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clinical health

Carrie D Patnode, Michelle L Henninger, Caitlyn A Senger, Leslie A Perdue, Evelyn P Whitlock
Importance: Although 80% of infants in the United States start breastfeeding, only 22% are exclusively breastfed up to around 6 months as recommended by a number of professional organizations. Objective: To systematically review the evidence on the benefits and harms of breastfeeding interventions to support the US Preventive Services Task Force in updating its 2008 recommendation. Data Sources: MEDLINE, PubMed, Cumulative Index for Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and PsycINFO for studies published in the English language between January 1, 2008, and September 25, 2015...
October 25, 2016: JAMA: the Journal of the American Medical Association
Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Paolo Fusar-Poli, Grazia Rutigliano, Daniel Stahl, André Schmidt, Valentina Ramella-Cravaro, Shetty Hitesh, Philip McGuire
Importance: Pretest risk estimation is routinely used in clinical medicine to inform further diagnostic testing in individuals with suspected diseases. To our knowledge, the overall characteristics and specific determinants of pretest risk of psychosis onset in individuals undergoing clinical high risk (CHR) assessment are unknown. Objectives: To investigate the characteristics and determinants of pretest risk of psychosis onset in individuals undergoing CHR assessment and to develop and externally validate a pretest risk stratification model...
October 26, 2016: JAMA Psychiatry
Kelly Walker, Megan Arbour, Justin Waryold
Graduate medical, nursing, and midwifery curricula often have limited amounts of time to focus on issues related to cultural competency in clinical practice, and respectful sexual and reproductive health care for all individuals in particular. Respectful health care that addresses sexual and reproductive concerns is a right for everyone, including those who self-identify as lesbian, gay, bisexual, or transgender (LGBT). LGBT persons have unique reproductive health care needs as well as increased risks for poor health outcomes...
October 26, 2016: Journal of Midwifery & Women's Health
Nancy W Selix, Stefan Rowniak
INTRODUCTION: Transgender individuals have unique health care needs and experience health disparities. There is an increased need for transgender health care services and primary care for this underserved population. However, provision of appropriate health care services for transgender persons requires cultural competency and skill on the part of the health care provider, and providers need specific skills to address the needs of this population. METHODS: A review of the literature was performed by accessing CINAHL, PsycINFO, and PubMed databases...
October 26, 2016: Journal of Midwifery & Women's Health
Maria Freytsis, Julia C Phillippi, Kim J Cox, Amy Romano, Leslie Cragin
In 2014, the American College of Nurse-Midwives (ACNM) launched a project called Clarity in Collaboration to develop data definitions related to midwifery and maternity care delivery processes. These definitions are needed to ensure midwifery care delivered in collaborative care models is accurately and consistently captured in clinical documentation systems, data registries, and systems being developed as part of health care restructuring and payment reform. The Clarity in Collaboration project builds on the efforts of the Women's Health Registry Alliance (WHRA), which was recently established by the American College of Obstetricians and Gynecologists...
October 26, 2016: Journal of Midwifery & Women's Health
Astrid Berg
Reflective practice forms a pivotal part of mental health intervention in a setting where language and cultural differences require working together with a community counselor for language interpretation. Reflective practice in infant mental health began with Esther Bick's () infant observations and continued with Selma Fraiberg's () parent-infant psychotherapy. These two models formed the basis of the practice of infant mental health in a community in South Africa. A clinical example will highlight the importance of culturally informed observation that is then reflected upon...
October 26, 2016: Infant Mental Health Journal
Carmen Rosa Noroña, Michelle L Acker
Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers...
October 26, 2016: Infant Mental Health Journal
Laura Denise Mendes da Silva, Mariana Gatto, Mariana Miziara de Abreu Teodoro, Marjorie de Assis Golim, Érika Alessandra Pelisson Nunes da Costa, Francilene Capel Tavares Carvalho, Daniela Ramos Rodrigues, Paulo Câmara Marques Pereira, Ângela Maria Victoriano de Campos Soares, Sueli Aparecida Calvi
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi is a serious public health issue. Its evolution involves an acute stage, characterized by no specific symptoms, and the chronic stage during most individuals are asymptomatic, but about 30 to 40% of them become symptomatic presenting the cardiac or digestive disease. Host immune response mechanisms involved in symptomatic or asymptomatic chronic disease are not fully understood. The pro-inflammatory cytokines are crucial in host resistance. However, a fine control of this inflammatory process, by action of anti-inflammatory cytokines, is necessary to avoid tissue injury...
October 26, 2016: Scandinavian Journal of Immunology
Donna M Lake, Patricia E Allen, Myrna L Armstrong
Nursing continues to face professional workforce and diversity shortage problems. This article advocates for examining an untapped resource-the consideration of applicants for nursing leadership and educational positions in civilian health care organizations. This untapped resource is highly qualified, already retired (or going to be separated) military nurse officers (MNOs) who possess extensive health care knowledge, as well as distinctive ethnicity and gender composition. Clinical educators, as part of the organizational leadership, can play an important role in assisting the MNO civilian position assimilation because they come from a structured and unique cultural environment...
November 1, 2016: Journal of Continuing Education in Nursing
Decio Brunoni, Silvana Maria Blascovi-Assis, Ana Alexandra Caldas Osório, Alessandra Gotuzo Seabra, Cibelle Albuquerque de la Higuera Amato, Maria Cristina Triguero Veloz Teixeira, Marina Monzani da Rocha, Luiz Renato Rodrigues Carreiro
The present study aimed to present an overview of recent national and international research on the Zika virus (ZIKV), as well as to explore possible action plans focused on children, their families and the health teams involved.Therefore, the study proposes the implementation of tracking systems in order to identify, describe and characterize the potential correlates of prenatal exposure to ZIKV, divided into three lines of action: 1. Diagnostic and etiological evaluation as well as screening of developmental problems in children confirmed or suspected of prenatal ZIKV infection...
October 2016: Ciência & Saúde Coletiva
Cristhiene Montone Nunes Ramires, Fátima Cristina Alves Branco-Barreiro, Érica Toledo Piza Peluso
Hearing loss among children, particularly those with severe and profound hearing impairment, has an effect on their communication and development, which in turn can have a significant impact on their parents. This study aimed to evaluate the quality of life of parents of children with hearing loss and identify the associated factors. A cross-sectional study was carried out involving parents of children that went through phonoaudiological therapy at a public university clinic in the city of São Paulo. The research instruments used were: the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-bref), the Social Support Questionnaire 6 (SSQ-6) and the General Health Questionnaire (GHQ-12)...
October 2016: Ciência & Saúde Coletiva
Charles Dalcanale Tesser, Armando Henrique Norman
This article contends that the distinction between clinical care (illness) and prevention of future disease is essential to the practice of quaternary prevention. The authors argue that the ongoing entanglement of clinical care and prevention transforms healthy into "sick" people through changes in disease classification criteria and/or cut-off points for defining high-risk states. This diverts health care resources away from those in need of care and increases the risk of iatrogenic harm in healthy people...
October 20, 2016: Cadernos de Saúde Pública
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan, Katia Santana Freitas, Renata Fonseca Mendoza
Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil...
September 2016: Revista Brasileira de Enfermagem
Flávia Paula Magalhães Monteiro, Thelma Leite de Araujo, Francisca Bertilia Chaves Costa, Telma Alteniza Leandro, Tahissa Frota Cavalcante, Marcos Venícios de Oliveira Lopes
Objective: to conduct the clinical validation of nursing diagnosis "Willingness for improved infant development". Method: a cross-sectional study, conducted in a Centro de Saúde da Família (Family Health Care center), with 45 healthy breastfed infants. The instrument for collecting the data was prepared based on the literature and validated by nurses. It contained the following variables: sociodemographic, gestational, and obstetrical variables; breastfed infant's nutritional profile; evaluation of the defining characteristics of the proposed nursing diagnosis...
September 2016: Revista Brasileira de Enfermagem
Jorge Barros, Susana Morales, Orietta Echávarri, Arnol García, Jaime Ortega, Takeshi Asahi, Claudia Moya, Ronit Fischman, María P Maino, Catalina Núñez
Objective: To analyze suicidal behavior and build a predictive model for suicide risk using data mining (DM) analysis. Methods: A study of 707 Chilean mental health patients (with and without suicide risk) was carried out across three healthcare centers in the Metropolitan Region of Santiago, Chile. Three hundred forty-three variables were studied using five questionnaires. DM and machine-learning tools were used via the support vector machine technique. Results: The model selected 22 variables that, depending on the circumstances in which they all occur, define whether a person belongs in a suicide risk zone (accuracy = 0...
October 20, 2016: Revista Brasileira de Psiquiatria
Tae-Jin Song, Soo-Jin Cho, Won-Joo Kim, Kwang Ik Yang, Chang-Ho Yun, Min Kyung Chu
Although tension-type headache (TTH) is a frequent type of headache disorder and imposes a significant burden, there is scant information about the prevalence and impact of comorbid anxiety and depression among individuals with TTH. We investigated the prevalence and clinical impact of anxiety and depression among patients with TTH in the general population. We recruited Korean participants aged 19-69 years using a two-stage clustered random sampling method. To identify the presence of headache type, anxiety, and depression, we used a semi-structured interview using certain questionnaires...
2016: PloS One
Michel Tchuenche, Eurica Palmer, Vibhuti Haté, Ananthy Thambinayagam, Dayanund Loykissoonlal, Emmanuel Njeuhmeli, Steven Forsythe
Given compelling evidence associating voluntary medical male circumcision (VMMC) with men's reduced HIV acquisition through heterosexual intercourse, South Africa in 2010 began scaling up VMMC. To project the resources needed to complete 4.3 million circumcisions between 2010 and 2016, we (1) estimated the unit cost to provide VMMC; (2) assessed cost drivers and cost variances across eight provinces and VMMC service delivery modes; and (3) evaluated the costs associated with mobilize and motivate men and boys to access VMMC services...
2016: PloS One
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are widely used for prevention of stroke secondary to nonvalvular atrial fibrillation (NVAF). Increased use of NOACs is partially a result of simplified regimens compared with warfarin, which has been associated with poor adherence and persistence to therapy. Few studies have assessed adherence to NOACs, especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To evaluate adherence to NOACs in a cohort of newly diagnosed NVAF patients who are commercially insured...
November 2016: Journal of Managed Care & Specialty Pharmacy
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
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