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Effect of Sustained Interventions from Infancy to Toddlerhood in Children with Cleft Lip and Palate for Preventing Early Childhood Caries.

Caries Res 2021 Jul 22:1-9. Epub 2021 Jul 22.

Department of Pediatric and Preventive Dentistry, Pushpagiri College of Dental Sciences, Thiruvalla, India.

The study aimed to evaluate the effectiveness of sustained interventions in children with cleft lip and palate (CLP) for preventing early childhood caries (ECC). This prospective, nonrandomized interventional cohort study was conducted in infants aged 0-12 months with congenital CLP. Interventions were given to parents/primary caregivers in the form of combined oral health-care measures (sterile wet gauze piece, finger brush, toothbrush, and toothpaste) by a motivational interviewing approach. Read More

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Insourcing and scaling a telemedicine solution in under 2 weeks: Lessons for the digital transformation of health care.

Healthc (Amst) 2021 Jul 19;9(3):100568. Epub 2021 Jul 19.

University of Pennsylvania Health System, Penn Medicine Center for Health Care Innovation, 3400 Civic Center Blvd, 14(th) Floor South Pavilion, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Office of the Chief Medical Information Officer, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA; University of Pennsylvania Health System, Cardiology, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Electronic address:

The Covid-19 pandemic required rapid scale of telemedicine as well as other digital workflows to maintain access to care while reducing infection risk. Both patients and clinicians who hadn't used telemedicine before were suddenly faced with a multi-step setup process to log into a virtual meeting. Unlike in-person examination rooms, locking a virtual meeting room was more error-prone and posed a risk of multiple patients joining the same online session. Read More

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Male involvement in promotion of safe motherhood in low- and middle-income countries: A scoping review.

Midwifery 2021 Jul 14;103:103089. Epub 2021 Jul 14.

Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom. Electronic address:

Background: Maternal health programmes that focus on the woman alone are limiting in LMICs as pregnant women often relate to maternity services through a complex social web that reflects power struggles within the kinship and the community.

Methods: A scoping review was conducted to explore the rationale for male involvement in maternal health in LMICs. This review was guided by the question: What is the current state of knowledge regarding the inclusion of men in maternal health services in LMICs? The literature search was conducted using mySearch, Bournemouth University`s iteration of the EBSCO Discovery Service (EDS) tool. Read More

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A French survey on the lockdown consequences of COVID-19 pandemic in Parkinson's disease. The ERCOPARK study.

Parkinsonism Relat Disord 2021 Jul 13;89:128-133. Epub 2021 Jul 13.

Service de Neurologie, Centre Hospitalier Universitaire, Toulouse, France; France CHU de Toulouse, Université de Toulouse-Toulouse 3, INSERM, UMR1214 Toulouse NeuroImaging Centre "TONIC," Center of Excellence in Neurodegeneration (CoEN), NeuroToul, Centre Expert Parkinson de Toulouse, Centre d'Investigation Clinique CIC1436, NS-Park/FCRIN Network, Services de Neurologie et de Pharmacologie Clinique, UMR 1048 Institute for Cardiovascular Diseases, Toulouse, France.

Background: In 2020 the coronavirus disease 19 (COVID-19) pandemic imposed a total and sudden lockdown. We aimed to investigate the consequences of the first COVID-19 lockdown (mid-March - mid-April 2020) on motor and non-motor symptoms (NMS) in a cohort of French people with Parkinson's disease (PwP).

Methods: PwP were enrolled either by an on-line survey sent from the national France Parkinson association (FP) to reach the French community of PwP or as part of outpatients' telemedicine visits followed by an hospital-based Parkinson Expert Center (PEC). Read More

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The birth trauma psychological therapy service: An audit of outcomes.

Midwifery 2021 Jul 13;102:103099. Epub 2021 Jul 13.

Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. Electronic address:

Objective: To evaluate routinely collected service data from a 'Birth Trauma' psychology clinic integrated into maternity services, in order to review effectiveness for women with symptoms of Post-Traumatic Stress Disorder (PTSD) following childbirth.

Background: Prevalence of PTSD after child-birth has been estimated to be around 3% for women meeting full diagnostic criteria and up to 9% for sub-threshold symptoms. This can occur even in response to deliveries considered to be medically straightforward. Read More

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Pembrolizumab for locally advanced and recurrent/metastatic cutaneous squamous cell carcinoma (KEYNOTE-629 Study): an open-label, nonrandomized, multicenter, phase 2 trial.

Ann Oncol 2021 Jul 19. Epub 2021 Jul 19.

Service de Dermatologie et Cancérologie Cutanée, Aix-Marseille University, Marseille, France.

Background: Pembrolizumab demonstrated clinically meaningful and durable antitumor activity with a manageable safety profile in recurrent/metastatic (R/M) cutaneous squamous cell carcinoma (cSCC).

Patients And Methods: KEYNOTE-629 was a global, open-label, nonrandomized, phase 2 trial of patients with locally advanced (LA) or R/M cSCC conducted at 59 centers. Eligible patients received intravenous pembrolizumab 200 mg every three weeks for up to 35 cycles. Read More

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Secondary Interpretations of Diagnostic Imaging Examinations: Patient Liabilities and Out-of-Pocket Costs.

J Am Coll Radiol 2021 Jul 19. Epub 2021 Jul 19.

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. Electronic address:

Background: Secondary interpretations of diagnostic imaging examinations are increasingly performed to improve care for complex patients. We sought to determine associated patient-billed liabilities and out-of-pocket payments and to identify patient and imaging study characteristics that correlate with higher patient bills and out-of-pocket payments.

Methods: Data extracted for 7,740 secondary imaging interpretations performed across our large metropolitan health system over 25 months included total professional charges, insurance payments, patient-billed liabilities, and patient out-of-pocket payments. Read More

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The Association of Service Use and Other Client Factors With the Time to Transition From Home Care to Facility-Based Care.

J Am Med Dir Assoc 2021 Jul 19. Epub 2021 Jul 19.

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

Objectives: People are living longer with complex health needs and wish to remain in their homes as their care needs change. We examined which client factors (sociodemographic, health service use, health, and function) influenced older persons' (≥65 years) time to transition from home living to assisted living (AL) or long-term care (LTC) facilities.

Design: Retrospective cohort study. Read More

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First-Line Health Care Providers' Reported Knowledge of and Referrals to Speech-Language Pathologists for Clients With Mild Traumatic Brain Injury.

Am J Speech Lang Pathol 2021 Jul 22:1-14. Epub 2021 Jul 22.

Department of Speech Pathology and Audiology, Miami University, Oxford, OH.

Purpose People with mild traumatic brain injury (mTBI) may experience deficits in cognition or communication that go unnoticed by first-line health care providers (FHPs). Speech-language pathologists (SLPs) assess and treat these domains yet are often underrepresented on mTBI multidisciplinary teams. This study's aim was to evaluate FHPs' reported knowledge of and referral practices to SLPs for individuals across the life span with mTBI. Read More

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Institutional delivery and associated factors in rural communities of Central Gondar Zone, Northwest Ethiopia.

PLoS One 2021 22;16(7):e0255079. Epub 2021 Jul 22.

Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Introduction: Institutional delivery has been considered as one of the important strategies to improve maternal and child health and significantly reduces birth-related complications. However, it is still low in developing countries though there are some improvements. Hence, the aim of this study was to assess the prevalence of institutional delivery and associated factors in the study area. Read More

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Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015.

PLoS One 2021 22;16(7):e0255134. Epub 2021 Jul 22.

Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS) and Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.

Aims: Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000-2015.

Methods And Results: Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm to identify and link patient-level sequential hospitalizations occurring within 30 days from first admission (considering all hospitalizations within the 30-day timeframe as belonging to the same ACS episode of care-ACS-EC). From 212,481 ACS-EC, 42,670 (20. Read More

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Effectiveness of mobile phone text message reminder interventions to improve adherence to antiretroviral therapy among adolescents living with HIV: A systematic review and meta-analysis.

PLoS One 2021 22;16(7):e0254890. Epub 2021 Jul 22.

KNCV Tuberculosis Foundation, The Hague, Netherlands.

Background: Poor adherence to antiretroviral therapy in adolescents living with HIV is a global challenge. One of the key strategies to improve adherence is believed to be the use of digital adherence tools. However, evidence is limited in this area. Read More

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Design and psychometric evaluation of schools' resilience tool in Emergencies and disasters: A mixed-method.

PLoS One 2021 22;16(7):e0253906. Epub 2021 Jul 22.

Department of Anesthesiology and Critical Care, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: In addition to their educational role, resilient schools have a good capacity in response to disasters. Due to the large student population, the schools can be a safe and secure environment during disasters, in addition to maintaining their performance after. Given the role and importance of the schools, the impact of culture and environment on resilience, without any indigenous and comprehensive tool for measuring the resilience in Iran, the study aimed to design and psychometrically evaluate the measurement tools. Read More

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Hypertension among people living with HIV/AIDS in Cameroon: A cross-sectional analysis from Central Africa International Epidemiology Databases to Evaluate AIDS.

PLoS One 2021 22;16(7):e0253742. Epub 2021 Jul 22.

Department of Public Health, New York Medical College, Valhalla, New York, United States of America.

Background: Antiretroviral therapy (ART) success has led people to live longer with HIV/AIDS (PLWH) and thus be exposed to increasing risk of cardiovascular diseases (CVD). Hypertension (HTN), the biggest contributor to CVD burden, is a growing concern among PLWH. The current report describes the prevalence and predictors of HTN among PLWH in care in Cameroon. Read More

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Predictors of use of dental care by children in north-central Appalachia in the USA.

PLoS One 2021 22;16(7):e0250488. Epub 2021 Jul 22.

Center for Oral Health Research in Appalachia, Appalachia, New York, United States of America.

Use of dental services in childhood, especially preventive care, is associated with many important oral health outcomes throughout life. The Andersen behavioral model of healthcare utilization posits that predisposing characteristics, enabling resources, and need factors predict utilization in oral and other healthcare domains. Inequities that produce lower utilization of dental services in north-central Appalachia have been documented in comparison to the USA generally. Read More

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Addressing antimicrobial resistance by improving access and quality of care-A review of the literature from East Africa.

PLoS Negl Trop Dis 2021 Jul 22;15(7):e0009529. Epub 2021 Jul 22.

The Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom.

Universal access to healthcare, including quality medicines, is a fundamental human right but is still out of reach for many in low- and middle-income countries (LMICs). An existing framework capturing variability of access to healthcare in low-resource settings includes the 5 dimensions: availability, accessibility, affordability, adequacy, and acceptability. This framework encompasses key components, including health infrastructure and means to access it as well as service organisation, costs, and factors that influence users' satisfaction. Read More

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Telestroke for acute ischaemic stroke: A systematic review of economic evaluations and a de novo cost-utility analysis for a middle income country.

J Telemed Telecare 2021 Jul 22:1357633X211032407. Epub 2021 Jul 22.

Deakin Health Economics, Institute for Health Transformation, 2104Deakin University, Australia.

Introduction: Telemedicine can alleviate the problems faced in rural settings in providing access to specialist stroke care. The evidence of the cost-effectiveness of this model of care outside high-income countries is limited. This study aimed to conduct: (a) a systematic review of economic evaluations of telestroke and (b) a cost-utility analysis of telestroke, using China as a case study. Read More

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Outpatient Practice Reactivation in an Integrated Community Practice During the COVID-19 Pandemic.

Telemed J E Health 2021 Jul 22. Epub 2021 Jul 22.

Department of Management Engineering and Consulting, Mayo Clinic, Rochester, Minnesota, USA.

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Confronting behaviour in palliative care: a qualitative study of the lived experience of nursing staff.

Int J Palliat Nurs 2021 Jul;27(5):245-253

Professor of Psycho-oncology, Olivia Newton-John Cancer Wellness and Research Centre, Melbourne, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, Australia.

Background: Little research examines the extent and impact of aggressive or uncomfortable 'confronting behaviour' experienced by palliative care nurses, despite palliative wards being an emotionally labile environment.

Methods: Qualitative data on nurses' experiences of confrontation were collected from 17 palliative care nurses at a major metropolitan hospital via a focus group and individual interviews. Data were analysed using inductive thematic analysis. Read More

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Outcomes of pregnancy in simultaneous pancreas and kidney transplant recipients: A single-center retrospective study.

Clin Transplant 2021 Jul 22. Epub 2021 Jul 22.

Department of Nephrology and Transplantation, London, UK.

Simultaneous pancreas and kidney (SPK) transplantation, in uremic women with insulin-dependent diabetes, increases the chance of a successful pregnancy and minimizes the risk to infants. The aim of this study was to document pregnancy and explore the challenges in this cohort of women. Retrospective analysis of women who underwent pancreas transplantation between 01/01/1998 and 01/08/2019 was conducted. Read More

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Effectiveness and acceptability of a multidisciplinary approach in improving the care of patients with advanced chronic kidney disease: a pilot study.

Int Urol Nephrol 2021 Jul 22. Epub 2021 Jul 22.

Duke-NUS Medical School, Health Services and Systems Research, Singapore, Singapore.

Objective: This study aimed at determining the feasibility of conducting a large-scale pragmatic effectiveness study on the implementation of multidisciplinary care (MDC) program for patients with advanced chronic kidney disease (CKD).

Methods: This is a single-arm pre-post intervention design pilot study over 12 months. Participants with an estimated glomerular filtration rate (eGFR) between 11 and 20 ml/min/1. Read More

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Eating Problems in Autistic Females and Males: A Co-twin Control Study.

J Autism Dev Disord 2021 Jul 22. Epub 2021 Jul 22.

Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, Floor 8, 113 30, Stockholm, Sweden.

This study investigated the association between autism and self-reported eating problems and the influence of gender on the association, in a sample of adolescent and adult twins (N = 192). Autistic traits and autism diagnosis were associated with both total and specific eating problems, including selective eating and sensory sensitivity during mealtimes. Interaction effects indicated a stronger association between autistic traits and total eating problems in females, as well as more difficulties with eating in social contexts among autistic females. Read More

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Evaluation of the InTray and Compact Dry culture systems for the diagnosis of urinary tract infections in patients presenting to primary health clinics in Harare, Zimbabwe.

Eur J Clin Microbiol Infect Dis 2021 Jul 22. Epub 2021 Jul 22.

Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, UK.

Antimicrobial resistance surveillance data is lacking from many resource-limited settings mainly due to limited laboratory testing. Novel culture systems may address some of the limitations of conventional culture media and expand the availability of microbiology services. The aims of this study were to evaluate the performance of InTray COLOREX Screen/ESBL and Compact Dry for the detection of uropathogens and of extended-spectrum beta-lactamase (ESBL)-producing organisms from urine samples. Read More

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Understanding the Effect of a Healthcare Provider-Led Family Planning Support Intervention on Contraception use and Pregnancy Desires among Postpartum Women Living with HIV in Southwestern Uganda.

AIDS Behav 2021 Jul 22. Epub 2021 Jul 22.

Mbarara University of Science and Technology, Mbarara, Uganda.

Modern contraceptive prevalence among women living with HIV (WLWH) in Uganda is still low at 45%, and up to a third of women are likely to discontinue the method within the first year of initiation. This increases risks of unplanned pregnancies, perinatal HIV transmission and pregnancy complications. We aim to explore and explain the mechanism of effect of a family planning support intervention investigated in a randomized controlled trial conducted between October 2016 and June 2018 among 320 postpartum WLWH at a referral hospital in Southwestern Uganda that led to improved uptake, decreased contraception discontinuation and lowered pregnancy rates. Read More

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A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya.

AIDS Behav 2021 Jul 22. Epub 2021 Jul 22.

Department of Health Systems Design and Global Health, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, 1216 Fifth Avenue, Fifth Floor, Room 556, New York, NY, USA.

Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15. Read More

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Noninvasive ventilation vs. high-flow nasal cannula oxygen for preoxygenation before intubation in patients with obesity: a post hoc analysis of a randomized controlled trial.

Ann Intensive Care 2021 Jul 22;11(1):114. Epub 2021 Jul 22.

Médecine Intensive Réanimation, CHU de Poitiers, Poitiers, France.

Background: Critically ill patients with obesity may have an increased risk of difficult intubation and subsequent severe hypoxemia. We hypothesized that pre-oxygenation with noninvasive ventilation before intubation as compared with high-flow nasal cannula oxygen may decrease the risk of severe hypoxemia in patients with obesity.

Methods: Post hoc subgroup analysis of critically ill patients with obesity (body mass index ≥ 30 kg·m) from a multicenter randomized controlled trial comparing preoxygenation with noninvasive ventilation and high-flow nasal oxygen before intubation of patients with acute hypoxemic respiratory failure (PaO/FiO < 300 mm Hg). Read More

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Evaluation of a Clinical Decision Support Strategy to Increase Seasonal Influenza Vaccination Among Hospitalized Children Before Inpatient Discharge.

JAMA Netw Open 2021 Jul 1;4(7):e2117809. Epub 2021 Jul 1.

Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.

Importance: Hospitalized children are at increased risk of influenza-related complications, yet influenza vaccine coverage remains low among this group. Evidence-based strategies about vaccination of vulnerable children during all health care visits are especially important during the COVID-19 pandemic.

Objective: To design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. Read More

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Exploring Older Adults' Experiences of a Home-Based, Technology-Driven Balance Training Exercise Program Designed to Reduce Fall Risk: A Qualitative Research Study Within a Randomized Controlled Trial.

J Geriatr Phys Ther 2021 Jul 14. Epub 2021 Jul 14.

School of Health, Medicine and Applied Science, Appleton Institute, CQUniversity, Melbourne, Victoria Australia. Public Health, Health Faculty, Torrens University Australia, Adelaide, South Australia, Australia. Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia. Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile. School of Population Health, University of New South Wales, Sydney, Australia. Neuroscience Research Australia, Randwick, Australia. Prince of Wales Hospital Clinical School, University of New South Wales, Sydney, Australia. Centre for Excellence in Population Ageing Research, The University of Sydney, Sydney, Australia. Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, the Netherlands. Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. School of Health, Medicine and Applied Science, Appleton Institute, CQUniversity, Rockhampton North, Australia.

Background And Purpose: With an aging population, falls have become an increasing public health concern. While face-to-face exercise programs have demonstrated efficacy in reducing falls, their effectiveness is hampered by low participation and adherence. Digital technologies are a novel and potentially effective method for delivering tailored fall prevention exercise programs to older adults. Read More

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