Corporate Philanthropy Toward Community Health Improvement in Manufacturing Communities.

Virtually all large employers engage in corporate philanthropy, but little is known about the extent to which it is directed toward improving community health. We conducted in-depth interviews with leaders of corporate philanthropy from 13 of the largest manufacturing companies in the US to understand how giving decisions were made, the extent to which funding was directed towards improving community health, and whether companies coordinate with local public health agencies. We found that corporate giving was sizable and directed towards communities in which the manufacturers have a large presence.

The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo.

Individuals are considered Ultra-High-Risk (UHR) for psychosis if they meet a set of standardised criteria including presumed genetic vulnerability (Trait), or a recent history of Attenuated Psychotic Symptoms (APS) or Brief Limited Intermittent Psychotic Symptoms (BLIPS). Recent calls to revise these criteria have arisen from evidence that Trait, APS and BLIPS groups may transition to psychosis at different rates. Concurrently, it has become clear that the UHR status confers clinical risk beyond transition to psychosis.

Big Data and Total Hip Arthroplasty: How Do Large Databases Compare?

Background: Use of large databases for orthopedic research has become extremely popular in recent years. Each database varies in the methods used to capture data and the population it represents. The purpose of this study was to evaluate how these databases differed in reported demographics, comorbidities, and postoperative complications for primary total hip arthroplasty (THA) patients.

Nonparametric methods for doubly robust estimation of continuous treatment effects.

Continuous treatments (e.g., doses) arise often in practice, but many available causal effect estimators are limited by either requiring parametric models for the effect curve, or by not allowing doubly robust covariate adjustment.

Broad clinical high-risk mental state (CHARMS): Methodology of a cohort study validating criteria for pluripotent risk.

Aim: The development of the ultra-high risk (UHR) criteria for psychosis created a new paradigm for the prevention research in psychiatry. Since (1) prevention research faces the challenge of achieving adequate statistical power when focusing on single low-incidence syndromes and (2) early clinical phenotypes are overlapping and non-specific, this study broadens the UHR state beyond psychosis as an outcome. The CHARMS (clinical high at-risk mental state) study aims to prospectively validate a set of trans-diagnostic criteria to identify help-seeking young people at risk of developing a range of serious mental illnesses.

Opening the Black Box of Cognitive-Behavioural Case Management in Clients with Ultra-High Risk for Psychosis.

Background: Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT and the severity of symptomatic outcome.

Methods: A sample of 268 UHR participants received 6 months of CBT with case management (CBCM) in the context of the multi-centre NEURAPRO trial with monthly assessments of attenuated psychotic symptoms (APS).

Are We Still Prescribing Opioids for Osteoarthritis?

Background: The United States is in the midst of an opioid epidemic. These medications continue to be used to manage pain associated with osteoarthritis, despite mounting evidence questioning the benefits. The rate at which opioids are prescribed for osteoarthritis is largely unknown.

Emergency Department Use across 88 Small Areas after Affordable Care Act Implementation in Illinois.

Introduction: This study analyzes changes in hospital emergency department (ED) visit rates before and after the 2014 Affordable Care Act (ACA) insurance expansions in Illinois. We compare the association between population insurance status change and ED visit rate change between a 24-month (2012-2013) pre-ACA period and a 24-month post-ACA (2014-2015) period across 88 socioeconomically diverse areas of Illinois.

Methods: We used annual American Community Survey estimates for 2012-2015 to obtain insurance status changes for uninsured, private, Medicaid, and Medicare (disability) populations of 88 Illinois Public Use Micro Areas (PUMAs), areas with a mean of about 90,000 age 18-64 residents.

Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

Background: Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.

Objectives: The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS) rates compared to control conditions in eligible women population at risk of cervical cancer.

Cryotherapy Reinvented: Application of Phase Change Material for Recovery in Elite Soccer.

Purpose: To examine whether donning lower-body garments fitted with cooled phase change material (PCM) would enhance recovery after a soccer match.

Methods: In a randomized, crossover design, 11 elite soccer players from the reserve squad of a team in the second-highest league in England wore PCM cooled to 15°C (PCM) or left at ambient temperature (PCM; sham control) for 3 h after a soccer match. To assess recovery, countermovement jump height, maximal isometric voluntary contraction (MIVC), muscle soreness, and the adapted Brief Assessment of Mood Questionnaire (BAM+) were measured before 12, 36, and 60 h after each match.

Strategies to Identify and Reduce Opioid Misuse Among Patients with Gastrointestinal Disorders: A Systematic Scoping Review.

Background: Scoping reviews are preliminary assessments intended to characterize the extent and nature of emerging research evidence, identify literature gaps, and offer directions for future research. We conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders.

Methods: We performed structured keyword searches to identify manuscripts published through June 2016 in the PubMed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases to extract original research articles that described healthcare practices, tools, or interventions to identify and reduce opioid misuse among GI patients.

Providing Pediatric Palliative Care Education Using Problem-Based Learning.

Background: The Institute of Medicine and the American Academy of Pediatrics has called for improvement in education and training of pediatricians in pediatric palliative care (PPC). Given the shortage of PPC physicians and the immediate need for PPC medical education, this study reports the outcomes of a problem-based learning (PBL) module facilitated by academic general and subspecialty pediatric faculty (non-PPC specialists) to third year medical students. Objectives/Setting: To test the effectiveness of a PPC-PBL module on third year medical students' and pediatric faculty's declarative knowledge, attitudes toward, perceived exposure, and self-assessed competency in PPC objectives.

Creation and Execution of a Novel Anesthesia Perioperative Care Service at a Veterans Affairs Hospital.

Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways.

Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care.

Objectives: To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care.

Design: Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models.

Setting: Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland.

Magnet hospital recognition in hospital systems over time.

Background: Magnet hospitals are recognized for nursing excellence and high-value patient outcomes, yet little is known about which and when hospitals pursue Magnet recognition. Concurrently, hospital systems are becoming a more prominent feature of the U.S.

Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures.

It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures.

Development and Design of Next-Generation Head-Mounted Ambulatory Microdose Positron-Emission Tomography (AM-PET) System.

Several applications exist for a whole brain positron-emission tomography (PET) brain imager designed as a portable unit that can be worn on a patient's head. Enabled by improvements in detector technology, a lightweight, high performance device would allow PET brain imaging in different environments and during behavioral tasks. Such a wearable system that allows the subjects to move their heads and walk-the Ambulatory Microdose PET (AM-PET)-is currently under development.

Accurate Differentiation of Carotenoid Pigments Using Flight Representative Raman Spectrometers.

Raman spectrometers will be utilized on two Mars rover missions, ExoMars and Mars 2020, in the near future, to search for evidence of life and habitable geological niches on Mars. Carotenoid pigments are recognized target biomarkers, and as they are highly active in Raman spectroscopy, they can be readily used to characterize the capabilities of space representative instrumentation. As part of the preparatory work being performed for the ExoMars mission, a gypsum crust colonized by microorganisms was interrogated with commercial portable Raman instruments and a flight representative Raman laser spectrometer.

The efficacy of cooling with phase change material for the treatment of exercise-induced muscle damage: pilot study.

Post-exercise cryotherapy treatments are typically short duration interventions. This study examined the efficacy of prolonged cooling using phase change material (PCM) on strength loss and pain after eccentric exercise. Eight adults performed 120 bilateral eccentric quadriceps contractions (90% MVC).

The Effect of Postoperative KT-1000 Arthrometer Score on Long-Term Outcome After Anterior Cruciate Ligament Reconstruction.

Background: Many long-term studies have looked at outcomes after anterior cruciate ligament reconstruction (ACLR), but none have correlated long-term outcomes with postoperative laxity greater than 5 mm. It has been stated previously that more than 5 mm of postoperative graft laxity constituted a procedural failure.

Purpose: To directly compare tight grafts (<3 mm) and loose grafts (>5 mm) to determine the effect of graft laxity, as measured by KT-1000 arthrometer, after ACLR on long-term clinical outcomes.

Multicenter Evaluation of the Cepheid Xpert Hepatitis C Virus Viral Load Assay.

Viral load monitoring for hepatitis C virus (HCV) is necessary to diagnose infection and monitor response to therapy, but the tests involved are currently confined to specialist institutions. There is a need for a fast, accurate assay with limited operator input to enhance the access to viral load monitoring. We evaluated the quantification of HCV RNA in serum and plasma by the Cepheid Xpert HCV Viral Load assay in comparison to the Abbott RealTie HCV assay.

The reporting of study and population characteristics in degenerative cervical myelopathy: A systematic review.

Object: Degenerative cervical myelopathy [DCM] is a disabling and increasingly prevalent condition. Variable reporting in interventional trials of study design and sample characteristics limits the interpretation of pooled outcomes. This is pertinent in DCM where baseline characteristics are known to influence outcome.

MED SCHOOL STUDENTS GETTING THE BUSINESS.

Positive response to a major university's project designed to gauge interest in business and management among medical students leads to implementation of a new curriculum for the next wave of physician leaders.

The AAHKS Clinical Research Award: What Are the Costs of Knee Osteoarthritis in the Year Prior to Total Knee Arthroplasty?

Background: Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status.

Methods: The Humana database was reviewed from 2007 to 2015 for primary TKA patients.