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Stigmatization of people with alcohol use disorders: An updated systematic review of population studies.

Alcohol Clin Exp Res 2021 May 10. Epub 2021 May 10.

Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.

Background: We summarize research on the public stigmatization of persons with alcohol use disorder (AUD) in comparison with other mental health conditions and embed the results into a conceptual framework of the stigma process.

Methods: We conducted a systematic search using Embase, MEDLINE, PubMed and PsycINFO (via Ovid), and Web of Science for population-based studies on the public stigma in AUD and at least 1 other mental health condition, published between October 1, 2010 and December 20, 2020, thus including all studies published since the last systematic review on this topic. The study is registered with PROSPERO (registration number: CRD42020173054). Read More

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Semiautomatic Recruitment of Trial Patients Using ELGA Data: Conceptual Design and Implementation of an IT Tool.

Stud Health Technol Inform 2021 May;279:38-45

Section for Medical Information Management, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria.

Reuse of EHR data can substantially improve the recruitment process of clinical trials. As shown earlier, Shared EHR systems are particularly attractive data sources. The goal of this work was to conceptually design and implement a user-friendly tool for semiautomatic trial recruitment using ELGA data. Read More

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Planning for patient-reported outcome implementation: Development of decision tools and practical experience across four clinics.

J Clin Transl Sci 2020 Apr 6;4(6):498-507. Epub 2020 Apr 6.

Northwestern University, Chicago, IL, USA.

Introduction: Many institutions are attempting to implement patient-reported outcome (PRO) measures. Because PROs often change clinical workflows significantly for patients and providers, implementation choices can have major impact. While various implementation guides exist, a stepwise list of decision points covering the full implementation process and drawing explicitly on a sociotechnical conceptual framework does not exist. Read More

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Current understandings of the impact of mandatory vaccination laws in Europe.

Expert Rev Vaccines 2021 Apr 26. Epub 2021 Apr 26.

Susan Wakil School of Nursing and Midwifery. Faculty of Medicine and Health. University of Sydney, Sydney, Australia.

Introduction: Vaccination is one of the most successful preventive tools to protect collective health. In response to alarming vaccines preventable diseases (VPDs) outbreaks resurgence, decreased vaccination coverage and vaccine refusal, several European countries have recently revised their vaccination policies introducing or extending mandatory vaccination. This review examines the health, political and ethical aspects of mandatory vaccination. Read More

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Generating and capitalizing on the demographic dividend potential in sub-Saharan Africa: a conceptual framework from a systematic literature review.

Gates Open Res 2020 25;4:145. Epub 2020 Sep 25.

Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.

Africa will double its population by 2050 and more than half will be below age 25. The continent has a unique opportunity to boost its socioeconomic welfare. This systematic literature review aims to develop a conceptual framework that identifies policies and programs that have provided a favorable environment for generating and harnessing a demographic dividend. Read More

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September 2020

Utility, Value, and Benefits of Contemporary Personal Health Records: Integrative Review and Conceptual Synthesis.

J Med Internet Res 2021 Apr 29;23(4):e26877. Epub 2021 Apr 29.

School of Engineering & Technology, Central Queensland University, Melbourne, Australia.

Background: Contemporary personal health record (PHR) technologies offer a useful platform for individuals to maintain a lifelong record of personally reported and clinically sourced data from various points of medical care.

Objective: This paper presents an integrative review and synthesis of the extant literature on PHRs. This review draws upon multiple lenses of analysis and deliberates value perspectives of PHRs at the product, consumer, and industry levels. Read More

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Blockchain Personal Health Records: Systematic Review.

J Med Internet Res 2021 Apr 13;23(4):e25094. Epub 2021 Apr 13.

National University Health System, Singapore, Singapore.

Background: Blockchain technology has the potential to enable more secure, transparent, and equitable data management. In the health care domain, it has been applied most frequently to electronic health records. In addition to securely managing data, blockchain has significant advantages in distributing data access, control, and ownership to end users. Read More

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How Are the Arts and Humanities Used in Medical Education? Results of a Scoping Review.

Acad Med 2021 Apr 6. Epub 2021 Apr 6.

T. Moniz is associate professor, Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0002-5078-4611. M. Golafshani is a second-year medical student, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. C.M. Gaspar is a PhD candidate, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-0412-5495. N.E. Adams is associate librarian and assistant dean of foundational sciences, Penn State College of Medicine, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-0534-6716. P. Haidet is director of medical education research, Woodward Center for Excellence in Health Sciences Education, Penn State College of Medicine, Hershey, Pennsylvania. J. Sukhera is associate professor, Departments of Psychiatry and Paediatrics, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0001-8146-4947. R.L. Volpe is associate professor and vice chair for education, Department of Humanities, Penn State College of Medicine, and director, Clinical Ethics Consultation Service, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania; ORCID: https://orcid.org/0000-0003-3406-9498. C. de Boer is director, Doctors Kienle Center for Humanistic Medicine, and founding director, Center Stage Arts in Health, Penn State College of Medicine and Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. She is president, National Organization for Arts in Health, San Diego, California. L. Lingard is professor, Department of Medicine, and scientist, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Purpose: Although focused reviews have characterized subsets of the literature on the arts and humanities in medical education, a large-scale overview of the field is needed to inform efforts to strengthen these approaches in medicine.

Method: The authors conducted a scoping review in 2019 to identify how the arts and humanities are used to educate physicians and interprofessional learners across the continuum of medical education in Canada and the United States. A search strategy involving 7 databases identified 21,985 citations. Read More

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Self-Care in Pediatric Patients with Chronic Conditions: A Systematic Review of Theoretical Models.

Int J Environ Res Public Health 2021 03 28;18(7). Epub 2021 Mar 28.

Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.

Background: To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support.

Aims: (1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework.

Methods: A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

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Bayesian G-Computation to Estimate Impacts of Interventions on Exposure Mixtures: Demonstration with Metals from Coal-fired Power Plants and Birthweight.

Am J Epidemiol 2021 Mar 6. Epub 2021 Mar 6.

Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin.

The importance of studying health impacts of exposure mixtures is increasingly recognized but presents many methodological and interpretation difficulties. We used Bayesian g-computation to estimate effects of a simulated public health action on exposure mixtures and birthweight in Milwaukee, Wisconsin in 2011-2013. We linked birth records data with census tract level air toxics data from the U. Read More

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Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review.

BMC Med Educ 2021 Mar 19;21(1):172. Epub 2021 Mar 19.

University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

Background: Entrustable professional activities (EPAs) are increasingly used in undergraduate medical education (UME). We conducted a scoping review to summarize the evidence for the use of EPAs in clinical rotations in UME.

Methods: We searched multiple databases for scoping reviews based on the PRISMA guidelines for articles reporting qualitative and quantitative research, as well as conceptual and curriculum development reports, on EPAs in UME clinical rotations. Read More

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Social and Behavioral Variables in the Electronic Health Record: A Path Forward to Increase Data Quality and Utility.

Acad Med 2021 Mar 16. Epub 2021 Mar 16.

E.C. Lasser is a research associate, Johns Hopkins Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; ORCID: https://orcid.org/0000-0002-1758-9822. J.M. Kim is assistant professor, Department of Pediatrics, and faculty, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland; ORCID: https://orcid.org/0000-0001-5678-6629. E. Hatef is assistant scientist, Johns Hopkins Center for Population Health Information Technology and Center for Health Disparities Solutions, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; ORCID: https://orcid.org/0000-0003-2535-8191. H. Kharrazi is associate professor, Johns Hopkins Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; ORCID: https://orcid.org/0000-0003-1481-4323. J.A. Marsteller is professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, and jointly appointed, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland; ORCID: https://orcid.org/0000-0002-8458-954X. L.R. DeCamp is associate professor, ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science), Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Denver, Colorado; ORCID: https://orcid.org/0000-0002-5210-4675.

Purpose: Social and behavioral determinants of health (SBDH) are important factors that affect the health of individuals but are not routinely captured in a structured and systematic manner in electronic health records (EHRs). The purpose of this study is to generate recommendations for systematic implementation of SBDH data collection in EHRs through (1) reviewing SBDH conceptual and theoretical frameworks and (2) eliciting stakeholder perspectives on barriers to and facilitators of using SBDH information in the EHR and priorities for data collection.

Method: The authors reviewed SBDH frameworks to identify key social and behavioral variables and conducted focus groups and interviews with 17 clinicians and researchers at Johns Hopkins Health System between March and May 2018. Read More

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Impact of the COVID-19 Pandemic on Older Adults: Rapid Review.

JMIR Aging 2021 Apr 12;4(2):e26474. Epub 2021 Apr 12.

Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada.

Background: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. Read More

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Healthcare Process Modeling to Phenotype Clinician Behaviors for Exploiting the Signal Gain of Clinical Expertise (HPM-ExpertSignals): Development and evaluation of a conceptual framework.

J Am Med Inform Assoc 2021 Feb 24. Epub 2021 Feb 24.

School of Nursing, Columbia University, New York, New York, USA.

Objective: There are signals of clinicians' expert and knowledge-driven behaviors within clinical information systems (CIS) that can be exploited to support clinical prediction. Describe development of the Healthcare Process Modeling Framework to Phenotype Clinician Behaviors for Exploiting the Signal Gain of Clinical Expertise (HPM-ExpertSignals).

Materials And Methods: We employed an iterative framework development approach that combined data-driven modeling and simulation testing to define and refine a process for phenotyping clinician behaviors. Read More

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February 2021

Toolkits for implementing and evaluating digital health: A systematic review of rigor and reporting.

J Am Med Inform Assoc 2021 Feb 23. Epub 2021 Feb 23.

WHO Collaborating Centre on eHealth (AUS-135), School of Population Health, UNSW Sydney, New South Wales, Australia.

Objective: Toolkits are an important knowledge translation strategy for implementing digital health. We studied how toolkits for the implementation and evaluation of digital health were developed, tested, and reported.

Materials And Methods: We conducted a systematic review of toolkits that had been used, field tested or evaluated in practice, and published in the English language from 2009 to July 2019. Read More

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February 2021

Senescent cells and the incidence of age-related diseases.

Aging Cell 2021 03 8;20(3):e13314. Epub 2021 Feb 8.

Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel.

Age-related diseases such as cancer, cardiovascular disease, kidney failure, and osteoarthritis have universal features: Their incidence rises exponentially with age with a slope of 6-8% per year and decreases at very old ages. There is no conceptual model which explains these features in so many diverse diseases in terms of a single shared biological factor. Here, we develop such a model, and test it using a nationwide medical record dataset on the incidence of nearly 1000 diseases over 50 million life-years, which we provide as a resource. Read More

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Factors associated with inpatient length of stay among hospitalised patients with chronic obstructive pulmonary disease, China, 2016-2017: a retrospective study.

BMJ Open 2021 02 5;11(2):e040560. Epub 2021 Feb 5.

Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.

Objectives: To identify factors associated with length of stay (LOS) in chronic obstructive pulmonary disease (COPD) hospitalised patients, which may help shorten LOS and reduce economic burden accrued over hospital stay.

Design: A retrospective cohort study.

Setting: This study was performed in a tertiary hospital in China. Read More

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February 2021

Doctors of chiropractic working with or within integrated healthcare delivery systems: a scoping review protocol.

BMJ Open 2021 01 25;11(1):e043754. Epub 2021 Jan 25.

Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.

Introduction: Back and neck pain are the leading causes of disability worldwide. Doctors of chiropractic (DCs) are trained to manage these common conditions and can provide non-pharmacological treatment aligned with international clinical practice guidelines. Although DCs practice in over 90 countries, chiropractic care is rarely available within integrated healthcare delivery systems. Read More

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January 2021

Social-ecological interactions in the Draa River Basin, southern Morocco: Towards nature conservation and human well-being using the IPBES framework.

Sci Total Environ 2021 May 6;769:144492. Epub 2021 Jan 6.

iES Landau, Institute for Environmental Sciences, University of Koblenz-Landau, Landau, Germany.

Water is essential to human societies and a prerequisite for flourishing nature, especially in arid regions. Yet, climate change and socio-economic developments are expected to exacerbate current and future stresses on water resources, demanding innovative approaches to balance water needs for society and nature conservation. In this study, we use the IPBES conceptual framework to combine ecological and socio-economic insights and analyse the connections between people and nature in the water scarce Draa River Basin, southern Morocco. Read More

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Harm reduction program and hepatitis C prevalence in people who inject drugs (PWID) in Iran: an updated systematic review and cumulative meta-analysis.

Harm Reduct J 2021 Jan 22;18(1):12. Epub 2021 Jan 22.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: Prevalence of hepatitis C virus (HCV) infection among people who inject drugs (PWID) in Iran is high. Since 2005, the Iranian government has implemented a harm reduction program to control HCV. We aimed to describe the prevalence of HCV antibody (Ab) in Iranian PWID before and after the implementation of harm reduction with cumulative meta-analysis. Read More

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January 2021

Implementing Health Care Quality Measures in Electronic Health Records: A Conceptual Model.

J Am Geriatr Soc 2021 Apr 19;69(4):1079-1085. Epub 2021 Jan 19.

Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

Background/objectives: There is significant literature on the development and validation of quality measures, but comparably less on their implementation into learning health systems. Electronic Health Records (EHRs) have made vast amounts of data available for quality improvement purposes. In this paper we describe a conceptual model for EHR implementation of quality measures. Read More

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Persistent inequitable design and implementation of patient portals for users at the margins.

J Am Med Inform Assoc 2021 Feb;28(2):276-283

Department of Ethics, Law, and Humanities, Amsterdam UMC - location VUmc, Amsterdam, Netherlands.

Objective: Diane Forsythe and other feminist scholars have long shown how system builders' tacit assumptions lead to the systematic erasure of certain users from the design process. In spite of this phenomena being known in the health informatics literature for decades, recent research shows how patient portals and electronic patients health records continue to reproduce health inequalities in Western societies. To better understand this discrepancy between scholarly awareness of such inequities and mainstream design, this study unravels the (conceptual) assumptions and practices of designers and others responsible for portal implementation in the Netherlands and how citizens living in vulnerable circumstances are included in this process. Read More

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February 2021

Development of a Knowledge-based Clinical Decision Support System for Multiple Sclerosis Diagnosis.

J Med Life 2020 Oct-Dec;13(4):612-623

Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The diagnosis of multiple sclerosis (MS) is difficult considering its complexity, variety in signs and symptoms, and its similarity to the signs and symptoms of other neurological diseases. The purpose of this study is to design and develop a clinical decision support system (CDSS) to help physicians diagnose MS with a relapsing-remitting phenotype. The CDSS software was developed in four stages: requirement analysis, system design, system development, and system evaluation. Read More

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January 2021

An investigation of community-dwelling older adults' opinions about their nutritional needs and risk of malnutrition; a scoping review.

Clin Nutr 2020 Dec 23. Epub 2020 Dec 23.

School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Republic of Ireland; UCD Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland. Electronic address:

Background & Aims: Understanding how older adults perceive their nutritional needs and malnutrition risk is important to inform strategies to improve prevention and management of the condition. This scoping review aimed to identify, characterize and summarize the findings from studies analysing community-dwelling older adults' opinions and perceptions towards their nutritional needs and malnutrition risk.

Methods: An electronic literature search was carried out using three databases, Pubmed, Embase, and CINAHL up to January 2020. Read More

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December 2020

Treatable but not curable cancer in England: a retrospective cohort study using cancer registry data and linked data sets.

BMJ Open 2021 01 8;11(1):e040808. Epub 2021 Jan 8.

Macmillan Cancer Support, London, UK.

Objectives: This study estimates the prevalence of cancers that are categorised as treatable but not curable (TbnC) in England. It provides a quantification of the population and a framework to aid identification of this group to enable the design of tailored support services.

Design: Through consultation with clinical and data experts an algorithmic definition of TbnC was developed. Read More

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January 2021

Biofluid Biomarkers in Traumatic Brain Injury: A Systematic Scoping Review.

Neurocrit Care 2021 Jan 5. Epub 2021 Jan 5.

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Sina Hospital, Hassan-Abad Square, Imam Khomeini Ave, Tehran, 11365-3876, Iran.

Emerging evidence suggests that biofluid-based biomarkers have diagnostic and prognostic potential in traumatic brain injuries (TBI). However, owing to the lack of a conceptual framework or comprehensive review, it is difficult to visualize the breadth of materials that might be available. We conducted a systematic scoping review to map and categorize the evidence regarding biofluid-based biochemical markers of TBI. Read More

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January 2021

Predicting mortality in critically ill patients with diabetes using machine learning and clinical notes.

BMC Med Inform Decis Mak 2020 12 30;20(Suppl 11):295. Epub 2020 Dec 30.

Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Diabetes mellitus is a prevalent metabolic disease characterized by chronic hyperglycemia. The avalanche of healthcare data is accelerating precision and personalized medicine. Artificial intelligence and algorithm-based approaches are becoming more and more vital to support clinical decision-making. Read More

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December 2020

Conceptual considerations for using EHR-based activity logs to measure clinician burnout and its effects.

J Am Med Inform Assoc 2021 Apr;28(5):1032-1037

Institute for Informatics, Washington University School of Medicine, St Louis, Missouri, USA.

Electronic health records (EHR) use is often considered a significant contributor to clinician burnout. Informatics researchers often measure clinical workload using EHR-derived audit logs and use it for quantifying the contribution of EHR use to clinician burnout. However, translating clinician workload measured using EHR-based audit logs into a meaningful burnout metric requires an alignment with the conceptual and theoretical principles of burnout. Read More

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