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We propose a methodology to leverage existing information to obtain robust estimates in a timely manner and with sufficient granularity to, after adjusting for comorbidity and matching with severity-specific service bundles, inform need-based planning efforts for adult (15 years and older) mental health and substance use services.
Obtaining reliable assessments of disorder prevalence and severity is a useful first step toward rationally estimating service need and plan health services. We propose a methodology to leverage existing information to obtain robust estimates in a timely manner and with sufficient granularity to, after adjusting for comorbidity and matching with severity-specific service bundles, inform need-based planning efforts for adult (15 years and older) mental health and substance use services.The Army Family Advocacy Program (Army FAP) strives to prevent family violence and intervene to reduce the deleterious effects of exposure to family violence. This paper examines the individual, family, community, and treatment factors associated with family violence revictimization. Case files of 134 families with substantiated child maltreatment and associated Army FAP interventions that closed in 2013 were coded across risk and protective factors and intervention characteristics and were matched to Army Central Registry files to identify revictimization rates through 2017. 3,4-Dichlorophenyl isothiocyanate solubility dmso Revictimization, experienced by 23% of families, was predicted by community risk and reduced by intervention dose. With the high rates of relocations, housing or neighborhood issues, and the isolation military families experience and the relationship of these concerns to repeated family violence, identifying the impact of community risk is particularly important. Similarly, research that elucidates the effective treatment components is needed.
Patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) were usually transferred from a primary stroke center (PSC) to a comprehensive stroke center (CSC) for endovascular treatment (drip-and-ship [DS]), while driving the doctor from a CSC to a PSC to perform a procedure is an alternative strategy (drip-and-drive [DD]).
To compare the efficacy and prognosis of the two strategies.
From February 2017 to June 2019, 62 patients with LVO received endovascular treatment via the DS and DD models and were retrospectively analyzed from the stroke alliance based on our CSC. Primary endpoint was door-to-reperfusion (DTR) time. Secondary endpoints included puncture-to-recanalization (PTR) time, modified Thrombolysis in Cerebral Infarction (mTICI) rates at the end of the procedure, and modified Rankin Scale (mRS) at 90 days.
Forty-one patients received the DS strategy and 21 patients received the DD strategy. The DTR time was significantly longer in the DS group compared to the DD group (315.5 ± 83.8 min vs. 248.6 ± 80.0 min;
< 0.05), and PTR time was shorter (77.2 ± 35.9 min vs. 113.7 ± 69.7 min;
= 0.033) compared with the DD group. Successful recanalization (mTICI 2b/3) was achieved in 89% (36/41) of patients in the DS group and 86% (18/21) in the DD group (
= 1.000). Favorable functional outcomes (mRS 0-2) were observed in 49% (20/41) of patients in the DS group and 71% (15/21) in the DD group at 90 days (
= 0.089).
Compared with the DS strategy, the DD strategy showed more effective and a trend of better clinical outcomes for AIS patients with LVO.
Compared with the DS strategy, the DD strategy showed more effective and a trend of better clinical outcomes for AIS patients with LVO.
We know little about the end-of-life suffering and symptoms of intensive care unit (ICU) decedents in general and those who undergo renal replacement therapy (RRT) in particular.
To examine differences in end-of-life suffering and various symptoms' contribution to suffering between ICU decedents who did not undergo RRT, those who underwent RRT for end-stage kidney disease (ESKD), and those who underwent RRT for acute kidney injury (AKI).
This is a cross-sectional study conducted at a quaternary-level referral hospital September 2015-March 2017. Nurses completed interviews about ICU patients' suffering and symptoms in their final week. We dichotomized overall suffering into elevated and non-elevated and each symptom as contributing or not to a patient's suffering.
Sixty-four nurses completed interviews on 165 patients. Median patient age was 67 years (interquartile range 57, 78); 41% were female. In a multivariable model, undergoing RRT for AKI (odds ratio [OR] 2.95, 95% confidence interval [CI] 1.34-6ts further study.To reduce the research to practice gap, promoting the utility of evidence-based repositories is essential among both practitioners and researchers. Organizing these repositories to address the needs of these audiences requires a user-centered design approach as proposed recently in an article by Harden et al, 2020. This commentary builds on the proposed solutions to introduce a recently redesigned Evidence-Based Cancer Control Programs (EBCCP) web repository (formerly Research-Tested Intervention Programs (RTIPs)) from the National Cancer Institute. Specifically, we describe the user-centered redesign process, strategies for broader dissemination of the repository using digital tools and provide future directions for the evidence-based program repository.Osteoarthritic degeneration of cartilage is a major social health problem. Tissue engineering of cartilage using combinations of scaffold and mesenchymal stem cells (MSCs) is emerging as an alternative to existing treatment options such as microfracture, mosaicplasty, allograft, autologous chondrocyte implantation, or total joint replacement. Induction of chondrogenesis in high-density pellets of MSCs is generally attained by soluble exogenous TGF-β3 in culture media, which requires lengthy in vitro culture period during which pellets gain mechanical robustness. On the other hand, a growth factor delivering and a mechanically robust scaffold material that can accommodate chondroid pellets would enable rapid deployment of pellets after seeding. Delivery of the growth factor from the scaffold locally would drive the induction of chondrogenic differentiation in the postimplantation period. Therefore, we sought to develop a biomaterial formulation that will induce chondrogenesis in situ, and compared its performance to soluble delivery in vitro.