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In-hospital and web-based intervention to counteract vaccine hesitancy in very preterm infants' families: a NICU experience.

Ital J Pediatr 2021 Sep 16;47(1):190. Epub 2021 Sep 16.

Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.

Background: Vaccine hesitancy is a global problem, carrying significant health risks for extremely vulnerable population as that of preterm infants. Social media are emerging as significant tools for public health promotion. Our aim was to evaluate both the coverage and the timeliness of routine immunizations in a cohort of preterm infants (< 33 weeks of gestational age) at 24 months of age whose families have been subjected to in-hospital and web-based interventions to counteract vaccine hesitancy. Read More

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September 2021

The analysis of the geographical distribution of emergency departments' frequent users: a tool to prioritize public health policies?

BMC Public Health 2021 Sep 16;21(1):1689. Epub 2021 Sep 16.

Emergency Department, Centre Hospitalier de Saint-Denis, Saint-Denis, France.

Background: The individual factors associated to Frequent Users (FUs) in Emergency Departments are well known. However, the characteristics of their geographical distribution and how territorial specificities are associated and intertwined with ED use are limited. Investigating healthcare use and territorial factors would help targeting local health policies. Read More

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September 2021

Prevalence and associated factors of post-traumatic stress disorder (PTSD) among a cohort of Srilankan post-partum mothers: a cross-sectional study.

BMC Pregnancy Childbirth 2021 Sep 17;21(1):626. Epub 2021 Sep 17.

Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Background: Post-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women. The aim of this study is to highlight the prevalence of Post Traumatic Stress Disorder among a cohort of postpartum mothers. Read More

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September 2021

The effect of individual reminiscence therapy on adaptation difficulties of the elderly: a randomized clinical trial.

Psychogeriatrics 2021 Sep 16. Epub 2021 Sep 16.

Faculty of Nursing, Department of Psychiatric Nursing, Akdeniz University, Antalya, Turkey.

Background: Reminiscence therapy is one of various interventions that can be made to protect and improve the mental health of the elderly. The aim of this study was to evaluate the effect of individual reminiscence therapy given during home visits on adaptation difficulties.

Method: This was a randomized controlled, single-blind study designed with a pretest-post-test and follow-up pattern. Read More

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September 2021

Cross-sectoral Analysis of 1.4 Million AOK-insured Patients with Back Pain in Baden-Württemberg - What Influence does Outpatient Specialist Care Have?

Z Orthop Unfall 2021 Sep 16. Epub 2021 Sep 16.

Berufsverband der Fachärzte für Orthopädie und Unfallchirurgie e. V. (BVOU), Berlin, Deutschland.

Background: Back pain is one of the leading causes of disability globally and the most common musculoskeletal pain in Germany. The lifetime prevalence of back pain ranges from 74% to 85%, and the point prevalence ranges from 32% to 49%. One in five individuals with statutory health insurance visits a doctor at least once a year for back pain, and 1 in 20 individuals is on sick leave at least once a year. Read More

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September 2021

Asthma self-management app for Indonesian asthmatics: A patient-centered design.

Comput Methods Programs Biomed 2021 Sep 13;211:106392. Epub 2021 Sep 13.

Department of Health Policy and Management, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. Electronic address:

Background: A proper education on asthma self-management helps asthmatics to improve health outcomes, such as better asthma knowledge and self-efficacy, increased frequency of symptom-free days, reduced unscheduled healthcare visits and absence from school or work days. In this modern digital era, the use of smartphone apps is increasing rapidly and reaching almost all aspects of our life, including health promotion and patient education on asthma self-management. Studies found that the apps make it easier for asthmatics to receive the education. Read More

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September 2021

The experience of patients with diabetes with the use of telemedicine and teleassistance services during the COVID-19 pandemic in Italy: factors associated with perceived quality and willingness to continue.

Diabetes Res Clin Pract 2021 Sep 13:109047. Epub 2021 Sep 13.

AUSL Diabetes Unit Romagna, Ravenna, Italy.

Aim: The purpose of this study is to investigate the individual and contextual determinants of the perceived quality (PQ) of the telemedicine and teleassistance (TMTA) services and the willingness to continue (WC) with them among patients with diabetes using TMTA services during the COVID-19 pandemic in one large region of Italy.

Methods: A structured survey was administered to patients with type 1 and 2 diabetes who used TMTA during the first wave of the COVID-19 pandemic. The questionnaire contained questions on TMTA service experience and participants' socio-demographic characteristics. Read More

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September 2021

Diagnostic Stability in Bipolar Disorder: A Follow-up Study in 130,000 Patient-Years.

J Clin Psychiatry 2021 Sep 14;82(6). Epub 2021 Sep 14.

Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Diagnostic stability is the degree to which a diagnosis remains unchanged during time. Our main objective was to evaluate the diagnostic stability of bipolar disorder (BD) in psychiatric outpatient consultations and determine the socio-demographic variables influencing its stability.

The Cumulative Register of Cases of the Community of Madrid provided data on all outpatient visits conducted at Madrid's Community Mental Healthcare Centers between 1980-2009. Read More

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September 2021

Does gender inequality matter for access to and utilization of maternal healthcare services in Bangladesh?

PLoS One 2021 16;16(9):e0257388. Epub 2021 Sep 16.

Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh.

There is a high prevalence of gender gap in Bangladesh which might affect women's likelihood to receive maternal healthcare services. In this backdrop, we aim to investigate how gender inequality measured by intrahousehold bargaining power (or autonomy) of women and their attitudes towards intimate partner violence (IPV) affects accessing and utilizing maternal health care services. We used Bangladesh Demographic and Health Survey (BDHS) data of 2014 covering 5460 women who gave birth at least one child in the last three years preceding the survey. Read More

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September 2021

Assessment of malaria infection among pregnant women and children below five years of age attending rural health facilities of Kenya: A cross-sectional survey in two counties of Kenya.

PLoS One 2021 16;16(9):e0257276. Epub 2021 Sep 16.

Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.

Background: In Kenya, health service delivery and access to health care remains a challenge for vulnerable populations, particularly pregnant women and children below five years. The aim of this study, therefore, was to determine the positivity rate of Plasmodium falciparum parasites in pregnant women and children below five years of age seeking healthcare services at the rural health facilities of Kwale and Siaya counties as well as their access and uptake of malaria control integrated services, like antenatal care (ANC), offered in those facilities.

Methods: Cluster random sampling method was used to select pregnant women and children below five years receiving maternal and child health services using two cross-sectional surveys conducted in eleven rural health facilities in two malaria endemic counties in western and coastal regions of Kenya. Read More

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September 2021

Asthma Surveillance - United States, 2006-2018.

MMWR Surveill Summ 2021 Sep 17;70(5):1-32. Epub 2021 Sep 17.

Division of Environmental Health Science and Practice, National Center for Environmental Health, CDC.

Problem: Asthma is a chronic disease of the airways that requires ongoing medical management. Socioeconomic and demographic factors as well as health care use might influence health patterns in urban and rural areas. Persons living in rural areas tend to have less access to health care and health resources and worse health outcomes. Read More

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September 2021

Health outcomes from an innovative enhanced medication therapy management model.

Am J Manag Care 2021 Sep;27(16 Suppl):S300-S308

Tabula Rasa HealthCare, Orlando, FL, and Université de Montréal, Montréal, Québec, Canada, 13485 Veterans Way, Ste 410, Orlando, FL 32827. Email:

Objective: To evaluate the impact of pharmacist-delivered medication safety reviews (MSRs) on total medical expenditures, hospitalizations, emergency department (ED) visits, and mortality in Medicare Part D beneficiaries, whose plan was a participant of the Enhanced Medication Therapy Management model.

Study Design: Retrospective, pre-post, cohort study.

Methods: We evaluated the aforementioned outcomes for beneficiaries who were targeted, according to their MedWise Risk Scores (MRS), for MSR services in both 2018 and 2019. Read More

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September 2021

Association of the MedWise Risk Score with health care outcomes.

Am J Manag Care 2021 Sep;27(16 Suppl):S280-S291

Tabula Rasa HealthCare, Orlando, FL, and Université de Montréal, Montréal, Québec, Canada, 13485 Veterans Way, Ste 410, Orlando, FL 32827. Email:

Objectives: Older patients are especially vulnerable to drug-related problems due to multiple prescription drugs, which increases their risk of drug-drug interactions and adverse drug events (ADEs). This study aimed to examine outcomes associated with the MedWise Risk Score (MRS) in a Medicare Part D population, including total medical expenditures, ADEs, falls, mortality, emergency department (ED) visits, hospital admissions, and length of stay (LOS).

Study Design: Retrospective observational study. Read More

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September 2021

Associations of midchildhood to early adolescence central adiposity gain with cardiometabolic health in early adolescence.

Obesity (Silver Spring) 2021 Sep 16. Epub 2021 Sep 16.

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.

Objective: This study examined the associations of central adiposity gain from midchildhood to early adolescence with cardiometabolic health markers in early adolescence.

Methods: A total of 620 participants were studied in Project Viva. In midchildhood (mean age = 7. Read More

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September 2021

Effect of Medication Reconciliation at Hospital Admission on 30-Day Returns to Hospital: A Randomized Clinical Trial.

JAMA Netw Open 2021 Sep 1;4(9):e2124672. Epub 2021 Sep 1.

Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Importance: According to international recommendations, hospitals should use medication reconciliation to prevent medication errors and improve patient safety.

Objective: To assess the impact of medication reconciliation at hospital admission on patient-centered health care outcomes.

Design, Setting, And Participants: This parallel group, open-label randomized controlled trial used centralized randomization to the intervention group (ie, individuals with medication reconciliation) or control group (ie, individuals with only standard, physician-acquired medication history). Read More

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September 2021

Using an mHealth App (iGAM) to Reduce Gingivitis Remotely (Part 2): Prospective Observational Study.

JMIR Mhealth Uhealth 2021 Sep 16;9(9):e24955. Epub 2021 Sep 16.

Department of Software Engineering, Azrieli College of Engineering, Jerusalem, Israel.

Background: Gingivitis is a nonpainful, inflammatory condition that can be managed at home. Left untreated, gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. Read More

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September 2021

REmote moBile Outpatient mOnitoring in Transplant (Reboot) 2.0: a randomized control trial protocol.

JMIR Res Protoc 2021 Apr 19. Epub 2021 Apr 19.

Ted Rogers Centre of Excellence in Heart Function, Peter Munk Cardiac Centre, University Health Network, 585 University Ave, Toronto, CA.

Background: The number of solid organ transplants (SOT) in Canada has increased 33% over the past decade. Hospital readmissions are common within the first year after transplant and are linked to increased morbidity and mortality. Nearly half of these admissions to hospital appear to be preventable. Read More

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Philips IntelliSpace Cognition digital test battery: equivalence and measurement invariance compared to traditional analog test versions.

Clin Neuropsychol 2021 Sep 16:1-22. Epub 2021 Sep 16.

Digital Cognitive Diagnostics, Philips Healthcare, Eindhoven, The Netherlands.

To collect evidence of validity for a selection of digital tests on the Philips IntelliSpace Cognition (ISC) platform. A total of 200 healthy participants (age 50-80) completed both the ISC battery and an analog version of the battery during separate visits. The battery included the following screeners and cognitive tests: Mini-Mental State Examination (2 edition), Clock Drawing Test, Trail-Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT), Rey-Osterrieth Complex Figure Test (ROCFT), Letter Fluency, Star Cancellation Test, and Digit Span Test. Read More

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September 2021

Development and piloting of four decision aids for implantable cardioverter-defibrillators in different media formats.

Pacing Clin Electrophysiol 2021 Sep 16. Epub 2021 Sep 16.

Adult and Child Consortium for Outcomes Research and Delivery Science.

Objectives:  Develop and pilot implantable cardioverter-defibrillator (ICD) decision aids (DAs) for patients considering primary prevention ICDs.

Background: Using DAs for preference-sensitive decisions is an evidence-based way to improve patient-centered decisions. Reimbursement mandates have increased the need for DAs in ICD care, although none have been formally evaluated. Read More

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September 2021

Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels.

Lancet Reg Health West Pac 2021 Oct 30;15:100230. Epub 2021 Jul 30.

Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.

Background: To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000-2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators.

Methods: We used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Read More

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October 2021

The Impact of Catastrophic Medical Insurance in China: A five-year patient-level panel study.

Lancet Reg Health West Pac 2021 Aug 5;13:100174. Epub 2021 Jul 5.

Stanford University, Stanford, CA.

In an effort to provide greater financial protection from the risk of large medical expenditures, China has gradually added catastrophic medical insurance (CMI) to the various basic insurance schemes. Tongxiang, a rural county in Zhejiang province, China, has had CMI since 2000 for their employee insurance scheme, and since 2014 for their resident insurance scheme. Compiling and analysing patient-level panel data over five years, we use a difference-in-difference approach to study the effect of the 2014 introduction of CMI for resident insurance beneficiaries in Tongxiang. Read More

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Regional Inequality in Dental Care Utilization in Japan: An Ecological Study Using the National Database of Health Insurance Claims.

Lancet Reg Health West Pac 2021 Jul 14;12:100170. Epub 2021 Jun 14.

Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.

Background: This study examined regional inequalities in dental care utilization in Japan and the association of dental care utilization with socioeconomic factors.

Methods: Using the Fourth National Database of Health Insurance Claims and Specific Health Checkups of Japan Open data, this ecological study analyzed 216 million pieces of aggregated data from April 2017 to March 2018. Nine indicators of dental care utilization were used: outpatient visits, outreach services, cavity fillings, pulpectomies, dental calculus removals, periodontal surgeries, tooth extractions, dental bridges, and dentures. Read More

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Investigation of the Clinical, Radiological and Biological Factors Associated with Disease Progression, Phenotypes and Endotypes of COPD in China (COMPASS): study design, protocol and rationale.

ERJ Open Res 2021 Jul 13;7(3). Epub 2021 Sep 13.

State Key Laboratory of Respiratory Disease and National Clinical Research Center of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.

COPD is heterogeneous, and its presentation varies between countries. The major COPD cohort studies have only been performed in Western populations; the disease is not well characterised in other regions. The COMPASS (Investigation of the Clinical, Radiological and Biological Factors, Humanistic and Healthcare Utilisation Burden Associated with Disease Progression, Phenotypes and Endotypes of COPD in China; NCT04853225) is a prospective, 2. Read More

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Assault-injured youth in the emergency centres of Khayelitsha, South Africa: A prospective study of recidivism and mortality.

Afr J Emerg Med 2021 Dec 6;11(4):379-384. Epub 2021 Sep 6.

University of North Carolina at Chapel Hill School of Medicine, Department of Emergency Medicine, Chapel Hill, NC, USA.

Introduction: Violence is a major cause of death worldwide among youth. The highest mortality rates from youth violence occur in low and middle-income countries (LMICs). We sought to identify risk factors for violent re-injury and emergency centre (EC) recidivism among assault-injured youth in South Africa. Read More

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December 2021

Associations between sinus tachycardia and adverse cardiovascular outcomes and mortality in cancer patients.

J Thorac Dis 2021 Aug;13(8):4845-4852

Director of Cardio-Oncology Services, Department of Cardiology, Rush University Medical Center, Chicago, IL, USA.

Background: Sinus tachycardia in cancer reflects a significant multi-system organ stressor and disease, with sparse literature describing its clinical significance. We assessed cardiovascular (CV) and mortality prognostic implications of sinus tachycardia in cancer patients.

Methods: We conducted a case-control study of 622 cancer patients at a U. Read More

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Opportunity costs of attending surgical clinic appointments and experiences with telemedicine for follow-up care.

SAGE Open Med 2021 11;9:20503121211045247. Epub 2021 Sep 11.

Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, SK, Canada.

Objectives: Telemedicine has been rapidly implemented in orthopedics during the coronavirus (COVID-19) pandemic. The purpose of this study was to quantify opportunity costs for patients attending typical in-person appointments and understand their perceptions of telemedicine for follow-up care.

Methods: A cross-sectional study was performed by surveying patients who had elective orthopedic surgery and attended at least one in-person and one phone call appointment. Read More

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September 2021

A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno District, Malawi.

BMJ Glob Health 2021 Sep;6(9)

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC). Read More

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September 2021

Domiciliary dentistry clinics: a multiple case study in the province of Quebec, Canada.

BMC Health Serv Res 2021 Sep 15;21(1):972. Epub 2021 Sep 15.

Faculty of Dentistry, McGill University, 2001 McGill College Ave, Montreal, Quebec, H3A 1G1, Canada.

Background: The demand for more flexible and person-centered models of oral healthcare delivery is increasing and while mobile and domiciliary dental services have the potential to increase access to oral healthcare among dependent elderly and people with disabilities; the uptake of this service model by dentists remains low. Therefore, the aim of this study was to understand how existing domiciliary dental services operate within a particular context.

Methods: We used a qualitative descriptive multiple case study design. Read More

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September 2021

Modeling count data for health care utilization: an empirical study of outpatient visits among Vietnamese older people.

BMC Med Inform Decis Mak 2021 Sep 15;21(1):265. Epub 2021 Sep 15.

Ministry of Economic Planning and Development, Capital Hill, Lilongwe 3, Malawi.

Background: Vietnam is undergoing a fast-aging process that poses potential critical issues for older people and central among those is demand for healthcare utilization. However, healthcare utilization, here measured as count data, creates challenges for modeling because such data typically has distributions that are skewed with a large mass at zero. This study compares empirical econometric strategies for the modeling of healthcare utilization (measured as the number of outpatient visits in the last 12 months) and identifies the determinants of healthcare utilization among Vietnamese older people based on the best-fitting model identified. Read More

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September 2021

Antenatal care dropout and associated factors among mothers delivering in public health facilities of Dire Dawa Town, Eastern Ethiopia.

BMC Pregnancy Childbirth 2021 Sep 15;21(1):623. Epub 2021 Sep 15.

Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Introduction: More than two-thirds of the pregnant women in Africa have at least one antenatal care contact with a health care provider. However, to achieve the full life-saving potential that antenatal care promises for women and babies, four visits providing essential evidence-based interventions - a package often called focused antenatal care are required. Hence, identifying the factors associated with dropout of maternal health care utilization would have meaningful implications. Read More

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September 2021