Cirrhosis accounts for a large number of deaths in the United States and worldwide, leading to an increasing burden on the healthcare system. Cirrhosis is, however, a progressive disease with different potential complications related to liver dysfunction and portal hypertension. Often, patients may present with complications of cirrhosis without having been diagnosed previously. It is pertinent that clinicians recognize these signs to place patients on an appropriate course of management to help delay or avoid further disease progression while avoiding deleterious outcomes and unnecessary utilization. We will discuss the epidemiology of liver disease, cirrhosis, and its complications (hepatic encephalopathy, ascites, and varices). In this study, we will discuss the rationale and impact of missing these diagnoses on the healthcare system and patient.
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http://dx.doi.org/10.1002/jhm.12918 | DOI Listing |
J Med Internet Res
January 2025
School of Journalism and Communication, Beijing Normal University, Beijing, China.
Background: Digital health interventions have emerged as promising tools to promote health behavior change and improve health outcomes. However, a comprehensive synthesis of strategies contributing to these interventions is lacking.
Objective: This study aims to (1) identify and categorize the strategies used in digital health interventions over the past 25 years; (2) explore the differences and changes in these strategies across time periods, countries, populations, delivery methods, and senders; and (3) serve as a valuable reference for future researchers and practitioners to improve the effectiveness of digital health interventions.
J Med Internet Res
January 2025
Department of Community Health Sciences, Boston University, Boston, MA, United States.
Background: Improving adherence to pre-exposure prophylaxis (PrEP) via digital health interventions (DHIs) for young sexual and gender minority men who have sex with men (YSGMMSM) is promising for reducing the HIV burden. Measuring and achieving effective engagement (sufficient to solicit PrEP adherence) in YSGMMSM is challenging.
Objective: This study is a secondary analysis of the primary efficacy randomized controlled trial (RCT) of Prepared, Protected, Empowered (P3), a digital PrEP adherence intervention that used causal mediation to quantify whether and to what extent intrapersonal behavioral, mental health, and sociodemographic measures were related to effective engagement for PrEP adherence in YSGMMSM.
JAMA Netw Open
January 2025
Department of Public Health and Preventive Medicine, State University New York (SUNY) Upstate Medical University, Syracuse, New York.
Importance: Environmental service workers (ESWs) have a critical role within the hospital infrastructure and are at the frontline of infection prevention. ESWs are highly trained in managing all forms of regulated waste, which includes biohazardous waste, and are responsible for the overall patient experience, janitorial work, and infection prevention. Without environmental services, patients have a 6 times greater risk of being infected by pathogens from patients who previously occupied their room.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Harvard School of Public Health, Boston, Massachusetts.
Importance: Improving access to high-quality maternity care and reducing maternal morbidity and mortality are major policy priorities in the US. Previous research has primarily focused on access to general obstetric care rather than access to high-risk pregnancy care provided by maternal-fetal medicine subspecialists (MFMs).
Objective: To measure access to MFM services and determine patient factors associated with MFM service use, including MFM telemedicine.
JAMA Netw Open
January 2025
VA Center for Health Information and Communication, US Department of Veterans Affairs, Veterans Health Administration, Health Systems Research CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
Importance: Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social and economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers to care and to address the causes of the disparities in the future.
Objective: To characterize mental health care utilization among TGD veterans with depression.
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