Increasing the Value of Health Intervention Trials: Qualitative Research in the Early Psychosis Intervention Network (EPINET).

Despite the substantial capacity of qualitative and mixed methods research to advance healthcare and interventions knowledge, most large-scale health intervention trials exclusively use quantitative methods. The authors argue that qualitative research can optimize investments in these studies. As researchers within the Early Psychosis Intervention Network (EPINET), the authors highlight examples of how qualitative research has enhanced this national initiative, organizing them with a Learning Health System (LHS) framework to demonstrate the ways qualitative research can increase value at each phase of a health trial.

Youth Inpatient and Residential Treatment Psychiatric Beds: National Trends and Potential Causal Factors, 2010-2022.

Objective: Youth inpatient and residential treatment psychiatric services are essential components of the continuum of care. Concern has grown about the diminished availability of these services and the increasing need for them. This study aimed to examine the number of youths treated at inpatient and residential psychiatric facilities over a 12-year period and to assess the perceptions of state mental health authorities (SMHAs) about the reasons for changes in availability.

External validation of predictive models for antibiotic susceptibility of urine culture.

Objective: To develop, externally validate, and test a series of computer algorithms to accurately predict antibiotic susceptibility test (AST) results at the time of clinical diagnosis, up to 3 days before standard urine culture results become available, with the goal of improving antibiotic stewardship and patient outcomes.

Patients And Methods: Machine learning algorithms were developed and trained to predict susceptibility or resistance using over 4.7 million discrete AST classifications from urine cultures in a cohort of adult patients from outpatient and inpatient settings from 2012 to 2022.

Fidelity to Common Elements of Coordinated Specialty Care: Outcomes of Clients With First-Episode Psychosis.

Objective: The present study examined whether clients enrolled in coordinated specialty care (CSC) programs for first-episode psychosis (FEP) across 22 states and territories showed improved clinical and functional outcomes and assessed whether program- or client-level predictors were associated with client outcomes. The study included CSC programs that subscribe to a variety of models, including Early Assessment and Support Alliance, OnTrack, and NAVIGATE.

Methods: Deidentified demographic and outcome data were collected from clients (N=770) receiving CSC services in 36 programs at the time of program entry and every 6 months for up to 18 months.

Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.

Introduction And Hypothesis: Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications.

Methods: We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management.

External Validation Demonstrates Machine Learning Models Outperform Human Experts in Prediction of Objective and Patient-reported Overactive Bladder Treatment Outcomes.

Objective: To predict treatment response for overactive bladder (OAB) for a specific patient remains elusive. We sought to develop accurate models using machine learning for prediction of objective and patient-reported treatment response to intravesical botulinum toxin (OBTX-A) injection. We sought to validate the models in a challenging setting using an external dataset of a markedly different patient cohort and dosing regimen.

Videourodynamics - role, benefits and optimal practice.

Videourodynamics (VUDS) is an advanced diagnostic procedure that simultaneously combines functional and anatomical evaluation of the lower urinary tract. The goal of this synchronous assessment is to promote accurate diagnosis of the aetiology responsible for patient symptoms, improving therapeutic decision-making. Overall, high-quality VUDS is advocated when other tests such as traditional urodynamics might not provide sufficient data to guide therapy, particularly in patients with complex, persistent or recurrent dysfunctions of the lower urinary tract.

Urinalysis is predictive for absence of urinary tract infection in men with and without catheters.

Objectives: To determine accuracy of negative urinalysis (UA) for predicting negative urine culture and the absence of urinary tract infection (UTI), and optimal urine culture growth cutoff for UTI diagnosis in men with and without urinary catheters.

Subjects And Methods: UAs with urine cultures within 1 week from adult men were identified and evaluated. Predictive values for the absence of UTI (absence of ≥1 of the following criteria: documentation of UTI diagnosis, antibiotic prescription, uropathogen presence on culture) were calculated.

Sacral neuromodulation device biofilm differs in the absence and presence of infection, harbors antibiotic resistance genes, and is reproducible in vitro.

Introduction/purpose: Sacral neuromodulation (SNM) is effective therapy for overactive bladder refractory to oral therapies, and non-obstructive urinary retention. A subset of SNM devices is associated with infection requiring surgical removal. We sought to compare microbial compositions of explanted devices in the presence and absence of infection, by testing phase, and other clinical factors, and to investigate antibiotic resistance genes present in the biofilms.

Standardizing Fidelity to Evidence-Based Practice in the Early Psychosis Intervention Network.

Objective: This study investigated variations in the measurement of fidelity to coordinated specialty care (CSC) within the Early Psychosis Intervention Network (EPINET), a learning health system that consists of 101 CSC programs within eight hubs. The study investigated the degree to which five fidelity scales could be mapped onto a standard scale.

Methods: The investigators identified six fidelity scales in use by EPINET participants; examined their item content, scoring, and data sources; and mapped five scales onto the First Episode Psychosis Services Fidelity Scale (FEPS-FS), which is the most widely used scale.

Assessing the Evidence Base for School-Based Promotion and Prevention Interventions: Introduction to the Series.

Schools are an important component in the mental health system of care for youths. Teachers and other school staff have unique opportunities to promote emotional wellness and prevent mental health conditions. Although numerous programs are available, identifying evidence-based and effective options is a significant challenge.

Outcomes of sequential third-line therapies in patients with refractory overactive bladder.

Introduction: Sacral neuromodulation (SNM) and onabotulinumtoxinA (BoNTA) injection are third-line therapies for overactive bladder (OAB). Although the efficacy of each third-line treatment has been well established in clinical trials, there is far less information about performing one third-line therapy after the other. Our aim is thus to investigate the outcomes of post-SNM BoNTA and post-BoNTA SNM as "second" third-line treatments.

Detrusor underactivity in symptomatic anterior pelvic organ prolapse.

Introduction: The aim of this study was to assess the detrusor underactivity (DUA) prevalence of females with symptomatic anterior pelvic organ prolapse (POP) and to evaluate the relationship between DUA and POP stage.

Material And Methods: This was a prospective study recruiting women with symptomatic anterior POP. Patients with symptomatic stage 2-4 POP quantification system (POP-Q) who underwent urodynamics (UD) between January 2018 and April 2021 were included.

Overactive bladder negatively affects erectile function and promotes premature ejaculation: findings from large representative population-level study.

Purpose: The effect of overactive bladder (OAB) on sexual health has been evaluated extensively for women but much less for men. Therefore, the aim of this study was to evaluate the relationship between OAB and men's sexual activity and the effect of OAB on erectile dysfunction (ED) and premature ejaculation (PE) in a large representative cohort of men at the population level.

Methods: This study was based on computer-assisted web interviews that used validated questionnaires.

Community- and Program-Level Predictors of Funding Streams Used by Coordinated Specialty Care Programs.

Objective: Although coordinated specialty care (CSC) is an effective service model to address first-episode psychosis, CSC is not widely accessible in the United States, and funding for this service model often remains challenging. The authors examined whether community- or program-level factors predict the use of public and private funding streams in a national sample of 34 CSC programs in 22 U.S.

Stereotactic Radiosurgery for Brain Metastases in Patients With Small Cell Lung Cancer.

Purpose: Treatment of small cell lung cancer (SCLC) with brain metastatic disease has traditionally involved whole brain radiation therapy (WBRT). The role of stereotactic radiosurgery (SRS) is unclear.

Methods And Materials: Our study was a retrospective review of an SRS database evaluating patients with SCLC who received SRS.

Cycles of reform in the history of psychosis treatment in the United States.

The history of psychosis treatment follows a series of four cycles of reform which provide a framework for understanding mental health services in the United States. The first three cycles of reform promoted the view that early treatment of mental disorders would reduce chronic impairment and disability. The Moral Treatment era (early 1800's to 1890) featured freestanding asylums, the Mental Hygiene movement (1890 to World War II) introduced psychiatric hospitals and clinics, and the Community Mental Health Reform period (World War II to late 1970's) produced community mental health centers.

First in Human Subjects Testing of the UroMonitor: A Catheter-free Wireless Ambulatory Bladder Pressure Monitor.

Purpose: Urodynamics is the standard method of diagnosing bladder dysfunction, but involves catheters and retrograde bladder filling. With these artificial conditions, urodynamics cannot always reproduce patient complaints. We have developed a wireless, catheter-free intravesical pressure sensor, the UroMonitor, which enables catheter-free telemetric ambulatory bladder monitoring.