Texts for Talking: Evaluation of a Mobile Health Program Addressing Speech and Language Delay.

Speech and language delays are common developmental disorders that can lead to long-term academic and psychosocial impairments. Affected families often benefit from instruction in cultivating a language-rich home environment. This study investigated the feasibility of utilizing text messaging to deliver developmental education to families.

Engaging Teammates in the Promotion of Concussion Help Seeking.

Concussion underreporting contributes to the substantial public health burden of concussions from sport. Teammates may be able to play an important role in encouraging injury identification and help seeking. This study assessed whether there was an association between beliefs about the consequences of continued play with a concussion and intentions to engage as a proactive bystander in facilitating or encouraging teammate help seeking for a possible concussion.

Using Clinical Vignettes to Assess Quality of Care for Acute Respiratory Infections.

Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. Our objective was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. We surveyed physicians (n = 78) and retail clinic clinicians (n = 109) between January and September 2013.

Data interchange using i2b2.

Objective: Reinventing data extraction from electronic health records (EHRs) to meet new analytical needs is slow and expensive. However, each new data research network that wishes to support its own analytics tends to develop its own data model. Joining these different networks without new data extraction, transform, and load (ETL) processes can reduce the time and expense needed to participate.

The Impact of Institutional Review Boards (IRBs) on Clinical Innovation: A Survey of Investigators and IRB Members.

We conducted a survey to assess the perspectives of principal investigators and Institutional Review Board (IRB) members on the impact of the IRB structure on the conduct of research and innovative therapy, defined as a nonstandard treatment intended to enhance the well-being of an individual patient. Although investigators and IRB members agreed that the IRB provides adequate protection to study subjects (97% vs. 100%) and an ethically insightful review (88% vs.

Funding allocation to surgery in low and middle-income countries: a retrospective analysis of contributions from the USA.

Objective: The funds available for global surgical delivery, capacity building and research are unknown and presumed to be low. Meanwhile, conditions amenable to surgery are estimated to account for nearly 30% of the global burden of disease. We describe funds given to these efforts from the USA, the world's largest donor nation.

Evaluation of a novel portable x-ray fluorescence screening tool for detection of arsenic exposure.

A new portable x-ray fluorescence (XRF) screening tool was evaluated for its effectiveness in arsenic (As) quantification in human finger and toe nails ([Formula: see text]). Nail samples were measured for total As concentration by XRF and inductively coupled plasma-mass spectrometry (ICP-MS). Using concordance correlation coefficient (CCC), kappa, diagnostic sensitivity (Sn) and specificity (Sp), and linear regression analyses, the concentration of As measured by XRF was compared to ICP-MS.

Growth and Obesity Among Older Single Ventricle Patients Presenting for Fontan Conversion.

Introduction: Long-term growth outcomes and the prevalence of obesity among older single ventricle (SV) patients have not been well characterized. We investigated these parameters, as well as the impact of obesity on survival, in an older cohort of SV patients presenting for Fontan conversion.

Methods: We analyzed preoperative height, weight, and body mass index (BMI) of patients who underwent Fontan conversion.

Concussion Education in U.S. Collegiate Sport: What Is Happening and What Do Athletes Want?

Concussion education for athletes has the potential to play a role in reducing the health burden of concussions from sport by modifying individual risk-related behaviors. In U.S.

Enhancing Patient Safety in Pediatric Primary Care: Implementing a Patient Safety Curriculum.

Objective: We developed and implemented a patient safety (PS) curriculum targeted at clinicians and nonclinical office practice staff within a large primary care pediatric network.

Methods: Curricular content was informed by medical literature, local PS experts, and malpractice claims data. Sessions were centered on illustrative closed malpractice cases or informed by identified safety events.

Toward high-throughput phenotyping: unbiased automated feature extraction and selection from knowledge sources.

Objective: Analysis of narrative (text) data from electronic health records (EHRs) can improve population-scale phenotyping for clinical and genetic research. Currently, selection of text features for phenotyping algorithms is slow and laborious, requiring extensive and iterative involvement by domain experts. This paper introduces a method to develop phenotyping algorithms in an unbiased manner by automatically extracting and selecting informative features, which can be comparable to expert-curated ones in classification accuracy.

Everyday discrimination and physical health: Exploring mental health processes.

Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation.

The volume-quality relationship in antibiotic prescribing: when more isn't better.

For many surgeries and high-risk medical conditions, higher volume providers provide higher quality care. The impact of volume on more common medical conditions such as acute respiratory infections (ARIs) has not been examined. Using electronic health record data for adult ambulatory ARI visits, we divided primary care physicians into ARI volume quintiles.

Novel radiographic feature classification of knee osteochondritis dissecans: a multicenter reliability study.

Background: Osteochondritis dissecans (OCD) is a vexing condition for patients, parents, and physicians because of the frequent slow healing and nonhealing that leads to prolonged treatment. Several features on plain radiographs have been identified as predictors of healing, but the reliability of their measurement has not been established.

Purpose: To determine the inter- and intrarater reliability of several radiographic features used in the diagnosis, treatment, and prognosis of OCD femoral condyle lesions.

Barriers and facilitators of pediatric weight management among diverse families.

Objective: To describe barriers and facilitators relevant to pediatric weight management from the perspective of at-risk overweight children and families.

Methods: Systematic thematic analysis of semistructured interviews with overweight children and families from diverse backgrounds at a large, urban academic pediatrics practice.

Results: Twenty-five parents and their children ages 2 to 18 years with mean body mass index percentile of 96th% (standard deviation 4.

Medical mistrust is related to lower longitudinal medication adherence among African-American males with HIV.

African-Americans living with HIV show worse health behaviors (e.g. medication adherence) and outcomes (e.

Systemic inflammation and cerebral palsy risk in extremely preterm infants.

The authors hypothesized that among extremely preterm infants, elevated concentrations of inflammation-related proteins in neonatal blood are associated with cerebral palsy at 24 months. In 939 infants born before 28 weeks gestation, the authors measured blood concentrations of 25 proteins on postnatal days 1, 7, and 14 and evaluated associations between elevated protein concentrations and cerebral palsy diagnosis. Protein elevations within 3 days of birth were not associated with cerebral palsy.

Barriers and facilitators to self-care communication during medical appointments in the United States for adults with type 2 diabetes.

Objective: Diabetes self-care is challenging and requires effective patient-provider communication to achieve optimal treatment outcomes. This study explored perceptions of barriers and facilitators to diabetes self-care communication during medical appointments.

Design: Qualitative study using in-depth interviews with a semistructured interview guide.