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Pushing the bench: A mixed methods study of barriers to and facilitators of identification and referral into depression care by professional nurses in KwaZulu-Natal, South Africa.

SSM Ment Health 2021 Dec 22;1. Epub 2021 Jul 22.

Centre for Rural Health, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa.

Objective: Integration of mental health and chronic disease services in primary care could reduce the mental health treatment gap and improve associated health outcomes in low-resource settings. Low rates of nurse identification and referral of patients with depression limit the effectiveness of integrated mental health care; the barriers to and facilitators of identification and referral in South Africa and comparable settings remain undefined. This study explored barriers to and facilitators of nurse identification and referral of patients with depressive symptoms as part of integrated mental health service delivery in KwaZulu-Natal, South Africa. Read More

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December 2021

Healthcare Provider Perspectives on the Use of a Digital Behavioral Health App to Support Patients: Qualitative Study.

JMIR Form Res 2021 Sep 13. Epub 2021 Sep 13.

UPMC Health Plan, U.S. Steel Tower600 Grant Street, Pittsburgh, US.

Background: Despite the growing evidence indicating the efficacy of digital interventions for behavioral health treatment, broad and consistent use of such interventions has been limited by knowledge obtained in real-world settings, including factors that impact provider uptake/referral. Engaging providers early in the implementation process offers an opportunity to explore their needs and behaviors, integrate interventions into workflows, and better understand provider setting capabilities.

Objective: To assess providers' views on the feasibility and acceptability of delivering a Cognitive Behavioral Therapy (CBT)-based mobile application (app) in multiple care settings. Read More

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September 2021

Local Dynamics of Collaboration for Maternal, Newborn and Child Health: A Social Network Analysis of Healthcare Providers and Their Managers in Gert Sibande District, South Africa.

Int J Health Policy Manag 2021 Sep 8. Epub 2021 Sep 8.

School of Public Health, University of the Western Cape, Cape Town, South Africa.

Background: Accountability for maternal, newborn and child health (MNCH) is a collaborative endeavour and documenting collaboration dynamics may be key to understanding variations in the performance of MNCH services. This study explored the dynamics of collaboration among frontline health professionals participating in two MNCH coordination structures in a rural South African district. It examined the role and position of actors, the nature of their relationships, and the overall structure of the collaborative network in two sub-districts. Read More

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September 2021

Acute Headache Due to Intracerebral Hemorrhage Secondary to Brain Metastases.

Cureus 2021 Aug 4;13(8):e16889. Epub 2021 Aug 4.

Emergency Medicine, Ocala Regional Medical Center, Ocala, USA.

Intracerebral hemorrhage (ICH) is a relatively common condition seen throughout the world, with the vast majority of cases referring to primary ICH. However, secondary ICH from other underlying conditions is also possible. In the present case, the patient presented with severe headaches. Read More

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Pediatric primary care and subspecialist providers' comfort, attitudes and practices screening and referring for social determinants of health.

BMC Health Serv Res 2021 Sep 13;21(1):956. Epub 2021 Sep 13.

Academic General Pediatrics, Social Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3544 Jerome Avenue, NY, 10467, Bronx, USA.

Background: Early detection and management of poverty-related disorders is a recommended pediatric practice; however, little is known about variations of practice between pediatric primary care physicians and subspecialists. The objectives of this study were to assess (1) provider perceptions and attitudes toward caring for low-income children in an urban academic medical center, and (2) variations between primary care physicians and subspecialists in social and financial needs screening and referral practices for low-income children.

Design/methods: Primary care providers (pediatric and family medicine) and subspecialists providing direct patient care in an urban academic medical center (response rate = 24 %, n = 85/356) completed a 24-item survey (adapted with permission from the AAP Periodic Survey of Fellows No. Read More

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September 2021

Cardiac Rehabilitation and Resting Blood Pressure: MONTANA OUTCOMES PROJECT CARDIAC REHABILITATION REGISTRY FINDINGS.

J Cardiopulm Rehabil Prev 2021 Sep 9. Epub 2021 Sep 9.

School of Integrative Physiology and Athletic Training, College of Health, University of Montana, Missoula (Dr Quindry); International Heart Institute, St Patrick Hospital, Missoula, Montana (Dr Quindry); and Cardiovascular Health Program, Montana Department of Public Health and Human Services, Helena, Montana (Mr McNamara and Mss Oser and Fogle).

Purpose: Exercise-based cardiac rehabilitation (CR) is essential for treating cardiovascular disease, and modifying risk factor modification, including hypertension. Because the causes of hypertension and benefits of CR are faceted, we examined the influence of phase II CR on resting blood pressure (BP).

Methods: Outcomes straddle the release of the updated BP guidelines, and study emphases included CR session number, sex, race/ethnicity, insurance provider, and referring diagnosis. Read More

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September 2021

The Prognostic Impact of Anti-thrombotic Treatment Strategies After Biological Aortic Valve Replacement.

Cardiovasc Drugs Ther 2021 Sep 10. Epub 2021 Sep 10.

Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Purpose: Optimal antithrombotic therapy in patients who underwent surgical biological aortic valve replacement (AVR) represents an issue of ongoing discussion. Additionally, the prognostic impact of anti-thrombotic treatment strategies after biological AVR and real-life data on anticoagulation strategies (AC) of patients presenting with short-term postoperative atrial fibrillation (POAF) has not clearly been investigated so far. Therefore, this study aimed to investigate the impact of therapeutic AC after biological AVR on patient outcome and whether the presence of POAF affects decision making on anti-thrombotic management. Read More

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September 2021

Dual-Mobility Cups in Primary Total Hip Arthroplasty.

Z Orthop Unfall 2021 Sep 9. Epub 2021 Sep 9.

Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany.

Dual-mobility cups (DMCs) were introduced in France more than 40 years ago and are increasingly used not only in hip revision but also primary hip arthroplasty. Due to a simulated large-head articulation and increased jumping distance, DMCs can contribute to a high range of motion in the hip joint and reduce the risk of instability. Numerous studies have reported low dislocation rates and high survival rates in the mid-term follow-up. Read More

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September 2021

Patient Responses to Diagnosis in Surgeon-Patient Consultations.

Health Commun 2021 Sep 9:1-10. Epub 2021 Sep 9.

Department of Primary Health Care and General Practice, University of Otago.

How diagnosis fits within the overall activity structure of surgical consultations remains under-researched. We set out to contribute to this developing area of research with a particular focus on responses to diagnosis as an achievement of patient agency. We identified 26 diagnostic sequences in a collection of 35 video recorded surgical consultations and examined these in detail using conversation analysis. Read More

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September 2021

Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness.

Can Geriatr J 2021 Sep 1;24(3):251-257. Epub 2021 Sep 1.

Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.

Background: We report on the feasibility and effectiveness of an integrated community collaborative care model in improving the health of seniors with depression/anxiety symptoms and chronic physical illness.

Methods: This community collaborative care model integrates geriatric medicine and geriatric psychiatry with care managers (CM) providing holistic initial and follow-up assessments, who use standardized rating scales to monitor treatment and provide psychotherapy (ENGAGE). The CM presents cases in a structured case review to a geriatrician and geriatric psychiatrist. Read More

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September 2021

Evaluation of the Relationship Between Primary Spontaneous Pneumothorax and Exercise and Return to Previous Activities in Patients Referring to Hospitals of Rasht during 2015-2017.

Ethiop J Health Sci 2021 May;31(3):619-624

Inflammatory Lung Diseases Research Center, Guilan University of Medical Science, iran.

Background: The most common cause of primary spontaneous pneumothorax (PSP) is subpleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise the time. In this study, we tend to investigate the relationship between training and PSP and time of return to exercise and previous activities. Read More

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Antibiotic prescribing for acute, non-complicated infections in primary care in Germany: baseline assessment in the cluster randomized trial ARena.

BMC Infect Dis 2021 Aug 26;21(1):877. Epub 2021 Aug 26.

Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

Background: Antimicrobial resistance is fueled by inappropriate use of antibiotics. Global and national strategies support rational use of antibiotics to retain treatment options and reduce resistance. In Germany, the ARena project (Sustainable reduction of antibiotic-induced antimicrobial resistance) intended to promote rational use of antibiotics for acute non-complicated infections by addressing network-affiliated physicians, primary care teams and patients through multiple interacting interventions. Read More

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The use of person-first language in scientific literature focused on drug-seeking behavior: a cross-sectional analysis.

J Osteopath Med 2021 Aug 23. Epub 2021 Aug 23.

Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Tulsa, OK, USA.

Person first language (PFL) - a way of referring to individuals with medical conditions or disability that emphasizes the person over their condition or disability - is important in reducing the stigma surrounding individuals who exhibit drug-seeking behavior. Drug-seeking behavior is generally associated with a negative connotation by healthcare professionals, which may create poor provider perceptions of these individuals and potentially impact patient care. Therefore, to reduce stigmatization surrounding drug-seeking behavior and to improve patient care in these individuals, the use of PFL should be promoted. Read More

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Extended roles in primary care when physiotherapist-initiated referral to X-ray can save time and reduce costs.

Int J Qual Health Care 2021 Sep;33(3)

Division Medical Service, Department of Radiology, Region Sörmland, Repslagaregatan 19, Nyköping SE-611 88, Sweden.

Objective: The objective of this study was to evaluate an extended role for the physiotherapist in primary care in referring patients to plain X-ray.

Methods: This prospective cohort study was set in a single region in Sweden. It included 20 physiotherapists who were educated in a 1-day training in performing referral to X-ray, along with 107 patients with musculoskeletal disorders who were referred to X-ray. Read More

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September 2021

Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement.

JAMA 2021 08;326(8):736-743

Tufts University School of Medicine, Boston, Massachusetts.

Importance: An estimated 13% of all US adults (18 years or older) have diabetes, and 34.5% meet criteria for prediabetes. The prevalences of prediabetes and diabetes are higher in older adults. Read More

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SAR11 Cells Rely on Enzyme Multifunctionality To Metabolize a Range of Polyamine Compounds.

mBio 2021 Aug 24;12(4):e0109121. Epub 2021 Aug 24.

Department of Microbiology, Oregon State Universitygrid.4391.f, Corvallis, Oregon, USA.

In the ocean surface layer and cell culture, the polyamine transport protein PotD of SAR11 bacteria is often one of the most abundant proteins detected. Polyamines are organic cations at seawater pH produced by all living organisms and are thought to be an important component of dissolved organic matter (DOM) produced in planktonic ecosystems. We hypothesized that SAR11 cells uptake and metabolize multiple polyamines and use them as sources of carbon and nitrogen. Read More

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Clinician needs and perceptions about cardioneuroablation for recurrent vasovagal syncope: An international clinician survey.

Heart Rhythm 2021 Aug 19. Epub 2021 Aug 19.

Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Vanderbilt Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Background: Cardioneuroablation (CNA) targets the intrinsic cardiac autonomic nervous system ganglionated plexi located in the peri-atrial epicardial fat. There is increasing interest in CNA as a treatment of vasovagal syncope (VVS), despite no randomized clinical trial (RCT) data.

Objective: The purpose of this study was to poll the opinion on CNA) for VVS. Read More

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Dynamic Contrast Magnetic Resonance Lymphangiography Localizes Lymphatic Leak to the Duodenum in Protein-losing Enteropathy.

J Pediatr Gastroenterol Nutr 2021 Aug 17. Epub 2021 Aug 17.

Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA Department of Radiology, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA Department of Surgery, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Objectives: Protein-losing enteropathy (PLE) is a disorder of intestinal lymphatic flow resulting in leakage of protein-rich lymph into the gut lumen. Our primary aim was to report the imaging findings of dynamic contrast magnetic resonance lymphangiography (DCMRL) in patients with PLE. Our secondary objective was to use these imaging findings to characterize lymphatic phenotypes. Read More

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Multicentre study of appendicitis management comparing a large South Island metropolitan hospital, to its referring regional and rural centres.

ANZ J Surg 2021 Aug 17. Epub 2021 Aug 17.

Department of Surgery, Timaru Hospital, Timaru, New Zealand.

Background: Globally, patients presenting with acute surgical disease in rural areas have poorer outcomes when compared to urban areas; little data are available regarding outcomes for New Zealand (NZ) rural patients. This study aimed to compare the surgical management of appendicitis in a large metropolitan centre with its regional referral centres.

Methods: In this retrospective cohort study, patient data were collated from the studied centres between November 2014 and October 2019. Read More

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Unmet needs in non-metastatic castration-resistant prostate cancer from the Japanese patient perspective: a discrete choice experiment.

BMJ Open 2021 08 16;11(8):e052471. Epub 2021 Aug 16.

Market Access Oncology, Bayer Yakuhin, Ltd, Osaka, Japan

Objectives: With novel antiandrogen treatments of varying clinical benefits and risks becoming available, this study investigates how patients with castration-resistant prostate cancer (CRPC) value differences in treatment characteristics.

Design: Cross-sectional observational study.

Setting: A discrete choice experiment was conducted. Read More

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Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey.

BMC Public Health 2021 08 14;21(1):1549. Epub 2021 Aug 14.

United Nations Office Drugs Crime (UNODC-ROEA), Nairobi, Kenya.

Background: A Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic. Read More

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A study of perceptions and exposure of drug promotional literature among clinicians in a teaching hospital.

Perspect Clin Res 2021 Jul-Sep;12(3):140-145. Epub 2020 May 7.

Department of Pharmacology, Armed Forces Medical College, Pune, Maharashtra, India.

Background: Drug promotional literature (DPL) forms a major marketing technique of pharmaceutical companies for propagating information regarding a drug. Many a times, it is the only source on which treating physicians depend for updating their knowledge about the existing and novel drugs.

Aims And Objectives: This study was conducted to understand the clinicians' perceptions about DPL and its critical appraisal so that relevant interventions can be made. Read More

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An R2R3-MYB Transcription Factor Responds to Chilling Stress of and Conferred Cold Tolerance of .

Front Plant Sci 2021 27;12:696919. Epub 2021 Jul 27.

College of Horticulture and Landscape Architecture, Northeast Agricultural University, Harbin, China.

A sudden cooling in the early spring or late autumn negatively impacts the plant growth and development. Although a number of studies have characterized the role of the transcription factors (TFs) of plant R2R3-myeloblastosis (R2R3-MYB) in response to biotic and abiotic stress, plant growth, and primary and specific metabolisms, much less is known about their role in under chilling stress. In the present study, , which encodes a nuclear-localized R2R3-MYB TF with a self-activation activity, was identified based on the earlier published RNA-seq data of plants exposed to short-term low-temperature stress and also on the results of prediction of the gene function referring . Read More

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Factors affecting primary care implementation for older veterans with multimorbidity in Veterans Health Administration (VA).

Health Serv Res 2021 Aug 6. Epub 2021 Aug 6.

Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, Massachusetts, USA.

Objective: To identify factors affecting implementation of Geriatric Patient-Aligned Care Teams (GeriPACTs), a patient-centered medical home model for older adults with complex care needs including multiple chronic conditions (MCC), designed to provide them with comprehensive, managed, and coordinated primary care.

Data Sources: Qualitative data were collected from key informants at eight Veterans Health Administration Medical Centers geographically spread across the United States.

Study Design: Guided by the Consolidated Framework for Implementation Research (CFIR), we collected prospective primary data through semi-structured interviews with GeriPACT team members (e. Read More

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Predictors for mortality due to acute exacerbation of COPD in primary care: Derivation of a clinical prediction rule in a multicentre cohort study.

Eur J Gen Pract 2021 Dec;27(1):211-220

Department of Health, Castile-Leon Government, Valladolid, Spain.

Background: In primary care (PC), 80% of the acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are treated. However, no predictive model has been derived or validated for use in PC to help general practitioners make decisions about these patients.

Objectives: To derive a clinical prediction rule for mortality from any cause 30 days after the last PC visit. Read More

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December 2021

A quality improvement initiative to improve primary care referral rates for penicillin allergy delabeling.

Ann Allergy Asthma Immunol 2021 Aug 2. Epub 2021 Aug 2.

Rady Children's Hospital, San Diego, California; Division of Allergy Immunology, Department of Pediatrics, University of California, San Diego, La Jolla, California. Electronic address:

Background: Of the US population, 10% reports a penicillin allergy but more than 90% can ultimately tolerate penicillin. Confirmation of these allergies in the pediatric population may improve future health outcomes and decrease costs. Referring patients for confirmatory testing is the first step in clarifying penicillin allergies. Read More

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Did inter-hospital transfer reduce mortality in patients with acute myocardial infarction in the real world? A nationwide patient cohort study.

PLoS One 2021 5;16(8):e0255839. Epub 2021 Aug 5.

Department of Prevention and Management, Inha University Hospital, School of Medicine, Inha University, Incheon, Korea.

Introduction: Inter-hospital transfer (IHT) and primary percutaneous coronary intervention (PCI) are preferred over onsite thrombolysis when provided expeditiously. On the other hand, its benefit has not been evaluated in a real-world situation. This study examined the effects of IHT on the short- and long-term mortality in patients with acute myocardial infarction (AMI) and compared the reperfusion treatments and resources between the referring and receiving hospitals. Read More

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The Cost of the Epistemic Step: Investigating Scalar Implicatures in Full and Partial Information Contexts.

Front Psychol 2021 19;12:679491. Epub 2021 Jul 19.

Institute of Philosophy II, Ruhr University of Bochum, Bochum, Germany.

We present the first ERP experiments that test the online processing of the scalar implicature ⇝ in contexts where the speaker competence assumption is violated. Participants observe game scenarios with four open cards on the table and two closed cards outside of the table, while listening to statements made by a virtual player. In the full access context, the player makes a fully informed statement by referring only to the open cards, as ; in the partial access context, she makes a partially informed statement by referring to the whole set of cards, as . Read More

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Macromeront Formation Induces Glycolytic Responses and Mitochondrial Changes in Primary Host Endothelial Cells.

Front Cell Infect Microbiol 2021 15;11:703413. Epub 2021 Jul 15.

Institute of Parasitology, Biomedical Research Center Seltersberg, Justus Liebig University of Giessen, Giessen, Germany.

is an intracellular apicomplexan parasite that causes considerable economic losses in the cattle industry worldwide. During the first merogony, forms large macromeronts with >140,000 merozoites I in host endothelial cells. Because this is a high-energy demanding process, exploits the host cellular metabolism to fulfill its metabolic requirements. Read More

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Exploring Predictors of Treatment Engagement in Urban Integrated Primary Care.

Clin Pract Pediatr Psychol 2020 Sep;8(3):228-240

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, and University of Pennsylvania Perelman School of Medicine.

Objective: Integrated primary care (IPC) is intended to address the gap in access to behavioral health care. This may be particularly true in urban settings; however, there is a paucity of research on treatment engagement in urban IPC. This study explored factors associated with treatment engagement. Read More

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September 2020