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As the number of older adults is expected to increase exponentially within the next few decades, loneliness, social isolation, and depression among seniors are growing public health concerns. Although formal treatment options, such as therapy and medication, can be helpful for depression, they can also be expensive and sometimes ineffective. It is therefore important to consider other potential treatment options and social interventions. Alternative methods for addressing mental health issues are especially important for older adults, as they may encounter barriers associated with aging such as limited mobility and decreased social networks. In these circumstances, online social networking may offer a potential "social cure" to alleviate loneliness, social isolation, and depression. check details The purpose of this scoping review was to gather and summarize the current literature on associations between online social networking and mental health outcomes (e.g., depression, life satisfaction, loneliness) among older adults. An initial search of 3,699 articles resulted in 52 articles that met criteria for inclusion. Five common themes were identified (1) enhanced communication with family and friends, (2) greater independence and self-efficacy, (3) creation of online communities, (4) positive associations with well-being and life satisfaction, and (5) decreased depressive symptoms. Implications for older adults' mental health, social connectedness, programs and policies are discussed.
In the era of widespread resistance, there are 2 time points at which most empiric prescription errors occur among hospitalized adults (1) upon admission (UA) when treating patients at risk of multidrug-resistant organisms (MDROs) and (2) during hospitalization, when treating patients at risk of extensively drug-resistant organisms (XDROs). These errors adversely influence patient outcomes and the hospital's ecology.
Retrospective cohort study, Shamir Medical Center, Israel, 2016.
Adult patients (aged >18 years) hospitalized with sepsis.
Logistic regressions were used to develop predictive models for (1) MDRO UA and (2) nosocomial XDRO. Their performances on the derivation data sets, and on 7 other validation data sets, were assessed using the area under the receiver operating characteristic curve (ROC AUC).
In total, 4,114 patients were included 2,472 patients with sepsis UA and 1,642 with nosocomial sepsis. The MDRO UA score included 10 parameters, and with a cutoff of ≥22 points, it had an ROC AUC of 0.85. The nosocomial XDRO score included 7 parameters, and with a cutoff of ≥36 points, it had an ROC AUC of 0.87. The range of ROC AUCs for the validation data sets was 0.7-0.88 for the MDRO UA score and was 0.66-0.75 for nosocomial XDRO score. We created a free web calculator (https//assafharofe.azurewebsites.net).
A simple electronic calculator could aid with empiric prescription during an encounter with a septic patient. Future implementation studies are needed to evaluate its utility in improving patient outcomes and in reducing overall resistances.
A simple electronic calculator could aid with empiric prescription during an encounter with a septic patient. Future implementation studies are needed to evaluate its utility in improving patient outcomes and in reducing overall resistances.
Symptoms may be more useful prognostic markers for mental illness than diagnoses. We sought to investigate symptom domains in women with pre-existing severe mental illness (SMI; psychotic and bipolar disorder) as predictors of relapse risk during the perinatal period.
Data were obtained from electronic health records of 399 pregnant women with SMI diagnoses from a large south London mental healthcare provider. Symptoms within six domains characteristically associated with SMI (positive, negative, disorganization, mania, depression, and catatonia) recorded in clinical notes 2years before pregnancy were identified with natural language processing algorithms to extract data from text, and associations investigated with hospitalization during pregnancy and 3months postpartum.
Seventy-six women (19%) relapsed during pregnancy and 107 (27%) relapsed postpartum. After adjusting for covariates, disorganization symptoms showed a positive association at borderline significance with relapse during pregnancy (adjusutine health records from text fields is relatively transferrable and could help inform predictive risk modelling.
To evaluate outcomes in patients with Turner Syndrome, especially those with cardiac conditions, compared to those without Turner syndrome.
Retrospective cohort study utilising hospitalisation data from 2006 to 2012. Conditional logistic regression models are used to analyse outcomes of interest all-cause mortality, increased length of stay, and discharge to home.
We identified 2978 women with Turner syndrome, matched to 11,912 controls by primary diagnosis.
Patients with Turner syndrome were more likely to experience inpatient mortality (odds ratio 1.44, 95% confidence interval 1.02-2.02, p = 0.04) and increased length of stay (OR 1.31, CI 1.18-1.46, p = 0.03) than primary diagnosis matched controls, after adjusting for age, race, insurance status, and Charlson comorbidity index. Patients with Turner syndrome were 32% less likely to be discharged to home (OR 0.68, CI 0.60-0.78, p < 0.001). When restricting the sample of patients to those admitted with a cardiac diagnosis, the likelihood of mortality (OR 3.10, CI 1.27-7.57, p = 0.01) and prolonged length of stay (OR 1.42, CI 1.03-1.95, p = 0.03) further increased, while the likelihood of discharge to home further decreased (OR 0.55, CI 0.38-0.80, p = 0.001) in Turner syndrome compared to primary diagnosis matched controls. Specifically, patients with congenital heart disease were more likely to have prolonged length of stay (OR 1.53, CI 1.18-2.00, p = 0.002), but not increased mortality or decreased discharge to home.
Hospitalised women with Turner syndrome carry a higher risk of adverse outcomes even when presenting otherwise similarly as controls, an important consideration for those treating them in these settings.
Hospitalised women with Turner syndrome carry a higher risk of adverse outcomes even when presenting otherwise similarly as controls, an important consideration for those treating them in these settings.
Website: https://www.selleckchem.com/products/gdc-0084.html
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