J Prim Care Community Health
December 2024
The objective of this study was to describe characteristics of effective pediatric primary care interventions that focused on parenting education about healthy parent-child relationships. A scoping review of 4 electronic databases searched for related systematic reviews published in English from January 2000 to June 2023. The full texts of 14 systematic reviews were evaluated by 2 independent reviewers and used to identify 25 unique parenting interventions of which 21 improved outcomes more than the comparison group.
View Article and Find Full Text PDFBackground: The Doctor of Public Health (DrPH) is the highest attainable degree in the field of public health, specifically designed to prepare professionals to address complex public health challenges in practical settings. This study was designed to explore the importance of achieving a shared and uniform understanding of DrPH education, assess the optimal direction for DrPH training, and investigate the specific curriculum requirements by gathering insights from current DrPH students and alumni in the United States.
Methods: A total of 13 focus group discussions and two in-depth interviews (total participants: 50) were conducted through Zoom to see how DrPH students and alumni assessed their DrPH educational programs.
Background: This study explored the current and desired identity of the DrPH degree, focusing on whether the competencies set by the Council on Education for Public Health (CEPH) adequately prepare DrPH graduates for effective public health practice. Additionally, the study investigated the necessity of standardization in DrPH training, referring to a consensus-driven approach that equips future public health practitioners with practical skillsets applicable in real-world scenarios.
Methods: A national cross-sectional online survey titled "National DrPH leaders & practitioners needs assessment" was conducted from November 2020 to February 2021.
Background And Aims: Cirrhosis is a major cause of death and is associated with extensive health care use. Patients with cirrhosis have complex treatment choices due to risks of morbidity and mortality. To optimally counsel and treat patients with cirrhosis requires tools to predict their longer-term liver-related survival.
View Article and Find Full Text PDFBackground: The highest incidence of gastric cancer is in East Asia, corresponding to a high prevalence of (), yet other regions with a similarly high prevalence of have lower cancer rates. Foreign-born persons who immigrate to the United States are thought to remain at high-risk for gastric cancer, but this has not been confirmed by large population-based studies.
Methods: We evaluated total and foreign-born populations in metropolitan statistical areas (MSAs).
Patients are prioritized for liver transplantation (LT) under an "urgency-based" system using the Model for End-Stage Liver Disease score. This system focuses solely on waitlist mortality, without considerations of posttransplant morbidity, mortality, and health care use. We sought to develop and internally validate a continuous posttransplant risk score during 5-year and 10-year time horizons.
View Article and Find Full Text PDFBackground & Aims: Liver transplant priority in the US and Europe follows the 'sickest-first' principle. However, for patients with hepatocellular carcinoma (HCC), priority is based on binary tumor criteria to expedite transplant for patients with 'acceptable' post-transplant outcomes. Newer risk scores developed to overcome limitations of these binary criteria are insufficient to be used for waitlist priority as they focus solely on HCC-related pre-transplant variables.
View Article and Find Full Text PDFBackground: Transplantation of kidneys from hepatitis C virus (HCV)-viremic donors into HCV-negative patients followed by direct-acting antiviral therapy was an important breakthrough to increase the number of life-saving kidney transplants. Data suggest that these transplants offer several benefits; however, it is unknown whether adoption of this practice has been shared equitably, especially among disadvantaged groups.
Methods: We evaluated United Network for Organ Sharing data on HCV-seronegative adult deceased-donor kidney transplant recipients from January 1, 2017, to June 12, 2020.
Recently proposed rulemaking from Centers for Medicare and Medicaid Services would change how organ procurement organizations (OPOs) are evaluated. The proposals include using national inpatient death data to define a standardized denominator to calculate comparable donation rates among OPOs. Based on these objective metrics, OPOs not performing at a prespecified threshold will be required to rapidly improve performance to avoid decertification.
View Article and Find Full Text PDFBackground: Aging frailty, characterized by decreased physical and immunological functioning, is associated with stem cell depletion. Human allogeneic mesenchymal stem cells (allo-hMSCs) exert immunomodulatory effects and promote tissue repair.
Methods: This is a randomized, double-blinded, dose-finding study of intravenous allo-hMSCs (100 or 200-million [M]) vs placebo delivered to patients (n = 30, mean age 75.
Rationale: Cell dose and concentration play crucial roles in phenotypic responses to cell-based therapy for heart failure.
Objective: To compare the safety and efficacy of 2 doses of allogeneic bone marrow-derived human mesenchymal stem cells identically delivered in patients with ischemic cardiomyopathy.
Methods And Results: Thirty patients with ischemic cardiomyopathy received in a blinded manner either 20 million (n=15) or 100 million (n=15) allogeneic human mesenchymal stem cells via transendocardial injection (0.
J Gerontol A Biol Sci Med Sci
October 2017
Background: Impaired endogenous stem cell repair capacity is hypothesized to be a biologic basis of frailty. Therapies that restore regenerative capacity may therefore be beneficial. This Phase 1 study evaluated the safety and potential efficacy of intravenous, allogeneic, human mesenchymal stem cell (allo-hMSC)-based therapy in patients with aging frailty.
View Article and Find Full Text PDFBackground: Although human mesenchymal stem cells (hMSCs) have been tested in ischemic cardiomyopathy, few studies exist in chronic nonischemic dilated cardiomyopathy (NIDCM).
Objectives: The authors conducted a randomized comparison of safety and efficacy of autologous (auto) versus allogeneic (allo) bone marrow-derived hMSCs in NIDCM.
Methods: Thirty-seven patients were randomized to either allo- or auto-hMSCs in a 1:1 ratio.
Importance: Whether culture-expanded mesenchymal stem cells or whole bone marrow mononuclear cells are safe and effective in chronic ischemic cardiomyopathy is controversial.
Objective: To demonstrate the safety of transendocardial stem cell injection with autologous mesenchymal stem cells (MSCs) and bone marrow mononuclear cells (BMCs) in patients with ischemic cardiomyopathy.
Design, Setting, And Patients: A phase 1 and 2 randomized, blinded, placebo-controlled study involving 65 patients with ischemic cardiomyopathy and left ventricular (LV) ejection fraction less than 50% (September 1, 2009-July 12, 2013).