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[PMID]:29500167
[Au] Autor:John B
[Ad] Endereço:DigitalProfessionalism.com, London, UK.
[Ti] Título:Are you ready for General Data Protection Regulation?
[So] Source:BMJ;360:k941, 2018 03 02.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Segurança Computacional/normas
Gestão da Informação/normas
Registros Médicos
Privacidade
[Mh] Termos MeSH secundário: Acesso à Informação
Inglaterra
Europa (Continente)
Seres Humanos
Medicina Estatal
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180304
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k941


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[PMID]:28465095
[Au] Autor:Arriola CS; Vasconez N; Thompson MG; Olsen SJ; Moen AC; Bresee J; Ropero AM
[Ad] Endereço:Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, GA, USA; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: wus3@cdc.gov.
[Ti] Título:Association of influenza vaccination during pregnancy with birth outcomes in Nicaragua.
[So] Source:Vaccine;35(23):3056-3063, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies have shown that influenza vaccination during pregnancy reduces the risk of influenza disease in pregnant women and their offspring. Some have proposed that maternal vaccination may also have beneficial effects on birth outcomes. In 2014, we conducted an observational study to test this hypothesis using data from two large hospitals in Managua, Nicaragua. METHODS: We conducted a retrospective cohort study to evaluate associations between influenza vaccination and birth outcomes. We carried out interviews and reviewed medical records post-partum to collect data on demographics, influenza vaccination during pregnancy, birth outcomes and other risk factors associated with adverse neonatal outcomes. We used influenza surveillance data to adjust for timing of influenza circulation. We assessed self-reports of influenza vaccination status by further reviewing medical records of those who self-reported but did not have readily available evidence of vaccination status. We performed multiple logistic regression (MLR) and propensity score matching (PSM). RESULTS: A total of 3268 women were included in the final analysis. Of these, 55% had received influenza vaccination in 2014. Overall, we did not observe statistically significant associations between influenza vaccination and birth outcomes after adjusting for risk factors, with either MLR or PSM. With PSM, after adjusting for risk factors, we observed protective associations between influenza vaccination in the second and third trimester and preterm birth (aOR: 0.87; 95% confidence interval (CI): 0.75-0.99 and aOR: 0.66; 95% CI: 0.45-0.96, respectively) and between influenza vaccination in the second trimester and low birth weight (aOR: 0.80; 95% CI: 0.64-0.97). CONCLUSIONS: We found evidence to support an association between influenza vaccination and birth outcomes by trimester of receipt with data from an urban population in Nicaragua. The study had significant selection and recall biases. Prospective studies are needed to minimize these biases.
[Mh] Termos MeSH primário: Vacinas contra Influenza/administração & dosagem
Influenza Humana/prevenção & controle
Complicações Infecciosas na Gravidez/prevenção & controle
Resultado da Gravidez
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Coortes
Feminino
Seres Humanos
Recém-Nascido de Baixo Peso
Recém-Nascido
Modelos Logísticos
Registros Médicos
Nicarágua/epidemiologia
Gravidez
Complicações Infecciosas na Gravidez/epidemiologia
Trimestres da Gravidez
Nascimento Prematuro/epidemiologia
Pontuação de Propensão
Estudos Retrospectivos
População Urbana/estatística & dados numéricos
Vacinação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Nm] Nome de substância:
0 (Influenza Vaccines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:28453767
[Au] Autor:Chu TPC; Moran GW; Card TR
[Ad] Endereço:Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
[Ti] Título:The Pattern of Underlying Cause of Death in Patients with Inflammatory Bowel Disease in England: A Record Linkage Study.
[So] Source:J Crohns Colitis;11(5):578-585, 2017 May 01.
[Is] ISSN:1876-4479
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and Aims: Numerous studies have established that mortality risk in inflammatory bowel disease [IBD] patients is higher than in the general population, but the causes of death have seldom been examined. We aimed to describe causes of death in IBD. Methods: A matched cohort study using UK general practice data from Clinical Practice Research Datalink linked to death registration records. We described the distribution of causes of death among IBD patients by age at death and time since IBD diagnosis. We estimated age-specific mortality rates and hazard ratios of death in multivariable Cox proportional hazards models. Results: 20293 IBD patients were matched to 83261 non IBD patients. The mortality rate was 40% higher in IBD patients [2005 deaths] than in non IBD patients [6024 deaths] (adjusted overall hazard ratio: = 1.4, 95% confidence interval [CI]: = 1.4-1.5], with greater risk of death in Crohn's disease [hazard ratio: = 1.6, 1.5-1.7] than in ulcerative colitis [1.3, 1.3-1.4]. Causes attributable to IBD constituted 3.7% of all deaths in ulcerative colitis and 8.3% in Crohn's disease. Among IBD patients, death was less likely to be due to circulatory, respiratory or neoplastic diseases than among non IBD patients. In both IBD and non IBD patients all these causes became more clinically important with advancing age, with the commonest neoplastic cause of death being lung cancer rather than gastrointestinal cancers. Conclusions: IBD patients have an additional risk of death. Most IBD patients die of circulatory or respiratory causes, and the contribution to mortality from long-term complications of IBD is clinically less important.
[Mh] Termos MeSH primário: Causas de Morte
Doenças Inflamatórias Intestinais/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Colite Ulcerativa/mortalidade
Doença de Crohn/mortalidade
Atestado de Óbito
Feminino
Seres Humanos
Lactente
Recém-Nascido
Armazenamento e Recuperação da Informação
Masculino
Registros Médicos/estatística & dados numéricos
Meia-Idade
Modelos de Riscos Proporcionais
Reino Unido/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/ecco-jcc/jjw192


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[PMID]:27771623
[Au] Autor:Suri D; Bhattad S; Gupta A; Trehan A; Bansal D; Rajwanshi A; Das A; Rawat A; Singh S
[Ad] Endereço:Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
[Ti] Título:Malignancies in Children with Human Immunodeficiency Virus Infection - Our Experience at Chandigarh, North India.
[So] Source:J Trop Pediatr;63(3):210-216, 2017 06 01.
[Is] ISSN:1465-3664
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: With improved survival in children living with human immunodeficiency virus (HIV) infection (CLHIV), malignancies are being increasingly recognized. Patients and methods: Among the CLHIV registered at our institute from January 1994 to March 2015, children with malignancy were analysed in detail. Results: In total, 734 children affected by HIV were registered. Out of these, 11 children (9 boys, 2 girls) were diagnosed to have malignancy. Malignancy was the presenting feature of HIV infection in 4 children. High-grade non-Hodgkin lymphoma (NHL) was the most common malignancy noted in 9 of 11 (81%) children, whereas the remaining 2 children had Hodgkin's lymphoma. Survival in our cohort was 80% among children in whom chemotherapy was initiated, and overall survival was 36% (4 of 11 children). Conclusion: NHL was the most common malignancy in CLHIV in our cohort. Low-conditioning chemotherapy protocols along with initiation of anti-retroviral therapy resulted in improved outcomes in CLHIV with malignancy.
[Mh] Termos MeSH primário: Infecções por HIV/complicações
Neoplasias/complicações
[Mh] Termos MeSH secundário: Adolescente
Distribuição por Idade
Criança
Estudos de Coortes
Feminino
Infecções por HIV/diagnóstico
Infecções por HIV/epidemiologia
Seres Humanos
Índia
Linfoma Relacionado a AIDS/diagnóstico
Linfoma Relacionado a AIDS/epidemiologia
Linfoma Relacionado a AIDS/patologia
Linfoma não Hodgkin
Masculino
Registros Médicos
Neoplasias/mortalidade
Fatores de Risco
Distribuição por Sexo
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1093/tropej/fmw074


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[PMID]:29465588
[Au] Autor:Ammann EM; Cuker A; Carnahan RM; Perepu US; Winiecki SK; Schweizer ML; Leonard CE; Fuller CC; Garcia C; Haskins C; Chrischilles EA
[Ad] Endereço:College of Public Health.
[Ti] Título:Chart validation of inpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) administrative diagnosis codes for venous thromboembolism (VTE) among intravenous immune globulin (IGIV) users in the Sentinel Distributed Database.
[So] Source:Medicine (Baltimore);97(8):e9960, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Sentinel Distributed Database (SDD) is a database of patient administrative healthcare records, derived from insurance claims and electronic health records, sponsored by the US Food and Drug Administration for evaluation of medical product outcomes. There is limited information on the validity of diagnosis codes for acute venous thromboembolism (VTE) in the SDD and administrative healthcare data more generally.In this chart validation study, we report on the positive predictive value (PPV) of inpatient administrative diagnosis codes for acute VTE-pulmonary embolism (PE) or lower-extremity or site-unspecified deep vein thrombosis (DVT)-within the SDD. As part of an assessment of thromboembolic adverse event risk following treatment with intravenous immune globulin (IGIV), charts were obtained for 75 potential VTE cases, abstracted, and physician-adjudicated.VTE status was determined for 62 potential cases. PPVs for lower-extremity DVT and/or PE were 90% (95% CI: 73-98%) for principal-position diagnoses, 80% (95% CI: 28-99%) for secondary diagnoses, and 26% (95% CI: 11-46%) for position-unspecified diagnoses (originating from physician claims associated with an inpatient stay). Average symptom onset was 1.5 days prior to hospital admission (range: 19 days prior to 4 days after admission).PPVs for principal and secondary VTE discharge diagnoses were similar to prior study estimates. Position-unspecified diagnoses were less likely to represent true acute VTE cases.
[Mh] Termos MeSH primário: Bases de Dados Factuais/normas
Imunoglobulinas Intravenosas/efeitos adversos
Classificação Internacional de Doenças/normas
Registros Médicos/normas
Tromboembolia Venosa/diagnóstico
[Mh] Termos MeSH secundário: Registros Eletrônicos de Saúde
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Embolia Pulmonar/induzido quimicamente
Embolia Pulmonar/diagnóstico
Reprodutibilidade dos Testes
Medição de Risco/normas
Medição de Risco/estatística & dados numéricos
Estados Unidos
Tromboembolia Venosa/induzido quimicamente
Trombose Venosa/induzido quimicamente
Trombose Venosa/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Immunoglobulins, Intravenous)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009960


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[PMID]:29385990
[Au] Autor:Schoendorfer N; Sharp N; Seipel T; Schauss AG; Ahuja KDK
[Ad] Endereço:School of Medicine, University of Queensland, Herston, Australia.
[Ti] Título:Urox containing concentrated extracts of Crataeva nurvala stem bark, Equisetum arvense stem and Lindera aggregata root, in the treatment of symptoms of overactive bladder and urinary incontinence: a phase 2, randomised, double-blind placebo controlled trial.
[So] Source:BMC Complement Altern Med;18(1):42, 2018 Jan 31.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Storage lower urinary tract symptoms (LUTS) including overactive bladder (OAB) and urinary incontinence (UI) affect millions of people worldwide, significantly impacting quality of life. Plant based medicines have been documented both empirically and in emerging scientific research to have varying benefits in reducing bladder symptoms. We assessed the efficacy of Urox®, a proprietary combination of phytomedicine extracts including, Cratevox™ (Crataeva nurvala) stem bark, Equisetem arvense stem and Lindera aggregata root, in reducing symptoms of OAB and UI. METHODS: Efficacy of the herbal combination on a variety of bladder symptoms compared to an identical placebo, were documented in a randomised, double-blind, placebo controlled trial conducted at two primary care centres. Data were collected at baseline, 2, 4 and 8 weeks, with the primary outcome being self-reported urinary frequency. Statistical analysis included mixed effects ordered logistic regression with post hoc Holm's test to account for repeated measures, and included an intention-to-treat analysis. RESULTS: One hundred and fifty participants (59% female, aged; mean ± SD; 63.5 ± 13.1 years) took part in the study. At week 8, urinary day frequency was significantly lower (OR 0.01; 95%CI 0.01 to 0.02; p < 0.001) in response to treatment (mean ± SD; 7.69 ± 2.15/day) compared to placebo (10.95 ± 2.47/day). Similarly, episodes of nocturia were significantly fewer (OR 0.03; 95%CI 0.02 to 0.05) after 8 weeks of treatment (2.16 ± 1.49/night) versus placebo (3.14 ± 1.36/night). Symptoms of urgency (OR 0.02; 95%CI 0.01 to 0.03), and total incontinence (OR 0.03; 95% CI 0.01 to 0.06) were also lower (all p < 0.01) in the treatment group. Significant improvements in quality of life were reported after treatment in comparison to placebo. No significant side effects were observed resulting in withdrawal from treatment. CONCLUSIONS: The outcome of this study demonstrated both statistical significance and clinical relevance in reducing symptoms of OAB, urinary frequency and/or urgency and incontinence. The demonstrated viability of the herbal combination to serve as an effective treatment, with minimal side-effects, warrants further longer term research and consideration by clinicians. TRIAL REGISTRATION: NCT02396160 (registered on 17 March 2015 - before any statistical analyses commenced).
[Mh] Termos MeSH primário: Extratos Vegetais/uso terapêutico
Bexiga Urinária Hiperativa/tratamento farmacológico
Incontinência Urinária/tratamento farmacológico
Agentes Urológicos/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Capparaceae
Equisetum
Feminino
Seres Humanos
Lindera
Masculino
Registros Médicos
Meia-Idade
Fitoterapia
Extratos Vegetais/farmacologia
Micção/efeitos dos fármacos
Agentes Urológicos/farmacologia
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Plant Extracts); 0 (Urological Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180202
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-018-2101-4


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[PMID]:29461352
[Au] Autor:Omogbai T; Milner KA
[Ad] Endereço:Author Affiliations: Nurse Manager (Mr Omogbai), Hudson Valley Veteran Affairs Healthcare System, New York; Associate Professor (Dr Milner), College of Nursing, Sacred Heart University, Fairfield, Connecticut.
[Ti] Título:Implementation and Evaluation of Shared Medical Appointments in Veterans With Diabetes: A Quality Improvement Study.
[So] Source:J Nurs Adm;48(3):154-159, 2018 Mar.
[Is] ISSN:1539-0721
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study is to implement and evaluate shared medical appointments (SMA) in veterans with diabetes. BACKGROUND: Health systems are challenged to meet the complex care needs of veterans with diabetes. Use of SMA has resulted in significant improvements in A1c, blood pressure, and self-management skills in this population. METHODS: Shared medical appointments were implemented in a Veterans Administration Health System. A1c, blood pressure, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, weight, and height were collected at baseline, 3 months, and 6 months; hospitalization anytime; and veteran satisfaction at baseline and 6 months. RESULTS: From October 15, 2015, to March 15, 2016, 30 male veterans with diabetes participated in monthly SMA. Outcome measures except for high-density lipoprotein improved significantly (P < .02) from baseline to 6 months. No veterans were hospitalized. Veteran satisfaction increased significantly (P < .001). CONCLUSION: Shared medical appointment can be a highly effective intervention for veterans with diabetes. Nursing leaders need to be at the forefront of implementing SMA for populations with chronic conditions.
[Mh] Termos MeSH primário: Agendamento de Consultas
Doenças Cardiovasculares/prevenção & controle
Diabetes Mellitus/terapia
Avaliação de Processos e Resultados (Cuidados de Saúde)/estatística & dados numéricos
Melhoria de Qualidade/organização & administração
Saúde dos Veteranos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doenças Cardiovasculares/diagnóstico
Doenças Cardiovasculares/epidemiologia
Comorbidade
Complicações do Diabetes/prevenção & controle
Complicações do Diabetes/terapia
Processos Grupais
Pesquisas sobre Serviços de Saúde
Implementação de Plano de Saúde
Seres Humanos
Masculino
Registros Médicos
New York
Estudos de Casos Organizacionais
Avaliação de Processos e Resultados (Cuidados de Saúde)/métodos
Avaliação de Programas e Projetos de Saúde
Melhoria de Qualidade/normas
Estudos Retrospectivos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1097/NNA.0000000000000590


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[PMID]:29257355
[Au] Autor:Lane JD; Bigelow PL; Majowicz SE; McColl RS
[Ti] Título:Impacts of Industrial Wind Turbine Noise on Sleep Quality: Results From a Field Study of Rural Residents in Ontario, Canada.
[So] Source:J Environ Health;79(1):8-12, 2016 Jul.
[Is] ISSN:0022-0892
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objectives of this study were to determine whether grid-connected industrial wind turbines (IWTs) are a risk factor for poor sleep quality, and if IWT noise is associated with sleep parameters in rural Ontarians. A daily sleep diary and actigraphy-derived measures of sleep were obtained from 12 participants from an IWT community and 10 participants from a comparison community with no wind power installations. The equivalent and maximum sound pressure levels within the bedroom were also assessed. No statistically significant differences were observed between IWT residents and non-IWT residents for any of the parameters measured in this study. Actigraphy and sleep diaries are feasible tools to understand the impact of IWTs on the quality of sleep for nearby residents. Further studies with larger sample sizes should be conducted to determine whether the lack of statistical significance observed here is a result of sample size, or reflects a true lack of association.
[Mh] Termos MeSH primário: Exposição Ambiental
Ruído/efeitos adversos
Energia Renovável/efeitos adversos
Transtornos do Sono-Vigília/etiologia
Sono
[Mh] Termos MeSH secundário: Actigrafia
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Registros Médicos
Meia-Idade
Ontário
População Rural
Vento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:28449911
[Au] Autor:Wong ML; Lau KNT; Espie CA; Luik AI; Kyle SD; Lau EYY
[Ad] Endereço:Department of Clinical Psychology, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong.
[Ti] Título:Psychometric properties of the Sleep Condition Indicator and Insomnia Severity Index in the evaluation of insomnia disorder.
[So] Source:Sleep Med;33:76-81, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The Sleep Condition Indicator (SCI) and Insomnia Severity Index (ISI) are commonly used instruments to assess insomnia. We evaluated their psychometric properties, particularly their discriminant validity against structured clinical interview (according to DSM-5 and ICSD-3), and their concurrent validity with measures of sleep and daytime functioning. METHODS: A total of 158 young adults, 16% of whom were diagnosed with DSM-5 insomnia disorder and 13% with ICSD-3 Chronic Insomnia by structured interview, completed the ISI and SCI twice in 7-14 days, in addition to measures of sleep and daytime function. RESULTS: The Chinese version of the SCI was validated with good psychometric properties (ICC = 0.882). A cutoff of ≥8 on the ISI, ≤5 on the SCI short form, and ≤21 on the SCI achieved high discriminant validity (AUC > 0.85) in identifying individuals with insomnia based on both DSM-5 and ICSD-3 criteria. The SCI and ISI had comparable associations with subjective (0.18 < r < 0.51) and actigraphic sleep (0.31 < r < 0.43) and daytime functioning (0.34 < r < 0.53). CONCLUSION: The SCI, SCI short form, and ISI were found to correctly identify individuals with DSM-5- and ICSD-3-defined insomnia disorder. Moreover, they showed good concordance with measures of daytime dysfunction, as well as subjective and objective sleep. The SCI and ISI are recommended for use in clinical and research settings.
[Mh] Termos MeSH primário: Psicometria/métodos
Distúrbios do Início e da Manutenção do Sono/diagnóstico
Transtornos do Sono-Vigília/diagnóstico
Sono/fisiologia
[Mh] Termos MeSH secundário: Actigrafia/métodos
Feminino
Seres Humanos
Masculino
Registros Médicos
Autorrelato
Índice de Gravidade de Doença
Distúrbios do Início e da Manutenção do Sono/fisiopatologia
Distúrbios do Início e da Manutenção do Sono/psicologia
Transtornos do Sono-Vigília/fisiopatologia
Transtornos do Sono-Vigília/psicologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29320540
[Au] Autor:Rockett IRH; Caine ED; Connery HS; D'Onofrio G; Gunnell DJ; Miller TR; Nolte KB; Kaplan MS; Kapusta ND; Lilly CL; Nelson LS; Putnam SL; Stack S; Värnik P; Webster LR; Jia H
[Ad] Endereço:Department of Epidemiology, West Virginia University, Morgantown, West Virginia, United States of America.
[Ti] Título:Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history.
[So] Source:PLoS One;13(1):e0190200, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation-the other two major, but overtly violent methods. METHODS: This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011-2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics. RESULTS: A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43-49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11-44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11-2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10-1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06-66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19-3.18) and depression (OR, 1.48; 95% CI, 1.17-1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases. CONCLUSIONS: Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.
[Mh] Termos MeSH primário: Overdose de Drogas/psicologia
Intenção
Suicídio/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Asfixia
Causas de Morte
Depressão/epidemiologia
Feminino
Seres Humanos
Masculino
Registros Médicos
Métodos
Meia-Idade
Transtornos do Humor/epidemiologia
Vigilância da População
Recidiva
Tentativa de Suicídio
Ferimentos por Arma de Fogo
Redação
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190200



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