Background: After 20 years of debate regarding the appropriateness of family-witnessed resuscitations (FWR), little substantive data exist to suggest a benefit or harm to the family member.
Objective: To compare bereavement-related depression and post-traumatic stress disorder (PTSD) symptoms among cardiopulmonary resuscitation (CPR) patients' family members who remain in the waiting room of an urban emergency department (ED) with those who are invited to witness CPR.
Methods: A prospective comparison study was conducted at two large, urban, Midwestern teaching hospitals. Adult family members of nontraumatic CPR ≥18 years of age patients were eligible. In the intervention hospital, emergency physicians were trained and encouraged to invite family members to witness CPR (FWR). At the control hospital, family remained in the ED waiting room (Non-FWR). Family members from each hospital were interviewed 30 and 60 days post-event regarding bereavement-related depression and PTSD symptoms. Relevant demographic information was also collected. Comparisons between FWR and Non-FWR were conducted using independent samples t tests and χ(2) where appropriate.
Results: Sixty-five family members (24 FWR and 41 Non-FWR) were included. There were no differences between groups in relationship to the patient (35% spouse/significant other), mean age (overall, 56 years), or race (75% African American). Patients in each group did not differ in need for assistance in any activities of daily living (overall, 44% needed assistance) prior to cardiac arrest. However, more FWR were female (83% versus 59%), and had higher levels of overall social support available. There were no differences between FWR and Non-FWR on overall PTSD scores (11.7 versus 11.4; mean difference = 0.3 [95 confidence interval (CI): -5.5; 6.1]) or depression scores (16.0 versus 20.6; mean difference = -4.5 [95CI: -12.0; 3.0]).
Conclusion: Bereavement related depression and PTSD symptoms are commonly seen in family members of cardiac arrest victims, however, the magnitude of the effect is not impacted by witnessing or not-witnessing CPR in the ED.
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http://dx.doi.org/10.1089/jpm.2010.0463 | DOI Listing |
Background: An estimated 17% of all couples worldwide are involuntarily childless (infertile). The clinically identifiable causes of infertility can be found in the male or female partner or in both. The molecular pathophysiology of infertility still remains unclear in many cases but is increasingly being revealed by genetic analyses.
View Article and Find Full Text PDFCancer Epidemiol Biomarkers Prev
January 2025
University of Kentucky, Lexington, KY, United States.
Background: Kentucky is within the top five leading states for breast mortality nationwide. This study investigates the association between neighborhood socioeconomic disadvantage and breast cancer outcomes, including surgical treatment, radiation therapy, chemotherapy, and survival, and how associations vary by race and ethnicity in Kentucky.
Methods: We conducted a retrospective cohort analysis using data from the Kentucky Cancer Registry (KCR) for breast cancer patients diagnosed between 2010 and 2017, with follow-up through December 31, 2022.
AIDS Patient Care STDS
January 2025
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, Oakland, California, USA.
Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.
Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.
JAMA Netw Open
January 2025
Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Importance: There is limited evidence regarding the association between age at menopause and incident type 2 diabetes (T2D).
Objective: To investigate whether age at menopause and premature menopause are associated with T2D incidence in postmenopausal Korean women.
Design, Setting, And Participants: This population-based cohort study was conducted among a nationally representative sample from the Korean National Health Insurance Service database of 1 125 378 postmenopausal women without T2D who enrolled in 2009.
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