieve greater reductions in cardiovascular risk...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28432148/systolic-blood-pressure-trajectory-frailty-and-all-cause-mortality-over-80-years-of-age-cohort-study-using-electronic-health-records
#2
Rathi Ravindrarajah, Nisha C Hazra, Shota Hamada, Judith Charlton, Stephen H D Jackson, Alex Dregan, Martin C Gulliford
Background -Clinical trials show benefit from lowering systolic blood pressure in people aged ≥80 years but non-randomised epidemiological studies suggest lower systolic blood pressure may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category over 80 years of age and to evaluate SBP trajectories before death. Methods -A population-based cohort study was conducted using electronic health records of 144,403 participants aged 80 and older registered with family practices in the United Kingdom from 2001 to 2014...
April 21, 2017: Circulation
https://www.readbyqxmd.com/read/28427371/inside-the-nation-s-largest-mental-health-institution-a-prevalence-study-in-a-state-prison-system
#3
Tala Al-Rousan, Linda Rubenstein, Bruce Sieleni, Harbans Deol, Robert B Wallace
BACKGROUND: The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system. METHODS: Cross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa...
April 20, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28426597/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#4
Christa Aubrey, Zubia Mumtaz, Patrick B Patterson, Radha Chari, B F Peter Mitchell
OBJECTIVE: To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician. METHODS: A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians)...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426439/high-mortality-among-patients-with-opioid-use-disorder-in-a-large-healthcare-system
#5
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
OBJECTIVES: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system. METHODS: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014...
April 20, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28426302/innovations-in-population-health-surveillance-using-electronic-health-records-for-chronic-disease-surveillance
#6
Sharon E Perlman, Katharine H McVeigh, Lorna E Thorpe, Laura Jacobson, Carolyn M Greene, R Charon Gwynn
With 87% of providers using electronic health records (EHRs) in the United States, EHRs have the potential to contribute to population health surveillance efforts. However, little is known about using EHR data outside syndromic surveillance and quality improvement. We created an EHR-based population health surveillance system called the New York City (NYC) Macroscope and assessed the validity of diabetes, hyperlipidemia, hypertension, smoking, obesity, depression, and influenza vaccination indicators. The NYC Macroscope uses aggregate data from a network of outpatient practices...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28425741/development-of-identity-clarity-and-content-in-adulthood
#7
Jennifer Lodi-Smith, Seth M Spain, Kimberly Cologgi, Brent W Roberts
The current research examines self-concept clarity over 2 assessment points with the aims of establishing patterns of stability and change in self-concept clarity across adulthood, modeling corollary changes in traits and health-related role limitations, and demonstrating the ways in which gender and age moderate these patterns. Within this sample of 461 adults age 19-86 years of age, self-concept clarity had robust rank-order stability and no significant mean-level change during a 3-year assessment window...
May 2017: Journal of Personality and Social Psychology
https://www.readbyqxmd.com/read/28423820/the-invisibility-of-disadvantage-why-do-we-not-notice
#8
Chris Showell, Elizabeth Cummings, Paul Turner
Personal health records (PHRs) offer tantalising benefits for patients and healthcare providers, including improvements in patient-provider communication, patient empowerment, and access to data and information. A suspicion that disadvantaged patients are less likely to use or benefit from PHRs stimulated a research agenda that included: (a) a literature review; and (b) empirical analysis of eight years' hospital admission and discharge data linked to measures of patient social disadvantage. The results demonstrated an association between disadvantage, increased use of public hospital services and barriers to PHR use...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423809/use-of-a-nationwide-personally-controlled-electronic-health-record-by-healthcare-professionals-and-patients-a-case-study-with-the-french-dmp
#9
Brigitte Seroussi, Jacques Bouaud
If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423796/personalized-guideline-based-treatment-recommendations-using-natural-language-processing-techniques
#10
Matthias Becker, Britta Böckmann
Clinical guidelines and clinical pathways are accepted and proven instruments for quality assurance and process optimization. Today, electronic representation of clinical guidelines exists as unstructured text, but is not well-integrated with patient-specific information from electronic health records. Consequently, generic content of the clinical guidelines is accessible, but it is not possible to visualize the position of the patient on the clinical pathway, decision support cannot be provided by personalized guidelines for the next treatment step...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423786/prevalence-estimation-of-protected-health-information-in-swedish-clinical-text
#11
Aron Henriksson, Maria Kvist, Hercules Dalianis
Obscuring protected health information (PHI) in the clinical text of health records facilitates the secondary use of healthcare data in a privacy-preserving manner. Although automatic de-identification of clinical text using machine learning holds much promise, little is known about the relative prevalence of PHI in different types of clinical text and whether there is a need for domain adaptation when learning predictive models from one particular domain and applying it to another. In this study, we address these questions by training a predictive model and using it to estimate the prevalence of PHI in clinical text written (1) in different clinical specialties, (2) in different types of notes (i...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423756/shared-decision-making-via-personal-health-record-technology-for-routine-use-of-diabetic-youth-a-study-protocol
#12
Selena Davis, Abdul Roudsari, Karen L Courtney
Engaging patients in the self-management decision-making provides opportunities for positive health outcomes. The process of shared decision making (SDM) is touted as the pinnacle of patient-centred care, yet it has been difficult to implement in practice. Access to tools resulting from the integration of all health data and clinical evidence, and an ease of communications with care providers are needed to engage patients in decision making. Personal health record (PHR) technology is a promising approach for overcoming such barriers...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423421/efficacy-of-some-wearable-devices-compared-with-spray-on-insect-repellents-for-the-yellow-fever-mosquito-aedes-aegypti-l-diptera-culicidae
#13
Stacy D Rodriguez, Hae-Na Chung, Kristina K Gonzales, Julia Vulcan, Yiyi Li, Jorge A Ahumada, Hector M Romero, Mario De La Torre, Fangjun Shu, Immo A Hansen
The current Zika health crisis in the Americas has created an intense interest in mosquito control methods and products. Mosquito vectors of Zika are of the genus Aedes, mainly the yellow fever mosquito, Aedes aegypti. L. The use of repellents to alter mosquito host seeking behavior is an effective method for the prevention of mosquito-borne diseases. A large number of different spray-on repellents and wearable repellent devices are commercially available. The efficacies of many repellents are unknown. This study focuses on the efficacy of eleven different repellents in reducing the number of Ae...
January 1, 2017: Journal of Insect Science
https://www.readbyqxmd.com/read/28423156/creation-of-an-internal-teledermatology-store-and-forward-system-in-an-existing-electronic-health-record-a-pilot-study-in-a-safety-net-public-health-and-hospital-system
#14
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
April 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28420405/do-international-health-partnerships-contribute-to-reverse-innovation-a-mixed-methods-study-of-thet-supported-partnerships-in-the-uk
#15
Kavian Kulasabanathan, Hamdi Issa, Yasser Bhatti, Matthew Prime, Jacqueline Del Castillo, Ara Darzi, Matthew Harris
BACKGROUND: International health partnerships (IHPs) are changing, with an increased emphasis on mutual accountability and joint agenda setting for both the high- and the low- or middle-income country (LMIC) partners. There is now an important focus on the bi-directionality of learning however for the UK partners, this typically focuses on learning at the individual level, through personal and professional development. We sought to evaluate whether this learning also takes the shape of 'Reverse Innovation' -when an idea conceived in a low-income country is subsequently adopted in a higher-income country...
April 18, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#16
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28418586/simulated-presence-therapy-for-dementia
#17
REVIEW
Iosief Abraha, Joseph M Rimland, Isabel Lozano-Montoya, Giuseppina Dell'Aquila, Manuel Vélez-Díaz-Pallarés, Fabiana M Trotta, Alfonso J Cruz-Jentoft, Antonio Cherubini
BACKGROUND: Dementia is a common and serious neuropsychiatric syndrome, characterised by progressive cognitive and functional decline. The majority of people with dementia develop behavioural disturbances, also known as behavioural and psychological symptoms of dementia (BPSD). Several non-pharmacological interventions have been evaluated to treat BPSD in people with dementia. Simulated presence therapy (SPT), an intervention that uses video or audiotape recordings of family members played to the person with dementia, is a possible approach to treat BPSD...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28414510/a-longitudinal-person-centered-perspective-on-youth-social-support-relations-with-psychological-wellbeing
#18
Joseph Ciarrochi, Alexandre J S Morin, Baljinder K Sahdra, David Litalien, Philip D Parker
Past research suggests that perceived social support from parents, teachers, and peers are all positively associated with wellbeing during adolescence. However, little longitudinal research has examined the implications of distinctive combinations of social support for developing adolescents. To address this limitation, we measured multiple dimensions of social support, psychological ill-health, and wellbeing in a sample of 2034 Australian adolescents (Mage = 13.7; 49.6% male) measured in Grades 8 and 11. Latent transition analyses identified a 6-profile solution for both waves of data, and revealed substantial inequality in perceived social support...
April 17, 2017: Developmental Psychology
https://www.readbyqxmd.com/read/28410997/international-incidence-of-childhood-cancer-2001-10-a-population-based-registry-study
#19
Eva Steliarova-Foucher, Murielle Colombet, Lynn A G Ries, Florencia Moreno, Anastasia Dolya, Freddie Bray, Peter Hesseling, Hee Young Shin, Charles A Stiller
BACKGROUND: Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control. METHODS: This population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and non-malignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001-10...
April 11, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28410981/predicting-healthcare-trajectories-from-medical-records-a-deep-learning-approach
#20
Trang Pham, Truyen Tran, Dinh Phung, Svetha Venkatesh
Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records...
April 11, 2017: Journal of Biomedical Informatics
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