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1. Prenatal opioid use as a predictor of postpartum suicide attempts among reproductive-age women enrolled in Oregon Medicaid

Author

Yoon, Jangho, Masoumirad, Mandana, Bui, Linh N, Richard, Patrick, and Harvey, S Marie

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Suicide, Prevention, Suicide Prevention, Pediatric, Behavioral and Social Science, Brain Disorders, Clinical Research, Reproductive health and childbirth, Good Health and Well Being, Pregnancy, United States, Female, Humans, Analgesics, Opioid, Suicide, Attempted, Oregon, Medicaid, Postpartum Period, Opioid-Related Disorders, Suicide attempts, Opioid use disorder, Postpartum, Depression, Substance use, Nursing, Paediatrics and Reproductive Medicine, Public Health and Health Services, Obstetrics & Reproductive Medicine, Reproductive medicine, Midwifery, Public health
Abstract

BackgroundThe rates of suicide and opioid use disorder (OUD) among pregnant and postpartum women continue to increase. This research characterized OUD and suicide attempts among Medicaid-enrolled perinatal women and examined prenatal OUD diagnosis as a marker for postpartum suicide attempts.MethodsData from Oregon birth certificates, Medicaid eligibility and claims files, and hospital discharge records were linked and analyzed. The sample included Oregon Medicaid women aged 15-44 who became pregnant and gave live births between January 2008 and January 2016 (N = 61,481). Key measures included indicators of suicide attempts (separately for any means and opioid poisoning) and OUD diagnosis, separately assessed during pregnancy and the one-year postpartum period. Probit regression was used to examine the overall relationship between prenatal OUD diagnosis and postpartum suicide attempts. A simultaneous equations model was employed to explore the link between prenatal OUD diagnosis and postpartum suicide attempts, mediated by postpartum OUD diagnosis.ResultsThirty-three prenatal suicide attempts by any means were identified. Postpartum suicide attempts were more frequent with 58 attempts, corresponding to a rate of 94.3 attempts per 100,000. Of these attempts, 79% (46 attempts) involved opioid poisoning. A total of 1,799 unique women (4.6% of the sample) were diagnosed with OUD either during pregnancy or one-year postpartum with 53% receiving the diagnosis postpartum. Postpartum suicide attempts by opioid poisoning increased from 55.5 per 100,000 in 2009 to 105.1 per 100,000 in 2016. The rate of prenatal OUD also almost doubled over the same period. Prenatal OUD diagnosis was associated with a 0.15%-point increase in the probability of suicide attempts by opioid poisoning within the first year postpartum. This increase reflects a three-fold increase compared to the rate for women without a prenatal OUD diagnosis. A prenatal OUD diagnosis was significantly associated with an elevated risk of postpartum suicide attempts by opioid poisoning via a postpartum OUD diagnosis.ConclusionsThe risk of suicide attempt by opioid poisoning is elevated for Medicaid-enrolled reproductive-age women during pregnancy and postpartum. Women diagnosed with prenatal OUD may face an increased risk of postpartum suicides attempts involving opioid poisoning.

Published
2024

2. UIT-Saviors at MEDVQA-GI 2023: Improving Multimodal Learning with Image Enhancement for Gastrointestinal Visual Question Answering

Author

Thai, Triet M., Vo, Anh T., Tieu, Hao K., Bui, Linh N. P., and Nguyen, Thien T. B.

Subjects
Computer Science - Computer Vision and Pattern Recognition, Computer Science - Human-Computer Interaction
Abstract

In recent years, artificial intelligence has played an important role in medicine and disease diagnosis, with many applications to be mentioned, one of which is Medical Visual Question Answering (MedVQA). By combining computer vision and natural language processing, MedVQA systems can assist experts in extracting relevant information from medical image based on a given question and providing precise diagnostic answers. The ImageCLEFmed-MEDVQA-GI-2023 challenge carried out visual question answering task in the gastrointestinal domain, which includes gastroscopy and colonoscopy images. Our team approached Task 1 of the challenge by proposing a multimodal learning method with image enhancement to improve the VQA performance on gastrointestinal images. The multimodal architecture is set up with BERT encoder and different pre-trained vision models based on convolutional neural network (CNN) and Transformer architecture for features extraction from question and endoscopy image. The result of this study highlights the dominance of Transformer-based vision models over the CNNs and demonstrates the effectiveness of the image enhancement process, with six out of the eight vision models achieving better F1-Score. Our best method, which takes advantages of BERT+BEiT fusion and image enhancement, achieves up to 87.25% accuracy and 91.85% F1-Score on the development test set, while also producing good result on the private test set with accuracy of 82.01%., Comment: ImageCLEF2023 published version: https://ceur-ws.org/Vol-3497/paper-129.pdf

Published
2023

3. Hospital Adoption of Electronic Decision Support Tools for Preeclampsia Management

Author

Bui, Linh N, Marshall, Cassondra, Miller-Rosales, Chris, and Rodriguez, Hector P

Subjects
Health Services and Systems, Public Health, Health Sciences, Networking and Information Technology R&D (NITRD), Hypertension, Health Services, Cardiovascular, Clinical Research, Patient Safety, Good Health and Well Being, Cross-Sectional Studies, Electronic Health Records, Electronics, Female, Hospitals, Humans, Pre-Eclampsia, Pregnancy, United States, clinical decision support, health information technology, hospitals, preeclampsia, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems
Abstract

BackgroundElectronic health record (EHR)-based clinical decision support tools can improve the use of evidence-based clinical guidelines for preeclampsia management that can reduce maternal mortality and morbidity. No study has investigated the organizational capabilities that enable hospitals to use EHR-based decision support tools to manage preeclampsia.ObjectiveTo examine the association of organizational capabilities and hospital adoption of EHR-based decision support tools for preeclampsia management.MethodsCross-sectional analyses of hospitals providing obstetric care in 2017. In total, 739 hospitals responded to the 2017-2018 National Survey of Healthcare Organizations and Systems (NSHOS) and were linked to the 2017 American Hospital Association (AHA) Annual Survey Database and the Area Health Resources File (AHRF). A total of 425 hospitals providing obstetric care across 49 states were included in the analysis. The main outcome was whether a hospital adopted EHR-based clinical decision support tools for preeclampsia management. Hospital organizational capabilities assessed as predictors include EHR functions, adoption of evidence-based clinical treatments, use of quality improvement methods, and dissemination processes to share best patient care practices. Logistic regression estimated the association of hospital organizational capabilities and hospital adoption of EHR-based decision support tools to manage preeclampsia, controlling for hospital structural and patient sociodemographic characteristics.ResultsTwo-thirds of the hospitals (68%) adopted EHR-based decision support tools for preeclampsia, and slightly more than half (56%) of hospitals had a single EHR system. Multivariable regression results indicate that hospitals with a single EHR system were more likely to adopt EHR-based decision support tools for preeclampsia (17.4 percentage points; 95% CI, 1.9 to 33.0; P < .05) than hospitals with a mixture of EHR and paper-based systems. Compared with hospitals having multiple EHRs, on average, hospitals having a single EHR were also more likely to adopt the tools by 9.3 percentage points, but the difference was not statistically significant (95% CI, -1.3 to 19.9). Hospitals with more processes to aid dissemination of best patient care practices were also more likely to adopt EHR-based decision-support tools for preeclampsia (0.4 percentage points; 95% CI, 0.1 to 0.6, for every 1-unit increase in dissemination processes; P < .01).ConclusionStandardized EHRs and policies to disseminate evidence are foundational hospital capabilities that can help advance the use of EHR-based decision support tools for preeclampsia management in the approximately one-third of US hospitals that still do not use them.

Published
2022

5. Postpartum Care Utilization Among Women with Medicaid-Funded Live Births in Oregon

Author

Robbins, Cheryl L., Deputy, Nicholas P., Patel, Roshni, Tong, Van T., Oakley, Lisa P., Yoon, Jangho, and Bui, Linh N.

Subjects
Usage, Demographic aspects, Patient outcomes, Maternal health services -- Usage -- Demographic aspects, Gestational diabetes -- Patient outcomes, Gestational hypertension -- Patient outcomes, Postnatal care -- Demographic aspects, Diabetes in pregnancy -- Patient outcomes, Hypertension in pregnancy -- Patient outcomes
Abstract

Author(s): Cheryl L. Robbins [sup.1] , Nicholas P. Deputy [sup.1] , Roshni Patel [sup.1] [sup.2] , Van T. Tong [sup.1] , Lisa P. Oakley [sup.3] , Jangho Yoon [sup.3] , [...], Introduction Postpartum care is an important strategy for preventing and managing chronic disease in women with pregnancy complications (i.e., gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP)). Methods Using a population-based, cohort study among Oregon women with Medicaid-financed deliveries (2009-2012), we examined Medicaid-financed postpartum care (postpartum visits, contraceptive services, and routine preventive health services) among women who retained Medicaid coverage for at least 90 days after delivery (n = 74,933). We estimated postpartum care overall and among women with and without GDM and/or HDP using two different definitions: 1) excluding care provided on the day of delivery, and 2) including care on the day of delivery. Pearson chi-square tests were used to assess differential distributions in postpartum care by pregnancy complications (p < .05), and generalized estimating equations were used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results Of Oregon women who retained coverage through 90 days after delivery, 56.6-78.1% (based on the two definitions) received any postpartum care, including postpartum visits (26.5%-71.8%), contraceptive services (30.7-35.6%), or other routine preventive health services (38.5-39.1%). Excluding day of delivery services, the odds of receiving any postpartum care (aOR 1.26, 95% CI 1.08-1.47) or routine preventive services (aOR 1.32, 95% CI 1.14-1.53) were meaningfully higher among women with GDM and HDP (reference = neither). Discussion Medicaid-financed postpartum care in Oregon was underutilized, it varied by pregnancy complications, and needs improvement. Postpartum care is important for all women and especially those with GDM or HDP, who may require chronic disease risk assessment, management, and referrals.

Published
2021
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8. Coordinated Care Organizations and mortality among low-income infants in Oregon

Author

Bui, Linh N., Yoon, Jangho, Harvey, S. Marie, and Luck, Jeff

Subjects
Analysis, Medicaid -- Analysis, Infant mortality -- Analysis, Health policy -- Analysis, Newborn infants -- Analysis, Death, Organizations, Infants
Abstract

1 | INTRODUCTION In the United States, infants and toddlers under 3 years of age are most likely to live in poverty. (1) Research has linked having low-income parents to [...], Objective: To examine the impact of Oregon's Coordinated Care Organizations (CCOs), an accountable care model for Oregon Medicaid enrollees implemented in 2012, on neonatal and infant mortality. Data Sources: Oregon birth certificates linked with death certificates, and Medicaid/CCO enrollment files for years 2008-2016. Study Design: The sample consisted of the pre-CCO birth cohort of 135 753 infants (August 2008-July 2011) and the post-CCO birth cohort of 148 650 infants (August 2012-December 2015). We used a difference-in-differences probit model to estimate the difference in mortality between infants enrolled in Medicaid and infants who were not enrolled. We examined heterogeneous effects of CCOs for preterm and full-term infants and the impact of CCOs over the implementation timeline. All models were adjusted for maternal and infant characteristics and secular time trends. Principal Findings: The CCO model was associated with a 56 percent reduction in infant mortality compared to the pre-CCO level (-0.20 percentage points [95% CI: -0.35; -0.05]), and also with a greater reduction in infant mortality among preterm infants compared to full-term infants. The impact on mortality grew in magnitude over the postimplementation timeline. Conclusions: The CCO model contributed to a reduction in mortality within the first year of birth among infants enrolled in Medicaid. KEYWORDS Health Care Organizations and Systems, Integrated Delivery Systems, Medicaid, Pediatrics, State Health Policies

Published
2019
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11. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, KC, Astha, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, François, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charles, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker-Collo, Suzanne L, Barquera, Simon, Barregard, Lars, Barrero, Lope H, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Boris, Abdulhak, Aref A Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G J, Campos-Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda-Orjuela, Carlos A, Castro, Ruben E, Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung-chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting-Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas KD, Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C Des, Dessalegn, Muluken, deVeber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthias, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F J, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J, Ferri, Cleusa P, Flaxman, Abraham D, Fleming, Thomas D, Foigt, Nataliya, Foreman, Kyle J, Paleo, Urbano Fra, Franklin, Richard C, Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G, Gansevoort, Ron T, García-Guerra, Francisco A, Gasana, Evariste, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Pete, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A M, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard L, Gugnani, Harish C, Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A, Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A, Hamadeh, Randah R, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I, Hedayati, Mohammad T, Heredia-Pi, Ileana B, Hernandez, Lucia, Heuton, Kyle R, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J, Hubbell, Bryan J, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L, Iburg, Kim M, Idrisov, Bulat T, Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H, Jansen, Henrica A, Jarvis, Deborah L, Jassal, Simerjot K, Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E, Karch, André, Karema, Corine K, Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Keren, Andre, Khader, Yousef S, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A, Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Chanda, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi J, Larsson, Anders, Laryea, Dennis O, Lavados, Pablo M, Lawrynowicz, Alicia E, Leasher, Janet L, Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Logroscino, Giancarlo, London, Stephanie J, Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A, Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M P, MacIntyre, Michael F, Magis-Rodriguez, Carlos, Mahdi, Abbas A, Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C, Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B, Martin, Randall V, Marzan, Melvin B, Mashal, Mohammad T, Masiye, Felix, Mason-Jones, Amanda J, Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M, Mazorodze, Tasara T, McKay, Abigail C, McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Hernandez, Julio C Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Mullany, Erin C, Murthy, Kinnari S, Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P, Newton, Charles R, Ngalesoni, Frida N, de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T, Nieuwenhuijsen, Mark J, Nisar, Muhammad I, Nogueira, José R, Nolla, Joan M, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O, Omer, Saad B, Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S, Jr., Pain, Amanda W, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun-Kee, Parry, Charles D, Caicedo, Angel J Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M, Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A L, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pond, Constance D, Pope, C Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima M, Quezada, Amado D, Quistberg, D Alex A, Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Rao, Mayuree, Razavi, Homie, Reddy, K Srinath, Refaat, Amany H, Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M, Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A, Salvo, Deborah, Sampson, Uchechukwu K, Sanabria, Juan R, Sanchez, Luz Maria, Sánchez-Pimienta, Tania G, Sanchez-Riera, Lidia, Sandar, Logan, Santos, Itamar S, Sapkota, Amir, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schmidt, Jürgen C, Schneider, Ione J C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan-Mori, Edson E, Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stapelberg, Nicolas J C, Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Talongwa, Roberto T, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J, Teixeira, Carolina M, Téllez Rojo, Martha M, Terkawi, Abdullah S, Texcalac-Sangrador, José Luis, Thackway, Sarah V, Thomson, Blake, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matias, Trujillo, Ulises, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Uzun, Selen B, van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H, van Os, Jim, Varakin, Yuri Y, Vasankari, Tommi J, Vasconcelos, Ana Maria N, Vavilala, Monica S, Veerman, Lennert J, Velasquez-Melendez, Gustavo, Venketasubramanian, N, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wallin, Mitchell T, Wan, Xia, Wang, Haidong, Wang, JianLi, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S, Watts, Charlotte H, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K Ryan, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles D A, Wong, John Q, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yan, Lijing L, Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z, Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R, Lopez, Alan D, Vos, Theo, and Murray, Christopher J

Published
2015
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13. Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam

Author

Tran, Quyen T. L., primary, Nguyen, Ha V., additional, Pham, Huyen T., additional, Mai, Tuan V., additional, Nguyen, Quyen H. M., additional, Le, Dzung V., additional, Bui, Linh N. H., additional, Hoang, Lan T. H., additional, Hoang, Trung Q., additional, and Trinh, Trung T., additional

Published
2022
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17. Child Melioidosis Deaths Caused by Burkholderia pseudomallei-Contaminated Borehole Water, Vietnam, 2019.

Author

Tran, Quyen T. L., Phan, Phuc H., Bui, Linh N. H., Bui, Ha T. V., Hoang, Ngoc T. B., Tran, Dien M., and Trinh, Trung T.

Abstract

Within 8 months, 3 children from 1 family in northern Vietnam died from melioidosis. Burkholderia pseudomallei of the same sequence type, 541, was isolated from clinical samples, borehole water, and garden and rice field soil. Boreholes should be properly constructed and maintained to avoid B. pseudomallei contamination. [ABSTRACT FROM AUTHOR]

Published
2022
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19. Erythritol as a single carbon source improves cultural isolation of Burkholderia pseudomallei from rice paddy soils

Author

Trinh, Trung T., primary, Assig, Karoline, additional, Tran, Quyen T. L., additional, Goehler, André, additional, Bui, Linh N. H., additional, Wiede, Claudia, additional, Folli, Bettina, additional, Lichtenegger, Sabine, additional, Nguyen, Tinh T., additional, Wagner, Gabriel E., additional, Kohler, Christian, additional, and Steinmetz, Ivo, additional

Published
2019
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22. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Forouzanfar, Mohammad H., Alexander, Lily, Anderson, H. Ross, Bachman, Victoria F., Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M., Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J., KC, Astha, Kyu, Hmwe H., Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A., Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F., Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Aburto, Tania C., Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K., Adsuar, José C., Afshin, Ashkan, Agardh, Emilie E., Al Khabouri, Mazin J., Al Lami, Faris H., Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I., Alegretti, Miguel A., Aleman, Alicia V., Alemu, Zewdie A., Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K., Alla, François, Allebeck, Peter, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Ameh, Emmanuel A., Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Atkinson, Charles, Avila, Marco A., Awuah, Baffour, Badawi, Alaa, Bahit, Maria C., Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M., Barker-Collo, Suzanne L., Barquera, Simon, Barregard, Lars, Barrero, Lope H., Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C., Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O., Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Benjet, Corina, Bennett, Derrick A., Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J., Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bikbov, Boris, Abdulhak, Aref A. Bin, Blore, Jed D., Blyth, Fiona M., Bohensky, Megan A., Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M., Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J., Brenner, Hermann, Briggs, Adam D. M., Broday, David M., Brooks, Peter M., Bruce, Nigel G., Brugha, Traolach S., Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N., Bukhman, Gene, Bulloch, Andrew G., Burch, Michael, Burney, Peter G. J., Campos-Nonato, Ismael R., Campuzano, Julio C., Cantoral, Alejandra J., Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O., Caso, Valeria, Castañeda-Orjuela, Carlos A., Castro, Ruben E., Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K., Chang, Jung-chen, Charlson, Fiona J., Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P., Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A., Chuang, Ting-Wu, Chugh, Sumeet S., Cirillo, Massimo, Claßen, Thomas K. D., Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M., Contreras, Alejandra G., Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T., Coresh, Josef, Courville, Karen J., Criqui, Michael H., Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., Davis, Adrian, Davitoiu, Dragos V., Dayama, Anand, de Castro, E. Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P., Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. Des, Dessalegn, Muluken, deVeber, Gabrielle A., Devries, Karen M., Dharmaratne, Samath D., Dherani, Mukesh K., Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. Ray, Driscoll, Tim R., Duan, Leilei, Durrani, Adnan M., Ebel, Beth E., Ellenbogen, Richard G., Elshrek, Yousef M., Endres, Matthias, Ermakov, Sergey P., Erskine, Holly E., Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A., Farzadfar, Farshad, Fay, Derek F. J., Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J., Ferri, Cleusa P., Flaxman, Abraham D., Fleming, Thomas D., Foigt, Nataliya, Foreman, Kyle J., Paleo, Urbano Fra, Franklin, Richard C., Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G., Gansevoort, Ron T., García-Guerra, Francisco A., Gasana, Evariste, Geleijnse, Johanna M., Gessner, Bradford D., Gething, Pete, Gibney, Katherine B., Gillum, Richard F., Ginawi, Ibrahim A. M., Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C., Goto, Atsushi, Gouda, Hebe N., Guerrant, Richard L., Gugnani, Harish C., Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A., Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A., Hamadeh, Randah R., Hammami, Mouhanad, Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I., Hedayati, Mohammad T., Heredia-Pi, Ileana B., Hernandez, Lucia, Heuton, Kyle R., Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H. Dean, Hoy, Damian G., Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J., Hubbell, Bryan J., Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L., Iburg, Kim M., Idrisov, Bulat T., Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H., Jansen, Henrica A., Jarvis, Deborah L., Jassal, Simerjot K., Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E., Karch, André, Karema, Corine K., Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre P., Keren, Andre, Khader, Yousef S., Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A., Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M., Kissela, Brett M., Kivipelto, Miia, Knibbs, Luke D., Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M. Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J., Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Anders, Laryea, Dennis O., Lavados, Pablo M., Lawrynowicz, Alicia E., Leasher, Janet L., Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lindsay, M. Patrice, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Logroscino, Giancarlo, London, Stephanie J., Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A., Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M. P., MacIntyre, Michael F., Magis-Rodriguez, Carlos, Mahdi, Abbas A., Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C., Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B., Martin, Randall V., Marzan, Melvin B., Mashal, Mohammad T., Masiye, Felix, Mason-Jones, Amanda J., Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M., Mazorodze, Tasara T., McKay, Abigail C., McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A., Meltzer, Michele, Memish, Ziad A., Mendoza, Walter, Mensah, George A., Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R., Mills, Edward J., Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A., Mokdad, Ali H., Mola, Glen L., Monasta, Lorenzo, Hernandez, Julio C. 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E., Aburto, Tania C., Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K., Adsuar, José C., Afshin, Ashkan, Agardh, Emilie E., Al Khabouri, Mazin J., Al Lami, Faris H., Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I., Alegretti, Miguel A., Aleman, Alicia V., Alemu, Zewdie A., Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K., Alla, François, Allebeck, Peter, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Ameh, Emmanuel A., Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Atkinson, Charles, Avila, Marco A., Awuah, Baffour, Badawi, Alaa, Bahit, Maria C., Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M., Barker-Collo, Suzanne L., Barquera, Simon, Barregard, Lars, Barrero, Lope H., Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C., Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O., Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Benjet, Corina, Bennett, Derrick A., Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J., Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bikbov, Boris, Abdulhak, Aref A. Bin, Blore, Jed D., Blyth, Fiona M., Bohensky, Megan A., Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M., Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J., Brenner, Hermann, Briggs, Adam D. M., Broday, David M., Brooks, Peter M., Bruce, Nigel G., Brugha, Traolach S., Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N., Bukhman, Gene, Bulloch, Andrew G., Burch, Michael, Burney, Peter G. J., Campos-Nonato, Ismael R., Campuzano, Julio C., Cantoral, Alejandra J., Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O., Caso, Valeria, Castañeda-Orjuela, Carlos A., Castro, Ruben E., Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K., Chang, Jung-chen, Charlson, Fiona J., Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P., Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A., Chuang, Ting-Wu, Chugh, Sumeet S., Cirillo, Massimo, Claßen, Thomas K. D., Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M., Contreras, Alejandra G., Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T., Coresh, Josef, Courville, Karen J., Criqui, Michael H., Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., Davis, Adrian, Davitoiu, Dragos V., Dayama, Anand, de Castro, E. Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P., Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. Des, Dessalegn, Muluken, deVeber, Gabrielle A., Devries, Karen M., Dharmaratne, Samath D., Dherani, Mukesh K., Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. 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Abstract

Summary Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the fi rst of a series of annual updates of the GBD. Risk factor quantifi cation, particularly of modifi able risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the fi rst level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular fi ltration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account

23. Determinants of Boarding of Patients with Severe Mental Illness in Hospital Emergency Departments.

Author

Yoon J, Bui LN, Govier DJ, Cahn MA, and Luck J

Subjects
Adolescent, Adult, Humans, Mental Disorders psychology, Middle Aged, Oregon, Patient Admission statistics & numerical data, Quality of Health Care, Substance-Related Disorders complications, United States, Young Adult, Bed Occupancy statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Inpatients statistics & numerical data, Medicaid statistics & numerical data, Mental Disorders therapy
Abstract

Background: Boarding of patients in hospital emergency departments (EDs) occurs routinely across the U.S. ED patients with behavioral health conditions are more likely to be boarded than other patients. However, the existing literature on ED boarding of psychiatric patients remains largely descriptive and has not empirically related mental health system capacity to psychiatric boarding. Nor does it show how the mental health system could better address the needs of populations at the highest risk of ED boarding., Aims of the Study: We examined extent and determinants of "boarding" of patients with severe mental illness (SMI) in hospital emergency departments (ED) and tested whether greater mental health system capacity may mitigate the degree of ED boarding., Methods: We linked Oregon's ED Information Exchange, hospital discharge, and Medicaid data to analyze encounters in Oregon hospital EDs from October 2014 through September 2015 by 7,103 persons aged 15 to 64 with SMI (N = 34,207). We additionally utilized Medicaid claims for years 2010-2015 to identify Medicaid beneficiaries with SMI. Boarding was defined as an ED stay over six hours. We estimated a recursive simultaneous-equation model to test the pathway that mental health system capacity affects ED boarding via psychiatric visits., Results: Psychiatric visits were more likely to be boarded than non-psychiatric visits (30.2% vs. 7.4%). Severe psychiatric visits were 1.4 times more likely to be boarded than non-severe psychiatric visits. Thirty-four percent of psychiatric visits by children were boarded compared to 29.6% for adults. Statistical analysis found that psychiatric visit, substance abuse, younger age, black race and urban residence corresponded with an elevated risk of boarding. Discharge destinations such as psychiatric facility and acute care hospitals also corresponded with a higher probability of ED boarding. Greater supply of mental health resources in a county, both inpatient and intensive community-based, corresponded with a reduced risk of ED boarding via fewer psychiatric ED visits., Discussion: Psychiatric visit, severity of psychiatric diagnosis, substance abuse, and discharge destinations are among important predictors of psychiatric ED boarding by persons with SMI. A greater capacity of inpatient and intensive community mental health systems may lead to a reduction in psychiatric ED visits by persons with SMI and thereby decrease the extent of psychiatric ED boarding., Implications for Health Policies: Continued investment in mental health system resources may reduce psychiatric ED visits and mitigate the psychiatric ED boarding problem.

Published
2020

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