Bredahlgibson1653

Compared to usual primary care, enhanced primary care was associated with an increase of 1.2 primary care visits (95% confidence interval [CI] 0.31 to 2.1) in the 18 months after the initial visit and decreases of 0.33 non-psychiatric inpatient stays (CI - 0.49 to - 0.16) and 3.0 non-psychiatric inpatient days (CI - 5.3 to - 0.60). Enhanced primary care had no significant effect on psychiatric service and ED use. Enhanced primary care increased the probability of glucose and HIV screening, decreased the probability of lipid screening, and had no effect on hemoglobin A1c and colorectal cancer screening.

Enhanced primary care for people with SMI can increase receipt of some preventive screening and decrease use of non-psychiatric inpatient care compared to usual primary care.

Enhanced primary care for people with SMI can increase receipt of some preventive screening and decrease use of non-psychiatric inpatient care compared to usual primary care.Personality is the description of an individual's tendencies when acting or reacting to others. Clinicians spontaneously form impressions of a patient's apparent personality yet such unstructured impressions might lead to snap judgments or unhelpful labels. Here we review the evidence-based five-factor model from psychology science for understanding personalities (OCEAN taxonomy). Openness to experience is defined as the general appreciation for a variety of experiences. Conscientiousness is the tendency to exhibit self-discipline. Extraversion is the degree of engagement with the external world. Agreeableness is the general concern for social harmony. Neuroticism is the tendency to experience negative emotions. An awareness of these five dimensions might help clinicians avoid faulty judgments from casual contact. Expert assessment of personality requires extensive training and data, thereby suggesting that clinicians should take a humble view of their own unsophisticated impressions of a patient's personality.

New virtual resources ("novel resources") have been incorporated into medical education. No recent large studies about their use and perception among internal medicine (IM) residents exist.

Characterize the use and perceived helpfulness of educational resources.

Nationwide survey from December 2019 to March 2020.

IM residents in the USA.

Residents were surveyed on their use and their perceived helpfulness of resources for both attaining general medical knowledge and for point-of-care (POC) learning. Traditional resources included board review resources, clinical experience, digital clinical resources (e.g., UpToDate), journal articles, pocket references, professional guidelines, textbooks, and residency curricula. Novel resources included Twitter, video streaming platforms (e.g., YouTube), online blogs, podcasts, and Wikipedia.

We had 662 respondents from 55 residency programs across 26 states. On average, residents used 9 total resources (7 traditional and 2 novel). Digital clinical resources andur findings can inform residency programs as they transition to virtual curricula in the wake of the COVID-19 pandemic.

Home telemonitoring has been used with discharged patients in an attempt to reduce 30-day readmissions with mixed results.

To assess whether home 30-day telemonitoring after discharge for patients at high risk of readmission would reduce readmissions or mortality.

Prospective, randomized controlled trial.

We compared 30-day readmission rates and mortality for patients at high risk for readmission who received home telemonitoring versus standard care between November 1, 2014, and November 30, 2018, in 2 tertiary care hospitals.

The intervention group received home-installed equipment to measure blood pressure, heart rate, pulse oximetry, weight if heart failure was present, and glucose if diabetes was present. Results were transmitted daily and reviewed by a nurse. Both groups received standard care.

The primary outcome was a composite end point of hospital readmission or death within 30days after discharge. The secondary outcome was an emergency department visit within 30days after discharge.

A total of 1380 participants (mean [SD] age, 66 [14] years; 722 [52.3%] men and 658 [47.7%] women) participated in this study. Using a modified intention-to-treat analysis, the risk of readmission or death within 30days among patients at high readmission risk was 23.7% (137/578) in the control group and 18.2% (87/477) in the telemonitoring group (absolute risk difference, -5.5% [95% CI, -10.4 to - 0.6%]; relative risk, 0.77 [95% CI, 0.61 to 0.98]; P = .03). Emergency department visits occurred within 30days after discharge in 14.2% (81/570) of patients in the control group and 8.6% (40/464) of patients in the telemonitoring group (absolute risk difference, -5.6% [95% CI, -9.4 to -1.8%]; relative risk, 0.61 [95% CI, 0.42 to 0.87]; P = .005).

Thirty days of postdischarge telemonitoring may reduce readmissions of high-risk patients.

ClinicalTrials.gov identifier NCT02136186.

ClinicalTrials.gov identifier NCT02136186.In the last years, technological advancements for the analysis of electroencephalography (EEG) recordings have permitted to investigate neural activity and connectivity in the human brain with unprecedented precision and reliability. A crucial element for accurate EEG source reconstruction is the construction of a realistic head model, incorporating information on electrode positions and head tissue distribution. In this paper, we introduce MR-TIM, a toolbox for head tissue modelling from structural magnetic resonance (MR) images. The toolbox consists of three modules 1) image pre-processing - the raw MR image is denoised and prepared for further analyses; 2) tissue probability mapping - template tissue probability maps (TPMs) in individual space are generated from the MR image; 3) tissue segmentation - information from all the TPMs is integrated such that each voxel in the MR image is assigned to a specific tissue. MR-TIM generates highly realistic 3D masks, five of which are associated with brain structures (brain and cerebellar grey matter, brain and cerebellar white matter, and brainstem) and the remaining seven with other head tissues (cerebrospinal fluid, spongy and compact bones, eyes, muscle, fat and skin). MTX-531 chemical structure Our validation, conducted on MR images collected in healthy volunteers and patients as well as an MR template image from an open-source repository, demonstrates that MR-TIM is more accurate than alternative approaches for whole-head tissue segmentation. We hope that MR-TIM, by yielding an increased precision in head modelling, will contribute to a more widespread use of EEG as a brain imaging technique.