Vocational rehabilitation following traumatic brain injury: what is the evidence for clinical practice?

Traumatic brain injury (TBI) typically affects young adults with potentially many years of working life ahead of them. For people who were in work prior to their injury, return to work (RTW) is a common goal. However, a systematic review of RTW rates for people with TBI who were in work prior to their injury found that approximately 41% were in work at one and two years post TBI [1]. Since TBI is a leading cause of morbidity worldwide in young adults [2], this discrepancy between what people with TBI want and what they achieve is important. The question is does the research evidence inform clinicians how to help a person with TBI return to work

Practices and Attitudes of Nursing Students Toward Patients With Disordered Eating Behaviors

Disordered eating (DE) behaviors are associated with obesity and eating disorders. This study describes practices and attitudes of nursing students toward patients exhibiting DE and how personal DE behaviors affect practices and attitudes. Most respondents had a mental health rotation (74.7 percent) and DE education (68 percent); however, only 34.7 percent felt prepared to screen for DE, and only 44 percent were taught to screen. Those scoring high for DE behaviors (n = 7) indicated greater rates of feeling prepared to screen. This knowledge can help nurse educators design curricula to increase the preparation of nurses to address DE behaviors

Precision Medicine: From Science To Value.

Precision medicine is making an impact on patients, health care delivery systems, and research participants in ways that were only imagined fifteen years ago when the human genome was first sequenced. Discovery of disease-causing and drug-response genetic variants has accelerated, while adoption into clinical medicine has lagged. We define precision medicine and the stakeholder community required to enable its integration into research and health care. We explore the intersection of data science, analytics, and precision medicine in the formation of health systems that carry out research in the context of clinical care and that optimize the tools and information used to deliver improved patient outcomes. We provide examples of real-world impact and conclude with a policy and economic agenda necessary for the adoption of this new paradigm of health care both in the United States and globally

The Global Market for Next-Generation Sequencing Tests Continues Its Torrid Pace.

The market for next-generation sequencing technologies (NGS) has grown dramatically. Health care decision-makers need empirical evidence on market growth and future trends in order to develop appropriate strategies and policies, but little has been published about the nature and size of these trends. We provide a snapshot of market trends through 2020. We found rapid growth of clinical NGS - the global clinical NGS services market was $2.2 billion in 2015 and is forecast to reach$7.7 billion by 2020. The reproductive health NGS test market is the largest market followed by the oncology NGS test market. The largest market is for tests that sequence >50 genes but not the entire exome or genome. Markets are growing rapidly in countries outside of the US. Despite rapid NGS test growth, there are a number of key issues that will need to be addressed to facilitate appropriate future growth

Economic Perspectives on Personalized Health Care and Prevention

The objective of this paper is to provide an overview of economic evaluation of personalized medicine, focusing particularly on the use of cost-effectiveness analysis and other methods of valuation. We draw on insights from the literature and our work at the University of California, San Francisco Center for Translational and Policy Research on Personalized Medicine (TRANSPERS). We begin with a discussion of why personalized medicine is of interest and challenges to adoption, whether personalized medicine is different enough to require different evaluation approaches, and what is known about the economics of personalized medicine. We then discuss insights from TRANSPERS research and six areas for future research

Aberrant migration and surgical removal of a heartworm (Dirofilaria immitis) from the femoral artery of a cat.

A cat was evaluated for an acute-onset of right pelvic limb paresis. Thoracic radiographs revealed normal cardiac size and tortuous pulmonary arteries. Abdominal ultrasound identified a heartworm (HW) extending from the caudal abdominal aorta into the right external iliac artery and right femoral artery. The cat was HW-antigen positive. Echocardiography revealed a HW within the right branch of the main pulmonary artery and evidence of pulmonary hypertension. An agitated-saline contrast echocardiogram revealed a small right to left intracardiac shunt at the level of the atria. Surgical removal of the HW was performed with no substantial postoperative complications. There was return of blood flow and improved motor function to the limb. The cat remains mildly paretic on the affected limb with no other clinical signs

The Effect of Dissolved Humic Acids on Aluminosilicate Formation and Associated Carbon Sequestration

Allophane and imogolite neogenesis in soils may occur in the presence of organic matter. To understand this process under conditions relevant to soils, the influence of dissolved organic carbon (DOC) as humic acid (HA), on aluminosilicate formation was studied at 25◦C, pH 6, and low-DOC concentrations. For solutions with initial Al/Si ratios of 1–2.1, and 0–6mg/L DOC, precipitates recovered after 20h had Al/Si ratios of 2.2–2.7. The formation of allophane, imogolite-like material, and aluminosilicate gel was confirmed by XRD, FTIR, and NMR. The effect of DOC was to produce a small, but systematic increase in imogolite-like Si in the precipitate, and a decrease in the formation of aluminosilicate gel. Results suggest that the presence of DOC as HA slows the otherwise rapid polymerization of Al and Si at low temperature, and may also promote the formation of imogolite. The high C content of these precipitates indicates that this process may facilitate the sequestration of organic matter, slowing C cycling in soils