Environmental Risk Factors for Systemic Lupus Erythematosus through the Lens of Social Determinants of Health.

Systemic lupus erythematosus (SLE) is a serious multisystem autoimmune disease, marked by alarming sociodemographic inequities. In the U.S.

Nonopioid vs opioid analgesics after impacted third-molar extractions: The Opioid Analgesic Reduction Study randomized clinical trial.

Background: Opioids are still being prescribed to manage acute postsurgical pain. Unnecessary opioid prescriptions can lead to addiction and death, as unused tablets are easily diverted.

Methods: To determine whether combination nonopioid analgesics are at least as good as opioid analgesics, a multisite, double-blind, randomized, stratified, noninferiority comparative effectiveness trial was conducted, which examined patient-centered outcomes after impacted mandibular third-molar extraction surgery.

Non-Tuberculous Mycobacteria: Single Center Analyses of Risk Factors, Management and Mortality Outcomes of Adults with HIV.

Background/objectives: In sub-Saharan Africa, there is paucity of data regarding non-tuberculous mycobacterial (NTM) infections, leading to underappreciation of disease burden. Consequently, fewer resources are allocated, leading to potential adverse outcomes. This study examines long-term mortality and risk factors of South African patients with positive NTM samples.

Assessments of working group effectiveness in the planning of the New Jersey Kids Study: An applied mixed-methods study on the science of team science.

Introduction: The New Jersey Kids Study (NJKS) is a transdisciplinary statewide initiative to understand influences on child health, development, and disease. We conducted a mixed-methods study of project planning teams to investigate team effectiveness and relationships between team dynamics and quality of deliverables.

Methods: Ten theme-based working groups (WGs) (e.

Responsibilities of Medical Professionals Amidst Geopolitical Conflict.

The ethical responsibilities of healthcare professionals amidst geopolitical conflict, particularly regarding their impact on patient care and healthcare delivery, present a significant challenge, especially during current strife. With the rise of national and international discord and debate, and the close relationship between war and healthcare, healthcare organizations are increasingly pressured to comment, which can reflect societal engagement, but also pose demands for maintaining professionalism. This article discusses the need for healthcare practitioners to navigate their roles in advocacy without compromising patient care, emphasizing the importance of self-reflection, adherence to ethical standards, and effective communication.

Interventions to Improve COVID-19 Vaccine Hesitancy.

Coronavirus disease 2019 (COVID-19) vaccine uptake among individuals with rheumatic conditions remains low despite heightened risk for related adverse outcomes. This is especially pronounced among historically marginalized populations who suffered disproportionately from the COVID-19 pandemic. Among the myriad of reasons for low vaccine uptake, mistrust in the healthcare system, misinformation related to the vaccine development process, fear of rheumatic disease flares, and inconsistent physician recommendations, are highlighted.

Vaccines in the fight against antimicrobial resistance - perspectives from South Africa.

Antimicrobial resistance (AMR), in which microbes adapt to and resist current therapies, is a well-recognised global problem that threatens to reverse gains made by modern medicine in the last decades. AMR is a complex issue; however, at its core, it is driven by the overuse and inappropriate use of antimicrobials. Socioeconomic factors have been identified as significant contributors to the emergence and exacerbation of AMR, especially in populations facing inadequate access to healthcare, poor sanitation services and high morbidity and mortality rates.

Severe community-acquired pneumonia at a tertiary academic hospital in Johannesburg, South Africa.

Purpose: There is a paucity of data from sub-Saharan Africa describing Severe Community Acquired Pneumonia (SCAP), a condition with significant morbidity and mortality.

Materials And Methods: This was a retrospective, single-centre, observational study of consecutive patients with SCAP admitted to the ICU at Charlotte Maxeke Johannesburg Academic Hospital, in South Africa between 1 July 2007 and 31 May 2019. Pneumonia was categorised as community-acquired if there had been no hospitalization in the preceding 2 weeks.

Associations between periodontal disease severity and selected cardiometabolic risk factors.

Objectives: To explore associations between periodontal disease (PD) severity and cardiometabolic risk factors, including body mass index (BMI), age, Type 2 Diabetes Mellitus (T2DM) risk, sex, and hypertension (HTN) in patients at an urban dental school clinic.

Methods And Materials: A cross-sectional study design was used to analyze electronic health record data, including periodontal status, demographic characteristics, cardiometabolic risk factors and the American Diabetes Association Diabetes Risk Test (DRT) Score. Chi-square tests and ordinal logistic regression were conducted using SAS 9.

Cost-Related Medication Behaviors for Patients With and Without Systemic Autoimmune Rheumatic Diseases.

Objective: Medication nonadherence challenges the management of systemic autoimmune rheumatic diseases (SARDs). We investigated cost-related medication behaviors among patients with SARDs, and compared them to those of patients without SARDs, in a large diverse cohort across the United States.

Methods: As part of the All of Us (version 7), a nationwide diverse adult cohort with linked electronic health records begun in 2017, participants completed questionnaires concerning cost-related medication behaviors.

Effects of Social Vulnerability and Environmental Burden on Care Fragmentation and Social Needs Among Individuals With Rheumatic Conditions.

Objective: Environmental hazards and heightened neighborhood social vulnerability coexist and disproportionately affect minoritized populations. We investigated associations between exposure to adverse environmental burden concentrated in areas with high social vulnerability and care fragmentation (missed appointments, emergency department visits, and hospitalizations) and social needs (eg, food and housing insecurity) among individuals with rheumatic conditions.

Methods: We identified adults receiving care in a Massachusetts multihospital system with at least two rheumatic disease codes and complete street addresses.

Screening to understand pregnancy preferences and offer referrals and treatment (SUPPORT): Results of a pilot quality improvement initiative.

Objective: To assess the feasibility of integrating a pregnancy intention assessment screening algorithm into the electronic medical record (EMR) at a multispecialty clinic focused on the health of women and people assigned female at birth (AFAB).

Study Design: This pilot quality improvement project implemented a series of clinician reminders, new data fields in the patient record, and templated clinical notes to prompt care providers across specialties to ask AFAB reproductive age individuals about their desire for future pregnancies. Investigators created a novel screening question based on prior literature and expert input.

Postinfectious Pulmonary Complications: Establishing Research Priorities to Advance the Field: An Official American Thoracic Society Workshop Report.

Continued improvements in the treatment of pulmonary infections have paradoxically resulted in a growing challenge of individuals with postinfectious pulmonary complications (PIPCs). PIPCs have been long recognized after tuberculosis, but recent experiences such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have underscored the importance of PIPCs following other lower respiratory tract infections. Independent of the causative pathogen, most available studies of pulmonary infections focus on short-term outcomes rather than long-term morbidity among survivors.

Leveraging Habits to Improve Adherence to Gout Medications: A Qualitative Study.

Objective: This study investigates patients' medication-taking routines and the feasibility of harnessing habit formation through context cues and rewards to improve medication adherence.

Methods: Semistructured qualitative interviews with patients with gout from an urban health care system were conducted to explore typical medication-taking behavior, experiences using electronic pill bottles, barriers to adherence, existing context cues, and potential cues and rewards for habit-forming behavior. Medication-taking patterns were recorded for six weeks using electronic pill bottles before interviews to inform discussion.

Considerations for Psychological Debriefing in the Context of Prolonged Disaster Response.

First responders face greater exposure to potentially traumatic events compared with the general public, which can lead to an increased likelihood of developing mental health concerns. The challenges of disaster relief take a physical and mental toll on first responders. Critical incident stress debriefing (CISD), the widely accepted gold-standard treatment for psychological debriefing, is often applied to offset this toll among first responders.