Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans.

Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery. Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults.

Infusion Pump Education: A Quality Improvement Project.

Purpose: This quality improvement project was designed to increase the number of registered nurses who have been educated and are proficient in working with the infusion medical pumps used for patients receiving continuous peripheral nerve block or epidural infusions. Our aim was to increase by 10% the percentage of nurses who are proficient with infusion pumps and increase by 25% the ability of nursing staff on 4 West at Brooke Army Medical Center to hang a new infusion bag and subsequently program the pump.

Design: Our outcome measured pre and post intervention surveys and timing exercises assessing the ability and efficiency of the nurses hanging new infusion bags and programming the pumps.

The dynamics of carbon emissions, energy, income, and life expectancy: Regional comparative analysis.

This paper examines the linear effects of economic growth on carbon emissions and their impact on mortality and morbidity rates in specific regions sub-Sahara Africa, Middle-East and North Africa, Europe and Central Asia (SSA, MENA, ECA). By analyzing longitudinal data for 82 panels over 30 years, we investigate the relationships between energy usage, per capita GDP, life expectancy, and carbon emissions. Our estimation results show positive correlations between energy use, carbon production, and life expectancy in both the combined sample and individual regions.

Comparing Outcomes after Oncoplastic Breast Reduction and Breast Reduction for Benign Macromastia.

Background: Oncoplastic breast reconstruction improves cosmetic outcomes when compared to standard breast conservation therapy alone. The authors studied whether tailoring a breast reduction to a cancer resection affects complication rates by comparing (1) outcomes between oncoplastic and benign macromastia patients and (2) complication rates between the cancer side and the symmetrizing side of an oncoplastic reduction.

Methods: A retrospective chart review was performed on female patients who underwent either oncoplastic or benign breast reduction over 9 years by a single surgeon.

Molecular characterization of Latin American invasive Streptococcus pneumoniae serotype 19A isolates.

Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, especially among children and the elderly. S. pneumoniae serotype 19A has emerged as a major cause of invasive disease in many countries, regardless of whether pneumococcal conjugate vaccines are used.

Emerging Multidrug-Resistant Candida duobushaemulonii Infections in Panama Hospitals: Importance of Laboratory Surveillance and Accurate Identification.

, a yeast closely related to , is thought to cause infections in rare cases and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for Suspected isolates were forwarded to the national reference laboratory for identification by matrix-assisted laser desorption ionization-time of flight mass spectrometry and antifungal susceptibility testing. Between November 2016 and May 2017, 17 of 36 (47%) isolates suspected to be were identified as These 17 isolates were obtained from 14 patients at six hospitals.

Attribute Development Using Continuous Stakeholder Engagement to Prioritize Treatment Decisions: A Framework for Patient-Centered Research.

Objectives: To develop a methodological approach for selecting, validating, and prioritizing attributes for health care decision making.

Methods: Participants (n = 48) were recruited from community support groups if they had a child aged 26 years or younger diagnosed with a coexisting mental health condition and cognitive impairment. Six in-depth interviews eliciting care management experiences were transcribed and coded into themes following the principles of grounded theory and the constant comparative method.

Metformin and the risk of endometrial cancer: a population-based cohort study.

Objective: While some observational studies have suggested a protective effect of metformin on incident cancer, concerns about potential bias remain. We compared the incidence of endometrial cancer in metformin versus sulfonylurea initiators. Research design and methods We conducted a retrospective cohort analysis using US healthcare claims (MarketScan®), 2000-2011.

Using claims data to predict dependency in activities of daily living as a proxy for frailty.

Purpose: Estimating drug effectiveness and safety among older adults in population-based studies using administrative health care claims can be hampered by unmeasured confounding as a result of frailty. A claims-based algorithm that identifies patients likely to be dependent, a proxy for frailty, may improve confounding control. Our objective was to develop an algorithm to predict dependency in activities of daily living (ADL) in a sample of Medicare beneficiaries.

Distressing adverse events after antidepressant switch in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial: influence of adverse events during initial treatment with citalopram on development of subsequent adverse events with an alternative antidepressant.

Study Objective: To determine whether distressing adverse events (DAEs) experienced during initial antidepressant treatment are associated with subsequent DAEs after switching to a second antidepressant.

Design: Secondary analysis of data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.

Setting: Primary care and psychiatric care facilities.

Psychometric properties of the Bender Gestalt Test using Lacks' version of the Hutt-Briskin scoring system.

Criterion-referenced (Livingston r) and norm-referenced (Gilmer-Feldt r and Coefficient Alpha) techniques were used to calculate the internal consistency reliability of the Bender-Gestalt Test (BGT) Total Score using the 12-item Lacks system of scoring. Livingston's r was found to be .825 for the Lacks BGT cutoff score of 5.