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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29150403/the-cortisol-reactivity-threshold-model-direction-of-trait-rumination-and-cortisol-reactivity-association-varies-with-stressor-severity
#2
Suzanne Vrshek-Schallhorn, Bradley M Avery, Maria Ditcheva, Vaibhav R Sapuram
Various internalizing risk factors predict, in separate studies, both augmented and reduced cortisol responding to lab-induced stress. Stressor severity appears key: We tested whether heightened trait-like internalizing risk (here, trait rumination) predicts heightened cortisol reactivity under modest objective stress, but conversely predicts reduced reactivity under more robust objective stress. Thus, we hypothesized that trait rumination would interact with a curvilinear (quadratic) function of stress severity to predict cortisol reactivity...
November 8, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29150310/zika-virus-in-french-polynesia-2013-14-anatomy-of-a-completed-outbreak
#3
REVIEW
Didier Musso, Hervé Bossin, Henri Pierre Mallet, Marianne Besnard, Julien Broult, Laure Baudouin, José Eduardo Levi, Ester C Sabino, Frederic Ghawche, Marion C Lanteri, David Baud
The Zika virus crisis exemplified the risk associated with emerging pathogens and was a reminder that preparedness for the worst-case scenario, although challenging, is needed. Herein, we review all data reported during the unexpected emergence of Zika virus in French Polynesia in late 2013. We focus on the new findings reported during this outbreak, especially the first description of severe neurological complications in adults and the retrospective description of CNS malformations in neonates, the isolation of Zika virus in semen, the potential for blood-transfusion transmission, mother-to-child transmission, and the development of new diagnostic assays...
November 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29150241/targeting-interleukin-1%C3%AE-protects-from-aortic-aneurysms-induced-by-disrupted-transforming-growth-factor-%C3%AE-signaling
#4
Francesco Da Ros, Raimondo Carnevale, Giuseppe Cifelli, Dario Bizzotto, Manuel Casaburo, Marialuisa Perrotta, Lorenzo Carnevale, Iolanda Vinciguerra, Stefania Fardella, Roberta Iacobucci, Giorgio M Bressan, Paola Braghetta, Giuseppe Lembo, Daniela Carnevale
Aortic aneurysms are life-threatening conditions with effective treatments mainly limited to emergency surgery or trans-arterial endovascular stent grafts, thus calling for the identification of specific molecular targets. Genetic studies have highlighted controversial roles of transforming growth factor β (TGF-β) signaling in aneurysm development. Here, we report on aneurysms developing in adult mice after smooth muscle cell (SMC)-specific inactivation of Smad4, an intracellular transducer of TGF-β. The results revealed that Smad4 inhibition activated interleukin-1β (IL-1β) in SMCs...
November 10, 2017: Immunity
https://www.readbyqxmd.com/read/29149776/effect-of-nebulized-3-hypertonic-saline-with-salbutamol-on-management-of-acute-asthma-in-outpatient-adults-a-double-blind-randomized-clinical-trial-in-emergency-department
#5
Arash Forouzan, Kambiz Masoumi, Ali Delirrooyfard, Ali Asgari Darian, Laaya Mokhtar Gandomani
Asthma is one of the most common disorders of respiratory tract, management of which still remains as a serious health problem. This study aimed to compare the efficacy of 3% hypertonic saline (HS) plus salbutamol with solely salbutamol on management of acute adults' asthma based on peak flow meter findings. In this double-blind randomized clinical trial, 340 adult patients with acute asthma attacks admitted to emergency department of Ahvaz Golestan and Emam hospitals were enrolled during 2014-2015. The patients were allocated randomly to intervention group (nebulized 2...
October 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29149393/challenges-in-minor-tbi-and-indications-for-head-ct-in-pediatric-tbi-an-update
#6
Navneet Singh, Ash Singhal
INTRODUCTION: Pediatric head trauma is one of the commonest presentations to emergency departments. Over 90% of such head injuries are considered mild, but still present risk acute clinical deterioration and longer term morbidity. Identifying which children are at risk of clinically important brain injuries remains challenging and much of the data on minor head injuries is based on the adult population. CHALLENGES IN PEDIATRICS: Children, however, are different, both anatomically and in terms of mechanism of injury, to adults and, even within the pediatric group, there are differences with age and stage of development...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29148830/age-differences-in-the-use-of-emotion-regulation-strategies-derived-from-the-process-model-of-emotion-regulation-a-systematic-review
#7
V C Allen, T D Windsor
OBJECTIVES: This review examines differences in the use of emotion regulation (ER) strategies among younger and older adults. METHOD: A systematic review using search terms related to ageing and ER identified 23 relevant studies. Narrative synthesis was adopted to analyse the findings. RESULTS: Generally, greater use of situation selection and attentional deployment was identified among older adults, although these relationships were dependent on contextual/moderator variables...
November 17, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/29148633/clinical-assessment-of-cardiovascular-disease-associated-risk-factors-in-jimmatown-southwest-ethiopia-a-community-based-cross-%C3%A2-sectional-study
#8
Hailemichael Desalegn, Sintayehu Fekadu, Amare Deribew
Introduction: Cardiovascular disease has been identified as emerging epidemic in developing world and Sub-saharan Africa. The prevalence of risk factors associated with cardiovascular disease is not clearly established in our country. We conducted this study to determine the prevalence of cardiovascular disease associated risk factors in Jimma town. Methods: A cross-sectional study was conducted in sampled adults in Jimma town. Multi-stage sampling was used by combining simple random sampling to select kebeles of Jimma town and then systematic random sampling to select the house hold ...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29148620/perceptions-of-adults-with-overweight-obesity-and-chronic-musculoskeletal-pain-an-interpretative-phenomenological-analysis
#9
Lesley Cooper, Louisa Ells, Cormac Ryan, Denis Martin
AIMS: To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain (CMP). Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population BACKGROUND: Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity however, qualitative research describing the complexities of the relationship is limited...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148321/impact-of-the-affordable-care-act-s-dependent-coverage-expansion-on-the-health-care-and-health-status-of-young-adults-what-do-we-know-so-far
#10
Joshua Breslau, Bradley D Stein, Bing Han, Shoshanna Shelton, Hao Yu
The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders' children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent...
December 1, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29147858/community-interventions-to-increase-stroke-preparedness-and-acute-stroke-treatment-rates
#11
REVIEW
Kathleen M Kelly, Kathryn T Holt, Gina M Neshewat, Lesli E Skolarus
PURPOSE OF REVIEW: Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness...
November 16, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29146418/diagnostic-accuracy-of-the-extended-focused-abdominal-sonography-for-trauma-e-fast-performed-by-emergency-physicians-compared-to-computed-tomography
#12
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29146155/a-comparison-of-childbirth-costs-for-adolescents-and-adults-from-2001-to-2010
#13
Smadar Ronen, Jinhyung Lee, Parin Patel, Pooja Patel
PURPOSE: Although teenage birth rates in America have fallen to a historic low of 26.2 births per 1,000 teenagers, the U.S. remains behind the rest of the industrialized world. Adolescent pregnancy is relatively well discussed in today's literature, with ever more detailed estimates constantly emerging to quantify the cost of children born to America's teenagers. This study, however, describes the financial cost of childbirth in the U.S. with a specific focus on understanding the impact of adolescent childbirth in comparison to that of adult women and of annual childbirth as a whole...
November 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29146122/health-and-wellbeing-of-indigenous-adolescents-in-australia-a-systematic-synthesis-of-population-data
#14
Peter S Azzopardi, Susan M Sawyer, John B Carlin, Louisa Degenhardt, Ngiare Brown, Alex D Brown, George C Patton
BACKGROUND: Indigenous populations have high rates of disease and premature mortality. Most Indigenous communities are young, and adolescence (age 10-24 years) provides great opportunities for population health gain. However, the absence of a comprehensive account of Indigenous adolescents' health has been a barrier to effective policy. We aimed to report a national health profile for Indigenous adolescents in Australia. METHODS: We undertook a systematic synthesis of population data to report the health and wellbeing of Indigenous adolescents in Australia...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29145878/improving-readiness-for-recruitment-through-simulated-trial-activation-the-adjuvant-steroids-in-adults-with-pandemic-influenza-asap-trial
#15
Wei Shen Lim, Garry Meakin, Clare Brittain, Thomas Bewick, Lelia Duley
BACKGROUND: Research in public health emergencies requires trials to be set up in readiness for activation at short notice and in anticipation of limited timelines for patient recruitment. We conducted a simulated activation of a hibernating pandemic influenza clinical trial in order to test trial processes and to determine the value of such simulation in maintaining trial readiness. METHODS: The simulation involved the Nottingham Clinical Trials Unit, one participating hospital, one manufacturing unit and the Investigational Medicinal Product (IMP) supplier...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29145581/prospective-epidemiological-research-studies-in-iran-the-persian-cohort-rationale-objectives-and-design
#16
Hossein Poustchi, Sareh Eghtesad, Farin Kamangar, Arash Etemadi, Abbas-Ali Keshtkar, Azita Hekmatdoost, Zahra Mohammadi, Zahra Mahmoudi, Amaneh Shayanrad, Farzin Roozafzai, Mahdi Sheikh, Alireza Jalaeikhoo, Mohammad Hossein Somi, Fariborz Mansour-Ghanaei, Farid Najafi, Ehsan Bahramali, Amirhoushang Mehrparvar, Alireza Ansari-Moghaddam, Ahmad Ali Enayati, Ali Esmaeili Nadimi, Abbas Rezaianzadeh, Nader Saki, Fatemeh Alipour, Roya Kelishadi, Afarin Rahimi-Movaghar, Nayyereh Aminisani, Paolo Boffetta, Reza Malekzadeh
Non-communicable diseases (NCDs) account for 76% of deaths in Iran and this number is on the rise, parallel to global rates. Many risk factors associated with NCDs are preventable; however it is first necessary to conduct observational studies to identify relevant risk factors, and the most appropriate approach to control them. Iran is a multi-ethnic country, therefore the Ministry of Health and Medical Education sought to launch a nationwide cohort study-the Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to identify the most prevalent NCDs among Iranian ethnicities, and to investigate effective methods of prevention...
November 14, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29145469/development-of-visual-cortical-function-in-infant-macaques-a-bold-fmri-study
#17
Tom J Van Grootel, Alan Meeson, Matthias H J Munk, Zoe Kourtzi, J Anthony Movshon, Nikos K Logothetis, Lynne Kiorpes
Functional brain development is not well understood. In the visual system, neurophysiological studies in nonhuman primates show quite mature neuronal properties near birth although visual function is itself quite immature and continues to develop over many months or years after birth. Our goal was to assess the relative development of two main visual processing streams, dorsal and ventral, using BOLD fMRI in an attempt to understand the global mechanisms that support the maturation of visual behavior. Seven infant macaque monkeys (Macaca mulatta) were repeatedly scanned, while anesthetized, over an age range of 102 to 1431 days...
2017: PloS One
https://www.readbyqxmd.com/read/29145409/predictors-of-suicide-ideation-among-older-adults-with-bipolar-disorder
#18
Norm O'Rourke, Marnin J Heisel, Sarah L Canham, Andrew Sixsmith
OBJECTIVES: Bipolar disorder (BD) carries the greatest risk of death by suicide of all psychiatric conditions as 25%-50% of those with BD will make one or more suicide attempt, and about 15% will intentionally end their lives. Among young adults with BD, substance misuse, medication non-adherence, age at onset, and comorbid psychiatric conditions each predict self-harm. It is currently unclear if these same factors or others predict suicide ideation among older adults with BD. METHODS: We recruited a global sample of 220 older adults with BD over 19 days using socio-demographically targeted, social media advertising and online data collection (Mean = 58...
2017: PloS One
https://www.readbyqxmd.com/read/29145131/removal-of-the-precursors-of-n-nitrosodiethylamine-ndea-an-emerging-disinfection-byproduct-in-drinking-water-treatment-process-and-its-toxicity-to-adult-zebrafish-danio-rerio
#19
Jian Zheng, Tao Lin, Wei Chen
N-nitrosodiethylamine (NDEA) is one of the emerging nitrogenous disinfection byproducts with probable cytotoxicity, genotoxicity, and carcinogenesis. Its potential toxicological effects have received extensive attention but remain to be poorly understood. In this study, changes in NDEA precursors in drinking water treatment process were studied using the trial of its formation potential (FP), and the toxicity induced by NDEA to adult zebrafish was investigated. NDEA FP in the raw water of Taihu Lake ranged from 46...
October 10, 2017: Chemosphere
https://www.readbyqxmd.com/read/29144852/-not-a-real-family-microaggressions-directed-toward-lgbtq-families
#20
Kari M Haines, C Reyn Boyer, Casey Giovanazzi, M Paz Galupo
The present study investigates microaggressions toward individuals in lesbian, gay, bisexual, transgender, and queer (LGBTQ) families. Microaggressions are subtle forms of discrimination experienced on a daily basis as verbal or behavioral slights against individuals in oppressed groups. LGBTQ microaggressions are often studied at an individual level and understood as being directed toward an individual based on perceived identity. The present study allows for an understanding of bias directed at the family system level...
November 16, 2017: Journal of Homosexuality
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