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Digitally transforming community mental healthcare: Real-world lessons from algorithmic workforce integration.
Psychiatry Res
January 2025
SA Health, Northern Adelaide Local Health Network, Northern Community Mental Health, Salisbury, Australia; Sonder, Headspace Adelaide Early Psychosis, Adelaide, Australia; The University of Adelaide, Adelaide Medical School, Discipline of Psychiatry, Adelaide, Australia.
Community-based high intensity services for people living with severe and enduring mental illnesses face critical workforce shortages and workflow efficiency challenges. The expectation to monitor complex, dynamic patient data from ever-expanding electronic health records leads to information overload, a significant factor contributing to worker burnout and attrition. An algorithmic workforce, defined as a suite of algorithm-driven processes, can work alongside health professionals assisting with oversight tasks and augmenting human expertise.
View Article and Find Full Text PDFPatient perspective: Is intensive screening of women at high risk of breast cancer evidence-based medicine or ?
Womens Health (Lond)
January 2025
Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, Glendale, AZ, USA.
In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002.
View Article and Find Full Text PDFComplex Cardiovascular Management in an 80-Year-Old Female With Gastrointestinal Bleeds and Klatskin Tumor: A Case of ST-Elevation Myocardial Infarction (MI) Management Complicated by Severe Anemia and Post-MI Ventricular Septal Defect Development.
Cureus
December 2024
Interventional Cardiology, Lee Health, Fort Myers, USA.
Managing acute coronary syndrome (ACS) in patients with a recent history of gastrointestinal bleeding presents a unique and challenging clinical dilemma, necessitating a careful balance between minimizing ischemic risk and avoiding potentially life-threatening rebleeding. Standard treatment for ACS typically involves dual antiplatelet therapy (DAPT) to prevent recurrent thrombotic events. However, in patients with recent gastrointestinal hemorrhage or significant anemia, these therapies may substantially increase the risk of life-threatening bleeding, complicating the decision-making process and often leading to conservative management strategies.
View Article and Find Full Text PDFHow I Treat Higher-Risk MDS.
Blood
January 2025
H. Lee Moffitt Cancer Center, Tampa, Florida, United States.
Myelodysplastic syndromes/neoplasms (MDS) are a widely heterogenous group of myeloid malignancies characterized by morphologic dysplasia, a defective hematopoiesis, and recurrent genetic abnormalities. The original and revised International Prognostic Scoring Systems (IPSS) have been used to risk-stratify patients with MDS to guide treatment strategies. In higher-risk MDS, the therapeutic approach is geared toward delaying leukemic transformation and prolonging survival.
View Article and Find Full Text PDFImplementing national antimicrobial consumption in Latin America and the Caribbean: opportunities and lessons learned.
Epidemiol Infect
January 2025
Pan American Health Organization, Washington, DC, USA.
Surveillance of antimicrobial consumption (AMC) is essential to anticipate and inform policies and public health decisions to prevent and/or contain antimicrobial resistance (AMR). This manuscript shares the experience on AMC data collection in Latin American & Caribbean (LAC). The WHO GLASS-AMC methodology for AMC surveillance was used for data registration during the period 2019-2022.
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