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Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Sophie Outh-Gauer, Marie Alt, Christophe Le Tourneau, Jérémy Augustin, Chloé Broudin, Cassandre Gasne, Thomas Denize, Haitham Mirghani, Elizabeth Fabre, Madeleine Ménard, Florian Scotte, Eric Tartour, Cécile Badoual
Cancer occurrence can be understood as the result of dysfunctions in immune tumoral microenvironment. Here we review the recent understandings of those microenvironment changes, regarding their causes and prognostic significance in head and neck (HN) carcinoma. We will focus on HN squamous cell cancer (SCC) and nasopharyngeal carcinomas (NPC). Their overall poor prognosis may be improved with immunotherapy in a subset of patients, as supported by current clinical trials. However, finding reliable markers of therapeutic response is crucial for patient selection, due to potential severe adverse reactions and high costs...
March 1, 2018: Cancer Treatment Reviews
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
Yves Lacasse, Ai-Yui M Tan, François Maltais, Jerry A Krishnan
Two landmark trials conducted more than 35 years ago provided scientific evidence that, under very specific circumstances, long-term oxygen therapy (LTOT) may prolong life. These two trials enrolled 290 patients with chronic obstructive pulmonary disease (COPD) and severe daytime hypoxemia documented by direct arterial blood gas measurement. From this moment, LTOT became a standard of care and the indications for oxygen therapy have expanded to include nocturnal oxygen therapy for isolated nocturnal oxygen desaturation, ambulatory oxygen to correct exercise-induced desaturation, and short-burst oxygen to relieve dyspnea...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Qingwang Xue, Chunxue Liu, Xia Li, Li Dai, Huaisheng Wang
Various fluorescent sensing systems for miRNAs detection have been developed. But they mostly contain enzymatic amplification reactions and label procedures. The strict reaction conditions of tool enzymes and the high cost of labeling limit their potential applications, especially in complex biological matrix. Here we have addressed the difficult problems and report a strategy for label-free fluorescent DNA dendrimers based on enzyme-free nonlinear hybridization chain reaction (HCR)-mediated multiple G-quadruplex for simple, sensitive and selective detection of miRNAs with low-background signal...
March 16, 2018: Bioconjugate Chemistry
Patricio López-Jaramillo, Silvia González-Gómez, Diego Zarate-Bernal, Andrés Serrano, Leonor Atuesta, Christian Clausen, Claudia Castro-Valencia, Paul Camacho-Lopez, Johanna Otero
The simplification of fixed dose medications by using a single 'polypill' is an attractive strategy to improve adherence to medications which has shown benefit to cardiovascular risk factor control and cardiovascular disease prevention or delay in the progression of these diseases. We review the evidence obtained from a series of clinical trials demonstrating an improvement in adherence to the polypill compared to the use of each compound separately, and found similar or better control of the classical cardiovascular risk factors and a similar safety profile...
March 1, 2018: Therapeutic Advances in Cardiovascular Disease
Tamar Mendelson, William W Eaton
PURPOSE: Prevention of mental disorders is a rapidly growing area of research with substantial potential benefits for population health. This paper reviews the evidence base for prevention of depression, anxiety, and schizophrenia. METHODS: We synthesized evidence from recent systematic reviews and meta-analyses published between 2013 and 2018 on prevention of depression, anxiety, and first-episode psychosis. We included reviews of randomized controlled trials testing psychological, psychosocial, and pharmacological preventive interventions...
March 15, 2018: Social Psychiatry and Psychiatric Epidemiology
Barbara J Howard, Raymond Sturner
Purpose of review: To describe benefits and problems with screening and addressing developmental and behavioral problems in primary care and using an online clinical process support system as a solution. Recent findings: Screening has been found to have various implementation barriers including time costs, accuracy, workflow and knowledge of tools. In addition, training of clinicians in dealing with identified issues is lacking. Patients disclose more to and prefer computerized screening...
December 2017: Current Developmental Disorders Reports
Brian E Lacy, Henry P Parkman, Michael Camilleri
Nausea is an uneasy feeling in the stomach while vomiting refers to the forceful expulsion of gastric contents. Chronic nausea and vomiting represent a diverse array of disorders defined by 4 weeks or more of symptoms. Chronic nausea and vomiting result from a variety of pathophysiological processes, involving gastrointestinal and non-gastrointestinal causes. The prevalence of chronic nausea and vomiting is unclear, although the epidemiology of specific conditions, such as gastroparesis and cyclic vomiting syndrome, is better understood...
March 15, 2018: American Journal of Gastroenterology
Kenneth A Miles, Stefan A Voo, Ashley M Groves
Initial clinical research comparing the diagnostic performance of Positron Emission Tomography (PET)/ Magnetic Resonance Imaging (MRI) and PET/ Computed Tomography (PET/CT) has largely shown equivalent diagnostic capabilities for these modalities in oncology. These uncertainties about the magnitude of diagnostic benefit are compounded by the considerable health economic challenges associated with clinical implementation. Therefore, there is a need to identify ways to extend the use of this technology beyond simple diagnosis so that PET/MRI can add sufficient clinical value beyond PET/CT or MRI alone, and become a cost-effective imaging modality in clinical practice...
March 15, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Til Wykes, Eileen Joyce, Tjasa Velikonja, Andrew Watson, Gregory Aarons, Max Birchwood, Matteo Cella, Sue Dopson, David Fowler, Kathy Greenwood, Sonia Johnson, Paul McCrone, Jesus Perez, Andrew Pickles, Clare Reeder, Diana Rose, Swaran Singh, Dominic Stringer, Matthew Taylor, Rumina Taylor, Rachel Upthegrove
BACKGROUND: Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder...
March 15, 2018: Trials
Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Neil Walker, Yaling Yang, Vasiliki Kiparoglou, Subhash Pokhrel, Hayley Robinson, Hugo van Woerden
BACKGROUND: Smoking cessation services provide support to smokers who desire to quit. Published studies to date have looked at the cost and benefit of service provision but typically focus on clinical trial data. Using routinely collected observational data, this study examined the costs involved in providing a service in terms of average health care expenditure per successful quit attempt in addition to population - level cost-effectiveness measures. METHODS: Data were analysed from Quit-51 smoking cessation service across five English regions between March 2013 and March 2016 (n = 9116)...
March 15, 2018: BMC Health Services Research
Martin Dübbers, Elena Nikolaou, Hans Fuchs, Janina Fischer, Hakan Alakus, Jessica Leers, Christiane Bruns, Grigore Cernaianu
BACKGROUND: Transumbilical laparoscopic-assisted appendectomy (TULAA) is fast and cost-effective since no endoloops, staplers or wound protection devices are used. We analyzed the effects of TULAA as first approach for perforated (PA) and non-perforated (NPA) appendicitis in children. PATIENTS: We performed a retrospective analysis of 181 children for whom TULAA was the first approach for appendicitis between October 2010 and March 2016. METHODS: Morbidity, additional laparoscopic instrument insertion (AI), conversions to open extraumbilical appendectomy (OC), and complications were evaluated...
March 15, 2018: Klinische Pädiatrie
Franck Maunoury, Aurore Clément, Chizoba Nwankwo, Laurie Levy-Bachelot, Armand Abergel, Vincent Di Martino, Eric Thervet, Isabelle Durand-Zaleski
OBJECTIVE: To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. DESIGN: This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context...
2018: PloS One
Christina Balderrama-Durbin, Christopher R Erbes, Melissa A Polusny, Dawne Vogt
Intimate partner communication has become a part of the daily routine of military couples during deployment. However, there is a scarcity of research examining the individual and relationship implications of communication during deployment, likely due in part to the lack of existing measures of deployment communication. The current study examined the psychometric characteristics of a newly developed, multidimensional tool for assessing the process and outcomes of deployment communication in a sample of 391 recently deployed male Army National Guard soldiers and their female intimate partners...
February 2018: Journal of Family Psychology: JFP
Junjian Zheng, Zhiwei Wang, Jinxing Ma, Shaoping Xu, Zhichao Wu
Inability to remove low molecular weight anthropogenic contaminants is a critical issue in low-pressure membrane filtration processes for water treatment. In this work, a novel electrochemical ceramic membrane filtration (ECMF) system using TiO2@SnO2-Sb anode was developed for removing persistent p-chloroaniline (PCA). Results showed that the ECMF system achieved efficient removal of PCA from contaminated waters. At a charging voltage of 3 V, the PCA removal rate of TiO2@SnO2-Sb ECMF system under flow-through mode was 2...
March 15, 2018: Environmental Science & Technology
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