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Matthew J Klebanoff, Jagpreet Chhatwal, Jacob D Nudel, Kathleen E Corey, Lee M Kaplan, Chin Hur
Importance: Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. Objective: To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. Design, Setting, and Patients: A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery...
October 26, 2016: JAMA Surgery
Antti Latvala, Ralf Kuja-Halkola, Christian Rück, Brian M D'Onofrio, Tomas Jernberg, Catarina Almqvist, David Mataix-Cols, Henrik Larsson, Paul Lichtenstein
Importance: Differences in cardiovascular autonomic activity between individuals with psychiatric disorders and healthy controls have been observed, but whether cardiovascular autonomic abnormalities are associated with subsequent psychiatric disorders is unknown. Objective: To investigate whether differences in cardiac autonomic function as indexed by resting heart rate and blood pressure are associated with psychiatric disorders during the lifetime of men in Sweden...
October 26, 2016: JAMA Psychiatry
Kate Bunton, Brad H Story
OBJECTIVE: The goal of the Arizona Child Acoustic Database project was to obtain a large set of acoustic recordings, primarily vowels, collected from a cohort of children over a critical period of growth and development. METHOD: Data was recorded longitudinally from 63 children between the ages of 2;0 and 7;0 at 3-month intervals. The protocol included individual American English vowels and diphthongs, nonsense multi-vowel transitions, word level multi-vowel sequences (e...
October 27, 2016: Folia Phoniatrica et Logopaedica
Pauline Mendola, Rajeshwari Sundaram, Germaine M Buck Louis, Liping Sun, Maeve E Wallace, Melissa M Smarr, Seth Sherman, Yeyi Zhu, Qi Ying, Danping Liu
We aimed to study the potential impact of proximity to major roadways on time-to-pregnancy and infertility in couples attempting pregnancy in the Longitudinal Investigation of Fertility and Environment (LIFE) study (2005-2009), a population-based, prospective cohort study. Couples attempting pregnancy (n=500) were enrolled and followed prospectively until pregnancy or 12months of trying and 393 couples (78%) had complete data and full follow-up. Time-to-pregnancy was based on a standard protocol using fertility monitors, tracking estrone-3-glucuonide and luteinizing hormone, and pregnancy test kits to detect human chorionic gonadotropin (hCG)...
October 23, 2016: Science of the Total Environment
Jacqueline M Limoges, Kim Jagos
BACKGROUND: Tensions and hierarchies among nurses who have different educational preparations can hinder effective communication and collaborative practices. METHOD: A 2-year longitudinal cohort study involving 214 participants explored the influences of joint education on Canadian Practical Nursing (PN) and Bachelor of Science in Nursing (BScN) students. RESULTS: Joint education helps students dismantle unhelpful power relations, address myths and misconceptions about the other, and develop respect for each other's contributions to patient care...
November 1, 2016: Journal of Nursing Education
Joan Maria Estrada-Masllorens, Eva Maria Guix-Comellas, Sandra Cabrera-Jaime, Jordi Galimany-Masclans, Juan Roldán-Merino, Teresa Lluch-Canut
BACKGROUND: The nursing education program framework in Spain has recently been adapted and modified. This study aimed to analyze university postgraduate master'slevel nursing education during the past 21 years in Spain in terms of educational supply and demand. METHOD: A retrospective, longitudinal, descriptive, and observational design was used. The educational offerings at 15 university nursing schools in Spain were examined. The target population was 7,871 registered and licensed nurses who had completed postgraduate education...
November 1, 2016: Journal of Nursing Education
Jean-Daniel Dubois, Vincent Cantin, Mathieu Piché, Martin Descarreaux
Despite an elusive pathophysiology, common characteristics are often observed in individuals with chronic low back pain (LBP). These include psychological symptoms, altered pain perception, altered pain modulation and altered muscle activation. These factors have been explored as possible determinants of disability, either separately or in cross-sectional studies, but were never assessed in a single longitudinal study. Therefore, the objective was to determine the relative contribution of psychological and neurophysiological factors to future disability in individuals with past LBP...
2016: PloS One
Ines Rama, Ines Llaudó, Pere Fontova, Gema Cerezo, Carlos Soto, Casimiro Javierre, Miguel Hueso, Nuria Montero, Alberto Martínez-Castelao, Juan Torras, Josep M Grinyó, Josep M Cruzado, Nuria Lloberas
BACKGROUND: Patients undergoing conventional hemodialysis (C-HD) present a greater immuno-inflammatory state probably related to uremia, sympathetic nervous system (SNS) activation and /or membrane bioincompatibility, which could improve with a technique-switching to online hemodiafiltration (OL-HD). The antigen-independent pathway activation of this modified immunologic state turns dendritic cells (DC) into an accurate cell model to study these patients. The aim of this study is to further evaluate the immune-inflammatory state of patients in C-HD assessed by DC maturation...
2016: PloS One
Alex Peaslee, Marleen Wickizer, Julie Olson, Robert Topp
BACKGROUND: Value-based insurance design (VBID) waives or reduces prescription copayments in order to decrease member cost barriers to refilling medications. Medication therapy management (MTM) is a member clinical intervention designed to reinforce members' knowledge of their medications, which addresses barriers to medication adherence. Both methods have been shown to increase adherence in members, particularly when used in combination. To date, studies of such combined programs have often been completed within integrated health systems but have rarely included control populations...
November 2016: Journal of Managed Care & Specialty Pharmacy
Wendy S Bibeau, Haoda Fu, April D Taylor, Anita Y M Kwan
BACKGROUND: Medication adherence is pivotal for the successful treatment of diabetes. However, medication adherence remains a major concern, as nonadherence is associated with poor health outcomes. Studies have indicated that increasing patients' share of medication costs significantly reduces adherence. Little is known about a potential out-of-pocket (OOP) cost threshold where substantial reduction in adherence may occur. OBJECTIVE: To examine the impact of diabetes OOP pharmacy costs on antihyperglycemic medication adherence and identify the potential threshold at which significant reduction in adherence may occur among patients with type 2 diabetes mellitus (T2DM)...
November 2016: Journal of Managed Care & Specialty Pharmacy
Joanna P MacEwan, Felicia M Forma, Jason Shafrin, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
BACKGROUND: Poor medication adherence contributes to negative treatment response, symptom relapse, and hospitalizations in schizophrenia. Many health plans use claims-based measures like medication possession ratios or proportion of days covered (PDC) to measure patient adherence to antipsychotics. Classifying patients solely on the basis of a single average PDC measure, however, may mask clinically meaningful variations over time in how patients arrive at an average PDC level. OBJECTIVE: To model patterns of medication adherence evolving over time for patients with schizophrenia who initiated treatment with an oral atypical antipsychotic and, based on these patterns, to identify groups of patients with different adherence behaviors...
November 2016: Journal of Managed Care & Specialty Pharmacy
JaeJin An
BACKGROUND: Current evidence suggests that patient-centered medical homes (PCMHs) potentially increase overall quality of disease management, including preventive care. However, there are mixed findings regarding quality of diabetes care, and little evidence exists with respect to the effect of PCMHs on medication adherence in patients with diabetes. OBJECTIVE: To investigate associations between PCMHs and process measures of diabetes care, as well as adherence to oral hypoglycemic agents (OHAs) in patients with diabetes in a nationally representative U...
November 2016: Journal of Managed Care & Specialty Pharmacy
Leah Dierking, Kyriakos Markides, Soham Al Snih, M Kristen Peek
OBJECTIVES: To determine predictors of fear of falling in older Mexican Americans over time. DESIGN: Longitudinal study. SETTING: Community-dwelling residents throughout California, Colorado, New Mexico, Arizona, and Texas. PARTICIPANTS: Community-dwelling Mexican Americans aged 72 and older participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly from 2000-01 to 2010-11 (N = 1,682)...
October 26, 2016: Journal of the American Geriatrics Society
Arthur Caye, James Swanson, Anita Thapar, Margaret Sibley, Louise Arseneault, Lily Hechtman, L Eugene Arnold, Janni Niclasen, Terrie Moffitt, Luis Augusto Rohde
There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD...
December 2016: Current Psychiatry Reports
Lauren A Maggio
INTRODUCTION: Evidence-based medicine (EBM) is an expectation of professional healthcare and a requisite component of medical school curricula. However, upon graduation medical students' EBM skills have been found lacking suggesting a need to examine EBM training. METHODS: This PhD report presents two studies on EBM education. The first study is a literature review that describes and attempts to assess educational interventions for teaching medical students EBM...
October 25, 2016: Perspectives on Medical Education
Xin Tan, Peng Fang, Jie An, Huan Lin, Yi Liang, Wen Shen, Xi Leng, Chi Zhang, Yanting Zheng, Shijun Qiu
INTRODUCTION: Patients with type 2 diabetes mellitus (T2DM) have usually been found cognitive impairment associated with brain white matter (WM) abnormalities. However, findings have varied across studies, and any potential relationship with Alzheimer's disease (AD) remains unclear. The aim of this study was to assess the whole-brain WM integrity of T2DM patients and to compare our findings with those of published AD cases. METHODS: In this study, we used diffusion tensor imaging (DTI) combined with tract-based spatial statistics (TBSS) to investigate whole-brain WM abnormalities in 48 T2DM patients and 48 healthy controls...
October 25, 2016: Neuroradiology
A A Suriawati, Hazreen Abdul Majid, Nabilla Al-Sadat, Mohd Nahar Azmi Mohamed, Muhammad Yazid Jalaludin
BACKGROUND: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. OBJECTIVE: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents. DESIGN: Cross-sectional. SETTING: Selected public secondary schools from the central and northern regions of Peninsular Malaysia...
October 24, 2016: Nutrients
Lawrence Cai, Vinita Puri, Mohan Krishna Dangol, Iftekhar Ibne Mannan, Shafquat Hussain Khundkar, Trung-Hau Le Thua, Godfrey Muguti, Shankar Man Rai, Yvonne Karanas, James Chang
BACKGROUND: Burn contractures can cause significant disability, particularly in patients in resource-limited settings. However, a gap exists in our ability to measure outcomes in patients with burn contractures of the neck. The objective of this study was to develop and validate the Stanford-ReSurge Burn Scar Contracture Scale-Neck to longitudinally assess functional status and measure functional improvement following contracture release of the neck. METHODS: A literature review was performed to identify scales used in neck assessment and burn assessment...
November 2016: Plastic and Reconstructive Surgery
Konstantinos Rallis, George D Kymionis, Ilias Georgalas, Marilita M Moschos, Chryssanthi Koutsandrea, Michael A Grentzelos, Dimitris Papaconstantinou
OBJECTIVE: To determine subtle changes of Heidelberg retina tomography (HRT) stereometric parameters and blue-on-yellow (B/Y) perimetry global indices for the early diagnosis of glaucoma in suspected subjects. PATIENTS AND METHODS: Cross-sectional data on 174 eyes of 87 subjects from a larger cohort, attending the Glaucoma Department of the "G. Gennimatas" General Hospital of Athens from January 2004 to February 2014, were used in the study. Subjects were assigned to 3 groups: (a) "normals" not requiring treatment throughout the study (group 1), (b) suspects who developed glaucoma and required treatment during the study (group 2), and (c) patients with incipient glaucoma (group 3)...
October 25, 2016: Journal of Glaucoma
Kimberly Howard-Quijano, Ali Salem, Charles Barkulis, Einat Mazor, Jennifer C Scovotti, Jonathan K Ho, Richard J Shemin, Tristan Grogan, David Elashoff, Aman Mahajan
BACKGROUND: Echocardiography-based speckle-tracking strain imaging is an emerging modality to assess left ventricular function. The aim of this study was to investigate the change in left ventricular systolic function after cardiac surgery with 3-dimensional (3D) speckle-tracking strain imaging and to determine whether preoperative 3D strain is an independent predictor of acute and long-term clinical outcomes after aortic valve, mitral valve, and coronary artery bypass grafting operations...
October 24, 2016: Anesthesia and Analgesia
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