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  • 1
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    Online Resource
    Evaluation of the Impact of Corticosteroid Dose on the Incidence of Hyperglycemia in Hospitalized Patients with an Acute Exacerbation of Chronic Obstructive Pulmonary Disease
    SAGE Publications ; 2016
    In:  Hospital Pharmacy Vol. 51, No. 4 ( 2016-04), p. 296-304
    Details
    In: Hospital Pharmacy, SAGE Publications, Vol. 51, No. 4 ( 2016-04), p. 296-304
    Abstract: Guidelines recommend systemic corticosteroids for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) albeit in lower doses than studies that cemented corticosteroids' place in therapy. Corticosteroids potentiate hyperglycemia, however it is undetermined how corticosteroid dose impacts hyperglycemia incidence. Objectives To establish whether a greater incidence of steroid-induced hyperglycemia (SIHGLY) exists for high- versus low-dose corticosteroids. Methods Patients with primary discharge diagnosis 491.21/491.22 in a community hospital were retrospectively reviewed and divided into tertiles based on corticosteroid dosage. Baseline characteristics and primary endpoint were statistically assessed between tertiles using logistic regression analysis. A Cox proportional hazards (CPH) model adjusted for potential covariates. Post hoc analysis for primary outcome and CPH model was run removing non-insulin dependent diabetics because of disproportionate event count. A secondary endpoint used a Kaplan-Meier curve to evaluate time to event between tertiles. Results Tertile divisions were 125 and 187.5 mg methylprednisolone equivalents. The primary outcome for incidence of SIHGLY was insignificant; post hoc analysis removing non-insulin-dependent diabetics narrowly missed significance between tertiles 1 and 3 ( P = .056). CPH analysis found significant differences in SIHGLY between tertiles 1 and 2 (hazard ratio [HR], 1.68; 95% CI, 1.02–2.76) and tertile 1 and 3 (HR, 1.79; 95% CI, 1.13–2.84), further post hoc analysis resulted in a loss of significance for the CPH analysis. Of 21 non-insulin-dependent diabetics, 20 met event status. The Kaplan-Meier analysis results were insignificant. Conclusions Study results suggest that a link between larger corticosteroid doses and hyperglycemia incidence may exist, but it requires further study. Results in non-insulin-dependent diabetics provide evidence for increased glucose monitoring upon initiation of corticosteroid therapy.
    Type of Medium: Online Resource
    ISSN: 0018-5787 , 1945-1253
    URL: Article
    DOI: 10.1310/hpj5104-296
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 2
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    Online Resource
    Prolonged Infusion Antibiotics for Suspected Gram-Negative Infections in the ICU: A Before-After Study
    SAGE Publications ; 2013
    In:  Annals of Pharmacotherapy Vol. 47, No. 2 ( 2013-02), p. 170-180
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 47, No. 2 ( 2013-02), p. 170-180
    Abstract: β-Lactam antibiotics demonstrate time-dependent killing. Prolonged infusion of these agents is commonly performed to optimize the time the unbound concentration of an antibiotic remains greater than the minimum inhibitory concentration and decrease costs, despite limited evidence suggesting improved clinical results. OBJECTIVE: To determine whether prolonged infusion of β-lactam antibiotics improves outcomes in critically ill patients with suspected gram-negative infection. METHODS: We conducted a single-center, before-after, comparative effectiveness trial between January 2010 and January 2011 in the intensive care units at Barnes-Jewish Hospital, an urban teaching hospital affiliated with the Washington University School of Medicine in St. Louis, MO. Outcomes were compared between patients who received standardized dosing of meropenem, piperacillin-tazobactam, or cefepime as an intermittent infusion over 30 minutes (January 1, 2010, to June 30, 2010) and patients who received prolonged infusion over 3 hours (August 1, 2010, to January 31, 2011). RESULTS: A total of 503 patients (intermittent infusion, n = 242; prolonged infusion, n = 261) treated for gram-negative infection were included in the clinically evaluable population. Approximately 50% of patients in each group received cefepime and 20% received piperacillin-tazobactam. More patients in the intermittent infusion group received meropenem (35.5% vs 24.5%; p = 0.007). Baseline characteristics were similar between groups, with the exception of a greater occurrence of chronic obstructive pulmonary disease (COPD) in the intermittent infusion group. Treatment success rates in the clinically evaluable group were 56.6% for intermittent infusion and 51.0% for prolonged infusion (p = 0.204), and in the microbiologically evaluable population, 55.2% for intermittent infusion and 49.5% for prolonged infusion (p = 0.486). Fourteen-day, 30-day, and inhospital mortality rates in the clinically evaluable population for the intermittent and prolonged infusion groups were 13.2% versus 18.0% (p = 0.141), 23.6% versus 25.7% (p = 0.582), and 19.4% versus 23.0% (p = 0.329). CONCLUSIONS: Routine use of prolonged infusion of time-dependent antibiotics for the empiric treatment of gram-negative bacterial infections offers no advantage over intermittent infusion antibiotic therapy with regard to treatment success, mortality, or hospital length of stay. These results were confirmed after controlling for potential confounders in a multivariate analysis.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1R523
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2053518-1
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  • 3
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    Provider Workforce Assessment in a Rural Hepatitis C Epidemic : Implications for Scale-up of Antiviral Therapy
    SAGE Publications ; 2015
    In:  Journal of Primary Care & Community Health Vol. 6, No. 3 ( 2015-07), p. 215-217
    Details
    In: Journal of Primary Care & Community Health, SAGE Publications, Vol. 6, No. 3 ( 2015-07), p. 215-217
    Abstract: New recommendations for birth cohort screening for hepatitis C virus (HCV) infection and the development of new, highly effective antiviral medications are expected to increase the demand for HCV treatment. In the past, antiviral therapy for HCV was almost exclusively prescribed by specialists in the field of gastroenterology and infectious diseases, meaning that people living in rural areas that are underserved by specialists may have poor access to treatment. We investigated the number and geographic distribution of medical providers who actively prescribed direct acting antiviral drugs for hepatitis C in Wisconsin during 2012. Using public health surveillance data and a state-wide prescription drug database, we found that there was 1 treatment provider for every 340 residents known to be living with HCV. However, 51 of 72 Wisconsin counties had no providers who provided HCV treatment in 2012.Scaling up antiviral treatment to address the epidemic of hepatitis C efficiently and equitably will require strategies to increase the number of treatment providers in rural communities. Providing education, training, and support to the primary care workforce serving rural communities should be considered a potentially effective and efficient approach to preventing future HCV-related illness.
    Type of Medium: Online Resource
    ISSN: 2150-1327 , 2150-1327
    URL: Article
    DOI: 10.1177/2150131914560229
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2550221-9
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  • 4
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    Genetic Influences on Vitamin D Status and Forearm Fracture Risk in African American Children
    SAGE Publications ; 2012
    In:  Journal of Investigative Medicine Vol. 60, No. 6 ( 2012-08), p. 902-906
    Details
    In: Journal of Investigative Medicine, SAGE Publications, Vol. 60, No. 6 ( 2012-08), p. 902-906
    Abstract: We sought to investigate the relationship between newly identified genetic variants and vitamin D levels and fracture risk in healthy African American (black) children. This case-control study included children of both sexes, ages 5 to 9 years, with and without forearm fractures. Serum 25-hydroxy vitamin D levels, bone mineral density, body mass index, and calcium/vitamin D intake were measured in 130 individuals (n = 60 cases and n = 70 controls). The 5 variants tested were located in the GC gene (rs2282679), in the NADSYN1 gene (rs12785878 and rs3829251), and in the promoter region of the CYP2R1 gene (rs2060793 and rs104741657). Associations between single nucleotide polymorphisms (SNPs) and vitamin D levels were tested using an analysis of covariance. Associations between SNPs and fracture status were tested using logistic regression. The GC gene variant was associated with vitamin D levels ( P = 0.038). None of the SNPs were associated with fracture status in young blacks. These results suggest that the variants tested, which are associated with circulating vitamin D levels in whites, are not associated with fracture status in healthy black children. Additional research is required to discover the genetics of fracture risk in blacks.
    Type of Medium: Online Resource
    ISSN: 1081-5589 , 1708-8267
    URL: Article
    DOI: 10.2310/JIM.0b013e3182567e2a
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
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  • 5
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    A Preliminary Investigation on the Acceptance and Feasibility of Acupuncture in the Intensive Care Unit
    SAGE Publications ; 2013
    In:  ICU Director Vol. 4, No. 2 ( 2013-03), p. 82-87
    Details
    In: ICU Director, SAGE Publications, Vol. 4, No. 2 ( 2013-03), p. 82-87
    Abstract: Objective. Acupuncture has been shown to decrease opioid requirements and respiratory distress in selected patients, and it may be helpful as an adjunctive therapy to sedatives and analgesics in the ICU. This preliminary study investigated the acceptance and feasibility of acupuncture in the ICU. Design. Forty-eight patients in a 12-bed medical–surgical ICU at Cedars-Sinai Medical Center who met eligibility criteria were offered the opportunity to receive free-of-charge daily acupuncture treatments during their time in the ICU. Primary endpoints were percentage of patients offered acupuncture who accepted treatment, the percentage of eligible days acupuncture therapy was received, and the incidence of adverse events related to acupuncture treatment. Main Results. Of the 48 patients who were eligible and offered acupuncture therapy, 20 (41%) patients enrolled in the study with an average age of 56 years (range = 18-91 years). The median and average number of days which patients received acupuncture was 2 and 3, respectively (range = 0-11 days), and a majority of patients (13/20) received acupuncture for each of the days for which they were eligible. One patient reported dizziness, which resolved spontaneously and was not associated with hemodynamic changes. No other adverse effects occurred in a total of 64 acupuncture treatments. Conclusions. This preliminary study demonstrates that acupuncture therapy in the ICU is a feasible treatment modality. Further clinical trials are warranted to determine the efficacy of acupuncture therapy as an adjunct to sedative and analgesics in critically ill patients.
    Type of Medium: Online Resource
    ISSN: 1944-4516 , 1944-4524
    URL: Article
    DOI: 10.1177/1944451612472700
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2533433-5
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  • 6
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    A Multisite Preregistered Paradigmatic Test of the Ego-Depletion Effect
    SAGE Publications ; 2021
    In:  Psychological Science Vol. 32, No. 10 ( 2021-10), p. 1566-1581
    Details
    In: Psychological Science, SAGE Publications, Vol. 32, No. 10 ( 2021-10), p. 1566-1581
    Abstract: We conducted a preregistered multilaboratory project ( k = 36; N = 3,531) to assess the size and robustness of ego-depletion effects using a novel replication method, termed the paradigmatic replication approach. Each laboratory implemented one of two procedures that was intended to manipulate self-control and tested performance on a subsequent measure of self-control. Confirmatory tests found a nonsignificant result ( d = 0.06). Confirmatory Bayesian meta-analyses using an informed-prior hypothesis (δ = 0.30, SD = 0.15) found that the data were 4 times more likely under the null than the alternative hypothesis. Hence, preregistered analyses did not find evidence for a depletion effect. Exploratory analyses on the full sample (i.e., ignoring exclusion criteria) found a statistically significant effect ( d = 0.08); Bayesian analyses showed that the data were about equally likely under the null and informed-prior hypotheses. Exploratory moderator tests suggested that the depletion effect was larger for participants who reported more fatigue but was not moderated by trait self-control, willpower beliefs, or action orientation.
    Type of Medium: Online Resource
    ISSN: 0956-7976 , 1467-9280
    URL: Article
    DOI: 10.1177/0956797621989733
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2022256-7
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  • 7
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    Highlights From the Annual Meeting of the American Epilepsy Society 2022
    SAGE Publications ; 2023
    In:  Epilepsy Currents
    Details
    In: Epilepsy Currents, SAGE Publications
    Abstract: With more than 6000 attendees between in-person and virtual offerings, the American Epilepsy Society Meeting 2022 in Nashville, felt as busy as in prepandemic times. An ever-growing number of physicians, scientists, and allied health professionals gathered to learn a variety of topics about epilepsy. The program was carefully tailored to meet the needs of professionals with different interests and career stages. This article summarizes the different symposia presented at the meeting. Basic science lectures addressed the primary elements of seizure generation and pathophysiology of epilepsy in different disease states. Scientists congregated to learn about anti-seizure medications, mechanisms of action, and new tools to treat epilepsy including surgery and neurostimulation. Some symposia were also dedicated to discuss epilepsy comorbidities and practical issues regarding epilepsy care. An increasing number of patient advocates discussing their stories were intertwined within scientific activities. Many smaller group sessions targeted more specific topics to encourage member participation, including Special Interest Groups, Investigator, and Skills Workshops. Special lectures included the renown Hoyer and Lombroso, an ILAE/IBE joint session, a spotlight on the impact of Dobbs v. Jackson on reproductive health in epilepsy, and a joint session with the NAEC on coding and reimbursement policies. The hot topics symposium was focused on traumatic brain injury and post-traumatic epilepsy. A balanced collaboration with the industry allowed presentations of the latest pharmaceutical and engineering advances in satellite symposia.
    Type of Medium: Online Resource
    ISSN: 1535-7597 , 1535-7511
    URL: Article
    DOI: 10.1177/15357597231187227
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 8
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    Online Resource
    Association of Surge Conditions with Mortality Among Critically Ill Patients with COVID-19
    SAGE Publications ; 2022
    In:  Journal of Intensive Care Medicine Vol. 37, No. 4 ( 2022-04), p. 500-509
    Details
    In: Journal of Intensive Care Medicine, SAGE Publications, Vol. 37, No. 4 ( 2022-04), p. 500-509
    Abstract: To determine whether surge conditions were associated with increased mortality. Design Multicenter cohort study. Setting U.S. ICUs participating in STOP-COVID. Patients Consecutive adults with COVID-19 admitted to participating ICUs between March 4 and July 1, 2020. Interventions None Measurements and Main Results The main outcome was 28-day in-hospital mortality. To assess the association between admission to an ICU during a surge period and mortality, we used two different strategies: (1) an inverse probability weighted difference-in-differences model limited to appropriately matched surge and non-surge patients and (2) a meta-regression of 50 multivariable difference-in-differences models (each based on sets of randomly matched surge- and non-surge hospitals). In the first analysis, we considered a single surge period for the cohort (March 23 – May 6). In the second, each surge hospital had its own surge period (which was compared to the same time periods in matched non-surge hospitals). Our cohort consisted of 4342 ICU patients (average age 60.8 [sd 14.8], 63.5% men) in 53 U.S. hospitals. Of these, 13 hospitals encountered surge conditions. In analysis 1, the increase in mortality seen during surge was not statistically significant (odds ratio [95% CI] : 1.30 [0.47-3.58], p = .6). In analysis 2, surge was associated with an increased odds of death (odds ratio 1.39 [95% CI, 1.34-1.43] , p  〈  .001). Conclusions Admission to an ICU with COVID-19 in a hospital that is experiencing surge conditions may be associated with an increased odds of death. Given the high incidence of COVID-19, such increases would translate into substantial excess mortality.
    Type of Medium: Online Resource
    ISSN: 0885-0666 , 1525-1489
    URL: Article
    DOI: 10.1177/08850666211067509
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 9
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    Effectiveness of a Screening and Brief Intervention protocol for heavy drinkers in dental practice: A cluster-randomized trial
    SAGE Publications ; 2015
    In:  Journal of Health Psychology Vol. 20, No. 12 ( 2015-12), p. 1534-1548
    Details
    In: Journal of Health Psychology, SAGE Publications, Vol. 20, No. 12 ( 2015-12), p. 1534-1548
    Abstract: Results of a cluster-randomized trial of a Screening and Brief Intervention for heavy drinkers in dental practice are reported. Data were obtained from 103 heavy drinking patients recruited from randomized intervention (7; n = 50) and control (6; n = 53) practices. Analysis of data revealed that 6-month decreases in total drinks per week were significantly ( p 〈 .05) greater for heavy drinking intervention (43%) than control patients (21%)—a 4 drink per week difference. Similar decreases were obtained for quantity and frequency among intervention patients compared to control patients. Despite power limitations, the 6-month results support the effectiveness of the Screening and Brief Intervention.
    Type of Medium: Online Resource
    ISSN: 1359-1053 , 1461-7277
    URL: Article
    DOI: 10.1177/1359105313516660
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2021897-7
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  • 10
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    The Psychological Science Accelerator: Advancing Psychology Through a Distributed Collaborative Network
    SAGE Publications ; 2018
    In:  Advances in Methods and Practices in Psychological Science Vol. 1, No. 4 ( 2018-12), p. 501-515
    Details
    In: Advances in Methods and Practices in Psychological Science, SAGE Publications, Vol. 1, No. 4 ( 2018-12), p. 501-515
    Abstract: Concerns about the veracity of psychological research have been growing. Many findings in psychological science are based on studies with insufficient statistical power and nonrepresentative samples, or may otherwise be limited to specific, ungeneralizable settings or populations. Crowdsourced research, a type of large-scale collaboration in which one or more research projects are conducted across multiple lab sites, offers a pragmatic solution to these and other current methodological challenges. The Psychological Science Accelerator (PSA) is a distributed network of laboratories designed to enable and support crowdsourced research projects. These projects can focus on novel research questions or replicate prior research in large, diverse samples. The PSA’s mission is to accelerate the accumulation of reliable and generalizable evidence in psychological science. Here, we describe the background, structure, principles, procedures, benefits, and challenges of the PSA. In contrast to other crowdsourced research networks, the PSA is ongoing (as opposed to time limited), efficient (in that structures and principles are reused for different projects), decentralized, diverse (in both subjects and researchers), and inclusive (of proposals, contributions, and other relevant input from anyone inside or outside the network). The PSA and other approaches to crowdsourced psychological science will advance understanding of mental processes and behaviors by enabling rigorous research and systematic examination of its generalizability.
    Type of Medium: Online Resource
    ISSN: 2515-2459 , 2515-2467
    URL: Article
    DOI: 10.1177/2515245918797607
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2904847-3
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