Publications by authors named "Wetzler S"

Background: Hypertensive disorders are major causes of maternal and neonatal morbidity and mortality, affecting ∼10% pregnancies worldwide.

Objective: Understanding the lived experience of women with hypertensive disorders during pregnancy is important to inform best practice and provide holistic care.

Study Design: This is a systematic review and meta-synthesis of studies containing qualitative components relating to direct lived experience of hypertensive disorders of pregnancy.

View Article and Find Full Text PDF
Article Synopsis
  • - The study examines the social characteristics influencing patients' choices between labor after cesarean (TOLAC) and scheduled repeat cesarean delivery (SRCD), aiming to address disparities in delivery methods.
  • - Analyzing data from 1,983 patients, results show that those with high social vulnerability, certain racial/ethnic identities, public insurance, and obesity were more likely to choose TOLAC over SRCD.
  • - The findings highlight that disadvantaged groups may prefer TOLAC, indicating the need for better individualized counseling and shared decision-making regarding delivery options.
View Article and Find Full Text PDF

Aim This study aims to assess the effect of implementing an enhanced prenatal genetic checklist to guide the provider's discussion on both screening and diagnostic options for fetal aneuploidy testing at the initial prenatal visit. Methods A retrospective quality improvement (QI) project was performed at a single, large, urban academic medical center. The implementation of this project was prospective; however, data was examined retrospectively after the QI initiative was implemented for three months.

View Article and Find Full Text PDF

Spontaneous uterine rupture in unscarred uteri complicated by pulmonary emboli is a rare event with major maternal morbidity and mortality. This is a case of a 32-year-old woman, G1P0, at term, with no pertinent past medical/surgical history, who underwent an emergency cesarean delivery for failed induction of labor complicated by uterine rupture. Post-operatively, the patient was tachycardic and hypoxic.

View Article and Find Full Text PDF

Background: Choosing whether to pursue a trial of labor after cesarean (TOLAC) or scheduled repeat cesarean delivery (SRCD) requires prenatal assessment of risks and benefits. Providers and patients play a central role in this process. However, the influence of provider-associated characteristics on delivery methods remains unclear.

View Article and Find Full Text PDF

The Affordable Care Act established Medicaid health homes to provide care management and coordination for high-need individuals, including many with serious mental illness. The authors used data from the Medicaid Data Warehouse to examine health care utilization over 3 years among 10,193 individuals who enrolled in a New York State health home and had at least one outpatient mental health visit during the year prior to enrollment. Results for postenrollment year 2 indicated a 43% decrease in inpatient mental health discharges, a 38% decrease in substance use discharges, and a 7% reduction in general medical discharges, whereas mental health outpatient treatment and behavioral and nonbehavioral medication utilization increased.

View Article and Find Full Text PDF

Background: This study presents an intervention designed to foster the implementation of health promotion programs within District Municipality Community Centers (DMCCs) in Jerusalem, and the creation of a peer network of healthy settings with a shared aspiration of collaborating and implementing health-promoting policies at the community level. We also present the evaluation strategy, based on the EQUIHP and RE-AIM frameworks.

Methods: Twenty DMCCs completed our program.

View Article and Find Full Text PDF

Established in 1990, Israel's Healthy Cities Network (HCN) performed its first evaluation in 2003-2004. A decade later, the present evaluation was implemented to assess members' compliance with the European HCN requirements and to determine progress made since the initial evaluation. A total of 31 of the existing 42 HCN members participated in this mixed methods evaluation.

View Article and Find Full Text PDF

Peripartum individuals with substance misuse are a high-risk population that challenge clinicians and child welfare specialists alike. Federal legislation was updated in 2016 with the Comprehensive Addiction Recovery Act (CARA) to improve care via expanded screening and treatment referrals for peripartum women with substance misuse. The implementation of CARA requires providers to update their policies and procedures in order to meet the requirements outlined by this legislation.

View Article and Find Full Text PDF

Hugh Diamond was a psychiatrist, antiquarian, and photographer, who was the first person to take photographs of female asylum patients. These photographs, using the newly invented technology of the camera, were intended to be objective and accurate visual indicators of mental illness. Considering Diamond's overlapping interests, his project must be understood within the larger cultural and historical context and the tensions inherent in medical photography and portraiture.

View Article and Find Full Text PDF

The relations between dietary features and human health are varied and complex. Health-related variables are many and they have intricate relations at different and interrelated nutritional levels: nutrients, food groups, and the complex overall pattern. Food-based dietary guidelines (FBDGs) are principally designed to synthesize this information to make it available to the public.

View Article and Find Full Text PDF

Polymer brushes are found in biomedical and industrial technologies, where they exhibit functionalities considerably dependent on polymer brush-solvent-analyte interactions. It remains a difficult challenge to quickly analyze solvent-swollen polymer brushes, both at the solvent-polymer brush interface and in the brush interior, as well as to monitor the kinetics of interaction of solvent-swollen brushes with key analytes. Here, we demonstrate the novel use of silicon photonic microring resonators to characterize swollen polymer brush-analyte interactions.

View Article and Find Full Text PDF

Objective: This study investigated service use by individuals with serious and nonserious mental illness receiving mental health care in medical and mental health settings.

Methods: Claims data from the New York State Medicaid Data Warehouse were examined for 8,988 patients who received at least one mental health service at an urban academic medical center during 2017 at a mental health setting, a medical setting, or both.

Results: Most patients (59%) received all of their mental health care in medical settings and from unaffiliated providers, including a large portion (16%) with serious mental illness.

View Article and Find Full Text PDF

Background: An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); however, this body of knowledge is largely symptom-based and from a clinical perspective and thus limited in capturing perspectives and values of individuals with lived experience of an ED. In this study, we performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature.

Methods: A systematic review and qualitative meta-synthesis approach was used.

View Article and Find Full Text PDF

Purpose: To describe the development of the first disease prevention intervention with ultra-Orthodox Jewish (UOJ) women in Israel using mixed methods and community-based participatory research (CBPR).

Design: This collaborative, 7-staged development process used an exploratory sequential mixed methods design integrated into a community-based participatory approach.

Setting: The UOJ community in Israel, a high-risk, low socioeconomic, culturally insular minority that practices strict adherence to religious standards, maintains determined seclusion from mainstream culture and preserves traditional practices including extreme modesty and separation between the sexes.

View Article and Find Full Text PDF

The field of marriage education has come to be dominated by nonprofessionals with no clinical training because clinicians interested in relationships typically provide marital therapy to couples in distress rather than marriage education to healthy couples. In this paper, we encourage clinicians to participate in the development of marriage education programs, such as that described by our Supporting Healthy Marriage program, which serves a large number of low-income couples, and propose a psychological conceptual framework for delivering marriage education services. It makes sense for clinicians to consider using this novel approach given the opportunity to impact such a large segment of society that might not receive psychological services.

View Article and Find Full Text PDF

Different European institutions have developed mathematical models to propose maximum safe levels either for fortified foods or for dietary supplements. The objective of the present study was to compare and check the safety of these different maximum safe levels (MSL) by using a probabilistic risk assessment approach. The potential maximum nutritional intakes were estimated by taking into account all sources of intakes (base diet, fortified foods and dietary supplements) and compared with the tolerable upper intake levels for vitamins and minerals.

View Article and Find Full Text PDF

The 2006 welfare reform legislation (Deficit Reduction Act of 2005) imposed more stringent work requirements and defined the amount of time cash assistance recipients are allowed to be exempted from the work requirement because of substance use treatment. As there is little empirical literature on the employability of substance users, it is difficult to know whether it is realistic to expect individuals with substance use disorders to meet the increased work requirement. Based on a comprehensive evaluation of nearly 9,000 substance-misusing welfare recipients from 2001 to 2007, University Behavioral Associates (UBA) Comprehensive Services Model program in Bronx, New York, found that 60% of recipients were not exempted from the work requirement owing to substance misuse at the outset, and an additional 24% were found nonexempt after 3 months of intensive outpatient treatment coupled with case management, resulting in a total of 84% of the UBA clients not being exempted from the work requirement because of substance misuse by Day 90.

View Article and Find Full Text PDF

The goals of this study were (a) to investigate the existence of substance abuse/dependence subtypes in a diverse low-income welfare to work sample and (b) to explore subtype differences in rates of comorbid psychiatric and medical conditions. Data for all demographic and clinical variables were extracted from deidentified case records of 4,977 clients enrolled in a comprehensive case management program for welfare recipients with substance use disorders. Latent class analysis supported a five-class model made up of a multiple abuse/dependence class (n = 1,133), a cocaine/alcohol class (n = 2,120), an opioids class (n = 1,346), a cannabis class (n = 362), and a small polysubstance/none primary class (n = 16).

View Article and Find Full Text PDF

This study aimed to compare energy balance, metabolic profiles and body composition between two inbred strains of rats (F344 and Lou) submitted to a self-selecting macronutrient. During the 3 weeks of experiment, the two strains did not differ significantly for their total energy intake; males: F344 = 5875.4 +/- 171.

View Article and Find Full Text PDF

Leptin resistance contributes to the pathogenesis of common obesity related metabolic diseases, including insulin resistance. However, the relationship between leptin and insulin resistance is not clearly established. Here, we show that induced hyperleptinemia by leptin infusion alters insulin signalling in rat liver.

View Article and Find Full Text PDF

The peripheral administration of leptin reduces food intake (FI) body weight gain (BWG) and modifies food choice. The aim of this study was to examine the effect of acute cerebral injections of leptin on food selection in rats. Male rats were first adapted to the food choice paradigm (protein, carbohydrate, fat) for 3 weeks.

View Article and Find Full Text PDF