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Youth anxiety and depression are common and undertreated. Pediatric transdiagnostic interventions for anxiety and/or depression may be associated with improved access to treatment among youths.
To evaluate the cost-effectiveness of a pediatric transdiagnostic brief behavioral therapy (BBT) program for anxiety and/or depression compared with assisted referral to community outpatient mental health care (ARC).
In this economic evaluation, an incremental cost-effectiveness analysis was performed from the societal perspective using data from a randomized clinical trial of youths with full or probable diagnoses of anxiety or depression who were recruited from pediatric clinics in San Diego, California, and Pittsburgh, Pennsylvania. The trial was conducted from October 6, 2010, through December 5, 2014, and this analysis was performed from January 1, 2019, through October 20, 2020.
In the randomized clinical trial, youths were randomized to BBT (n = 95) or ARC (n = 90). The BBT program consisted of 8 to 12 wgs suggest that transdiagnostic BBT may be associated with improved youth anxiety and functioning at a reasonable cost.
Implant registries provide valuable information on the performance of implants in a real-world setting, yet they have traditionally been expensive to establish and maintain. Electronic health records (EHRs) are widely used and may include the information needed to generate clinically meaningful reports similar to a formal implant registry.
To quantify the extractability and accuracy of registry-relevant data from the EHR and to assess the ability of these data to track trends in implant use and the durability of implants (hereafter referred to as implant survivorship), using data stored since 2000 in the EHR of the largest integrated health care system in the United States.
Retrospective cohort study of a large EHR of veterans who had 45 351 total hip arthroplasty procedures in Veterans Health Administration hospitals from 2000 to 2017. Data analysis was performed from January 1, 2000, to December 31, 2017.
Total hip arthroplasty.
Number of total hip arthroplasty procedures extracted from the EHR, tsurveillance of implant performance.
There is evidence of central nervous system impairments associated with coronavirus disease 2019 (COVID-19) infection, including encephalopathy. Multimodal monitoring of patients with COVID-19 may delineate the specific features of COVID-19-related encephalopathy and guide clinical management.
To investigate clinical, biological, and brain magnetic resonance imaging (MRI) findings in association with electroencephalographic (EEG) features for patients with COVID-19, and to better refine the features of COVID-19-related encephalopathy.
This retrospective cohort study conducted in Pitié-Salpêtrière Hospital, Paris, France, enrolled 78 hospitalized adults who received a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) and underwent EEG between March 30 and June 11, 2020.
Detection of SARS-CoV-2 from a nasopharyngeal specimen using a reverse transcription-polymerase chain reaction assay or, in the case of associated pneumonia, on a computed tomography scan of the chest.
Data on tle cause of brain injury outside COVID-19 were further isolated; their brain injury was defined as COVID-19-related encephalopathy. They represented 1% (9 of 644) of patients with COVID-19 requiring hospitalization. Six of these 9 patients had movement disorders, 7 had frontal syndrome, 4 had brainstem impairment, 4 had periodic EEG discharges, and 3 had MRI white matter-enhancing lesions.
The results from this cohort of patients hospitalized with COVID-19 suggest there are clinical, EEG, and MRI patterns that could delineate specific COVID-19-related encephalopathy and guide treatment strategy.
The results from this cohort of patients hospitalized with COVID-19 suggest there are clinical, EEG, and MRI patterns that could delineate specific COVID-19-related encephalopathy and guide treatment strategy.
Epidemiological literature on children's mental health and children's adverse childhood experiences (ACEs) have consistently pointed to widespread, unaddressed, and treatable high-risk conditions among children.
To estimate the proportion of children with either high levels of ACEs and/or high levels of mental health symptoms who were not receiving services from behavioral health professionals.
This cross-sectional study included 11 896 children who participated in 3 National Surveys of Children's Exposure to Violence (NatSCEV), which were nationally representative surveys conducted in 2008, 2011, and 2014. The surveys entailed telephone interviews with youth aged 10 to 17 years and caregivers of children aged 2 to 9 years. Data were analyzed from February to August 2020.
Nationally representative samples were obtained from a mix of random digit dial and address-based sampling methods. The primary outcome was the proportion of children with high ACEs, high distress symptoms, and both who were receivinow for Black children aged 2 to 9 years with high ACEs compared with non-Hispanic White children with the same age and exposure (odds ratio, 0.26; 95% CI, 0.14-0.49).
In this cross-sectional study combining findings from 3 US national surveys, large portions of children at high risk because of adversity or mental health symptoms were not receiving clinical services. selleck chemical Better ways are needed to find these at-risk populations and help them obtain relevant intervention resources.
In this cross-sectional study combining findings from 3 US national surveys, large portions of children at high risk because of adversity or mental health symptoms were not receiving clinical services. Better ways are needed to find these at-risk populations and help them obtain relevant intervention resources.
The effectiveness and importance of contact precautions for endemic pathogens has long been debated, and their use has broad implications for infection control of other pathogens.
To estimate the association between contact precautions and transmission of methicillin-resistant Staphylococcus aureus (MRSA) across US Department of Veterans Affairs (VA) hospitals.
This retrospective cohort study used mathematical models applied to data from a population-based sample of adults hospitalized in 108 VA acute care hospitals for at least 24 hours from January 1, 2008, to December 31, 2017. Data were analyzed from May 2, 2019, to December 11, 2020.
A positive MRSA test result, presumed to indicate contact precautions use according to the VA MRSA Prevention Initiative.
The main outcome was the association between contact precautions and MRSA transmission, defined as the relative transmissibility attributed to contact precautions. A contact precaution effect estimate (<1 indicates a reduction in transmission associated with contact precautions) was estimated for each hospital and then pooled over time and across hospitals using meta-regression.
