Evaluating Harms Associated with Prolonged Antibiotic Duration of Therapy in Community Dwelling Older Adults: A Cohort Study using Instrumental Variable Analysis.

Background: Shorter courses of antibiotic therapy are increasingly recommended to reduce antibiotic exposure. However quantifying the real-world impact of duration of therapy is hindered by bias common in observational studies. We aimed to evaluate the harms and benefits of longer versus shorter duration of therapy in older adults.

Physician Engagement in Addressing Health-Related Social Needs and Burnout.

Importance: Previous research suggests that a greater capacity of health care organizations to address patients' health-related social needs (HRSNs) is associated with lower physician burnout. However, individual physician-level engagement in addressing HRSNs has not been fully characterized, and its association with physician burnout remains understudied.

Objective: To characterize physicians' engagement in addressing HRSNs and examine its association with burnout.

Riluzole is associated with reduced risk of heart failure.

Background: Reduction of intracellular Na accumulation through late Na current inhibition has been recognized as a target for cardiac Ca handling which underlies myocardial contractility and relaxation in heart failure (HF). Riluzole, an Na channel blocker with enhancement of Ca-activated K channel function, used for management of amyotrophic lateral sclerosis (ALS), is effective in suppressing Ca leak and therefore may improve cardiac function.

Objectives: The study aim was to investigate whether riluzole lowers HF incidence.

Explanatory models of common mental disorders among South Asians in high-income countries: A systematic review.

Mental health service use by individuals of South Asian origin living outside of South Asia is influenced by cultural factors such as endorsing psycho-social-spiritual over biological explanations, somatisation, and stigma. The aim of this review is to synthesise the evidence about (a) explanatory models of common mental disorders (CMDs) among people of South Asian origin residing in high-income countries, and (b) their help-seeking for CMDs, including formal and informal care. The systematic review protocol was registered a priori on Prospero (registration number CRD42021287583).

Associations between nurse-to-patient ratio, nurse educational level, and nurse-sensitive patient outcomes: A 12-month prospective observational study.

Aim: To investigate the associations between nurse staffing levels, nurse educational level, and nurse-sensitive patient outcomes among patients in medical and surgical wards.

Background: Patient outcomes are affected by a variety of factors, including nurse staffing and registered nurse (RN) educational levels. An examination of the associations between these factors and patient outcomes will help identify the impact that nurses make on patient care, including health and safety.

The Impact of the COVID-19 Pandemic on Oldest-Old Social Capital and Health and the Role of Digital Inequalities: Longitudinal Cohort Study.

Background: During the COVID-19 pandemic, information and communication technology (ICT) became crucial for staying connected with loved ones and accessing health services. In this scenario, disparities in ICT use may have exacerbated other forms of inequality, especially among older adults who were less familiar with technology and more vulnerable to severe COVID-19 health consequences.

Objective: This study investigated changes in ICT use, psychological and physical health, and social capital before and after the pandemic among the oldest old population (aged 80 years or older after the pandemic) and explored how internet use influenced these changes.

The socioeconomic burden of cervical cancer and its implications for strategies required to achieve the WHO elimination targets.

Introduction: Cervical cancer is almost entirely preventable by vaccination and screening. Population based vaccination and screening programs are effective and cost effective, but millions of people do not have access to these programs, causing immense suffering. The WHO Global Strategy for the elimination of cervical cancer as a public health problem calls for countries to meet ambitious vaccination, screening and treatment targets.

Short-term outcomes of gradual ulnar lengthening in multiple hereditary osteochondromas of the forearm with monolateral external fixator.

Hereditary multiple exostoses is an autosomal dominant genetic condition primarily affecting long bones. Forearm deformities, including wrist ulnar deviation, ulnar shortening, radial or ulnar bowing, and radial head dislocation, are common manifestations. Gradual ulnar lengthening is suggested as a viable treatment option for managing these deformities.

Cost-effectiveness of finerenone therapy for patients with chronic kidney disease and type 2 diabetes in England & Wales: results of the FINE-CKD model.

Objective: Chronic kidney disease (CKD) is the leading cause of kidney failure, end-stage kidney disease (ESKD), and cardiovascular (CV) events in patients with type 2 diabetes (T2D). The FIDELIO-DKD trial demonstrated that finerenone lowered the risk of renal and CV events in patients with CKD and T2D, regardless of cardiovascular disease history. This study evaluated the cost-effectiveness of finerenone added to background treatment (finerenone + BT) versus background treatment (BT) alone in patients with CKD and T2D from the perspective of the National Health Service in England and Wales.

Impact of Heart Transplant Allocation Changes on Waitlist Mortality and Clinical Practice in Pediatric and Adult Patients With Congenital Heart Disease and Cardiomyopathy.

Background: The United Network of Organ Sharing made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. Although recent work has evaluated the impact of the revised allocation systems on mechanical circulatory support practices and waitlist outcomes, there are limited data that focus more specifically on the impact of the allocation changes on patients with congenital heart disease (CHD) or cardiomyopathy and how these relationships might differ in pediatric and adult patients.

Methods: The United Network of Organ Sharing database was queried for pediatric (<18 years of age) and adult (18-50 years of age) patients with a CHD or cardiomyopathy diagnosis listed for HT.

Racism and Postpartum Blood Pressure in a Multiethnic Prospective Cohort.

Background: Postpartum hypertension is a key factor in racial-ethnic inequities in maternal mortality. Emerging evidence suggests that experiences of racism, both structural and interpersonal, may contribute to disparities. We examined associations between gendered racial microaggressions (GRMs) during obstetric care with postpartum blood pressure (BP).

Examining the Potential Impact of Recreational Cannabis Legalization on Individuals Receiving Treatment for Substance Use Disorder: An Interrupted Time Series Study in Guelph, Ontario, Canada.

Objective: The present research evaluated the impact of legalizing recreational cannabis among individuals with substance use disorders (SUDs) who may already use cannabis at high rates.

Method: Using an interrupted time series study design, we evaluated the potential impact of legalizing recreational cannabis among individuals seeking treatment for SUD within a hospital-based treatment setting in Guelph, Ontario. We examined 2,925 individuals who entered an inpatient SUD treatment program between April 2017 and December 2021.

Changes in Cannabis Use Patterns in Psychiatric Populations Pre- and Post-Legalization of Recreational Cannabis Use in Canada: A Repeated Cross-Sectional Survey.

Objective: Since the federal Canadian government legalized cannabis in 2018, cannabis use in the general population has slightly increased. However, little is known about the impact of cannabis legalization on pattens of cannabis use in psychiatric populations.

Method: We studied changes in daily/almost daily and average 30-day cannabis use amongst individuals currently using cannabis who reported past 12-month experiences of specific mental health disorders and among those without past 12-month experiences of any mental health disorder before and after Canadian legalization of recreational cannabis use ( = 13,527).

Perceptions of Obesity Among Healthcare Professionals and Policy Makers in 2023: Results of the Global OPEN Survey.

Objective: Obesity is a disease with severe health impacts on individuals and economic impacts on society, yet healthcare practitioners (HCPs) and policy makers often fail to address it. This survey was conducted to examine current global obesity care and perceptions influencing care delivery among HCPs and healthcare decision makers (HC DMs).

Methods: A survey with a cross-sectional design was conducted among 1200 HCPs (primary care providers, endocrinologists, cardiologists, and nurses) and 414 HC DMs from eight countries across five continents.

Cerebral white matter damage in patients with end-stage kidney disease associates with cognitive impairment.

Background: Damage to brain white matter often occurs in individuals with chronic kidney disease, which might be related to their cognitive decline. This study aims to investigate tract-specific white matter damage in patients with end-stage kidney disease by using fixel-based analysis.

Methods: Images of 31 end-stage kidney disease patients and 16 normal controls (aged: 61.

Prevalence and Factor Influencing Intimate Partner Violence against Women during COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Background: It seems that the prevalence of intimate partner violence increased during the COVID-19 pandemic. To investigate the prevalence of different types of IPV and its contributing factors on a global scale during the COVID-19 pandemic.

Methods: This is a systematic review and meta-analysis study.

A policy assessment tool to identify causes of inequities that influence obesity prevalence.

When policy-makers propose health-related initiatives they need to assess the impact on health inequalities, including disparities in diet-related diseases and obesity. Health impact assessments, including health equity assessments, can provide insights into the potential health outcomes, but they are usually based on engagement with stakeholders and beneficiaries and their quality is not easy to evaluate. In this paper, we propose a policy assessment tool designed to ask a set of questions on the impact on health equity of policies and interventions that may be answerable from empirical evidence or from public health principles.

Policy coherence of price controls on food and noncommunicable disease prevention, WHO South-East Asia and Western Pacific regions.

Noncommunicable diseases are the leading cause of death and disability globally, with suboptimal diet being a significant risk factor. Fiscal policies that promote nutritious foods have been identified as part of a best-practice package of interventions and are a focus for governments in the current context of rising food prices. Price controls are a strategy that governments commonly apply to limit mark-up on prices of specific foods, with the aim of protecting consumers and promoting food security.

Establishing links between drug registers and essential medicines lists.

Access to essential medicines is still suboptimal in many countries. Recent studies examining the registration of medicines at the country level show that a considerable proportion of essential medicines do not have any corresponding products registered for use at the country level and therefore cannot be available at all times. Conversely, many non-essential medicines are registered by regulatory authorities for local markets, potentially facilitating inappropriate drug use and antimicrobial resistance.

Changing or validating physician opioid prescribing behaviors through audit and feedback and academic detailing interventions in primary care.

Background: In Ontario, Canada, province-wide initiatives supporting safer opioid prescribing in primary care include voluntary audit and feedback reports and academic detailing. In this process evaluation, we aimed to determine the fidelity of delivery and receipt of the interventions, the observed change strategies used by physicians, potential mechanisms of action, and how complementary the initiatives can be to each other.

Method: Semi-structured interviews were conducted with academic detailers and with physicians who received both interventions.

Pediatric cardiac surgical site infections: A single-center quality improvement initiative.

Objective: Pediatric cardiac surgery site infections (SSI) represent significant morbidity. Our institution reported elevated SSI rates of 3.48 per 100 cases over a 5-year period above target rates of 2.

Five-year comparison of clinical and echocardiographic outcomes of pure aortic stenosis with pure aortic regurgitation or mixed aortic valve disease in the COMMENCE trial.

Objective: To compare outcomes of aortic valve replacement (AVR) in patients with pure aortic stenosis (Pure AS) and those with pure aortic regurgitation (Pure AR) or mixed AS and AR (MAVD) in the COMMENCE trial.

Methods: Of 689 patients who underwent AVR in the COMMENCE trial, patients with moderate or severe AR with or without AS (Pure AR + MAVD; n = 135) or Pure AS (n = 323) were included. Inverse probability of treatment weighting Kaplan-Meier survival curves were used for time-to-event endpoints, and longitudinal changes in hemodynamics were evaluated using mixed-effects models.

Surgery versus surveillance for ascending aortic aneurysms in elderly patients.

Background: Whether elderly patients with aortic root or ascending aortic aneurysm (ATAA) would benefit from the new surgical size threshold of 5.0 cm is unknown. This study aimed to evaluate the natural history of ATAA in elderly patients and to compare long-term outcomes of those who underwent initial surveillance versus surgery.