Mayo Clinic proceedings. Innovations, quality & outcomes最新文献

{"title":"Use of Complementary and Integrative Medicine Among Low-Income Persons With Mental Health Disorders","authors":"Kavita Prasad MD ,&nbsp;Abhiram Prasad MD ,&nbsp;Natalie L. Dyer PhD ,&nbsp;Brent A. Bauer MD ,&nbsp;Jennifer N. Soderlind BA ,&nbsp;Karen M. Fischer MPH ,&nbsp;Ivana T. Croghan PhD ,&nbsp;Caroline C. Kaufman PhD ,&nbsp;David H. Rosmarin PhD ,&nbsp;Dietlind L. Wahner-Roedler MD","doi":"10.1016/j.mayocpiqo.2024.11.002","DOIUrl":"10.1016/j.mayocpiqo.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the use of complementary and integrative medicine (CIM) among a low-income population with mental health diagnoses and to assess differences in social determinants of health (SDOH) on the basis of CIM use.</div></div><div><h3>Patients and Methods</h3><div>We surveyed patients with mental health diagnoses and/or substance use disorders during outpatient evaluations between August 11, 2020, and November 18, 2021, at a community behavioral health center in Rochester, MN. We measured knowledge of current CIM, interest in future use of CIM, and SDOH. Differences in mean number of SDOH risk factors were compared by use or nonuse of any CIM.</div></div><div><h3>Results</h3><div>Among 102 patients, depression (87%) and anxiety (85%) diagnoses were common. Moreover, 72% of patients used at least 1 CIM. The 3 most common modalities were prayer (41%), spirituality (37%), and music (36%). CIM use had perceived benefits for mood (49%), stress (49%), and sadness (43%). One-third of patients added CIM to conventional treatments, and 19% reported that traditional medical treatments did not work well for their symptoms. More than two-thirds had not discussed their use of CIM with their physicians. Social isolation and loneliness were common. The number of SDOH risk factors did differ by use of CIM.</div></div><div><h3>Conclusion</h3><div>Prayer, spirituality, and music are frequently used by patients with mental health disorders and were perceived to be helpful in relieving symptoms. CIM use was not related to SDOH risk factors. Integrating CIM therapies may be beneficial for improving mental health in this population.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"9 1","pages":"Article 100585"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Noninvasive Testing Before Invasive Coronary Angiography in the Assessment for Revascularization","authors":"Simon Parlow MD ,&nbsp;Richard G. Jung MD, PhD ,&nbsp;Pietro Di Santo MD ,&nbsp;Joanne Joseph MD ,&nbsp;Stephanie Skanes MD ,&nbsp;Omar Abdel-Razek MD ,&nbsp;Graeme Prosperi-Porta MSc, MD ,&nbsp;Pouya Motazedian MD ,&nbsp;Michael Froeschl MSc, MD ,&nbsp;Marino Labinaz MD ,&nbsp;Rebecca Mathew MD ,&nbsp;F. Daniel Ramirez MSc, MD ,&nbsp;Trevor Simard MD, PhD ,&nbsp;Benjamin Hibbert MD, PhD","doi":"10.1016/j.mayocpiqo.2024.100589","DOIUrl":"10.1016/j.mayocpiqo.2024.100589","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the role of noninvasive testing (NIT) before invasive coronary angiography (ICA) by evaluating the association between a positive myocardial perfusion imaging (MPI) or computed tomography angiography (CTA) result and the decision to perform coronary revascularization.</div></div><div><h3>Patients and Methods</h3><div>We screened all patients who received ICA between August 1, 2015, and July 31, 2019, and identified those who received MPI or CTA within the preceding 12 months. We considered MPI to be a positive result if it found moderate or severe ischemia in a specific coronary territory and CTA to be a positive result if it identified a stenosis greater than 50% in any major coronary artery.</div></div><div><h3>Results</h3><div>Of the 17,181 individual procedures, 2183 were included. Positive CTA had an odds ratio (OR) of 2.68 (95% CI, 1.82-3.94) for revascularization and positive MPI an OR of 1.29 (95% CI, 1.07-1.56). Overall sensitivity for CTA in the prediction of revascularization was 80.4% (95% CI, 75.7%-84.6%), with vessel-level sensitivity ranging from 57.3% (95% CI, 47.5%-66.7%) to 71.8% (95% CI, 65.8%-77.4%). Overall sensitivity of MPI was 48.2% (95% CI, 44.7%-51.7%), with territory-specific sensitivity ranging from 33.7% (95% CI, 29.9%-37.7%) to 36.5% (95% CI, 32.6%-40.6%). Overall specificity for CTA was low, at 39.5% (32.9%-46.3%), but higher when evaluating at the vessel level, ranging from 60.3% (95% CI, 54.5%-66.0%) to 83.5% (95% CI, 79.6%-86.9%). Overall specificity for MPI was 58.1% (95% CI, 54.9%-61.3%), with territory-specific specificity ranging from 78.6% (95% CI, 76.1%-80.9%) to 78.9% (95% CI, 76.5%-81.3%).</div></div><div><h3>Conclusion</h3><div>In this population of patients referred for ICA, positive CTA was more closely associated with revascularization than MPI. Further studies are necessary to determine the role of NIT before ICA.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"9 1","pages":"Article 100589"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/j.mayocpiqo.2024.11.005","DOIUrl":"10.1016/j.mayocpiqo.2024.11.005","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"9 1","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Weapons in the Health Care Setting: A Systematic Review and Meta-Analysis","authors":"Sarayna S. McGuire MD, MS ,&nbsp;Casey M. Clements MD, PhD ,&nbsp;Dana J. Gerberi MLIS ,&nbsp;M. Hassan Murad MD, MPH","doi":"10.1016/j.mayocpiqo.2024.11.004","DOIUrl":"10.1016/j.mayocpiqo.2024.11.004","url":null,"abstract":"<div><div>This study aimed to systematicically evaluate and quantify the prevalence of weapons in the health care setting. A systematic search of MEDLINE, Embase, Scopus, Web of Science, CINAHL, and EBSCO MegaFILE was performed from inception to January 12, 2024. The primary outcome was the prevalence of weapons in the health care setting on patients and/or visitors. Prevalence was pooled across studies and estimated using a random effects model. Subgroup analyses were done based on types of weapons, characteristics of weapon carriers, weapons screening/detection technology, and screened population characteristics. A total of 14 observational studies were included. All studies were from the United States and were published between 1984 and 2023. Weapons prevalence ranged from 0.4% to 26.3% among populations screened in the included studies. The overall pooled weapons prevalence was 4.0% (95% CI, 2.0%-7.8%). Most weapons were bladed (3.8%; 95% CI, 1.5%-8.9%), followed by other weapons (0.6%; 95% CI, 0.3%-1.3%), and firearms (0.1%; 95% CI, 0.02%-0.5%; <em>P</em>&lt;.01). Weapons prevalence was 2.0% (95% CI, 0.7%-5.8%) among individuals entering the hospital setting, compared with 1.6% (95% CI, 0.7%-3.4%) of individuals entering the emergency department and highest (24.3%; 95% CI, 21.6%-27.2%) when major trauma patients were hand-searched. Prevalence was higher in males than that in females (11.1% vs 3.1%; <em>P</em>=.01). Weapons should be expected on individuals presenting to hospitals in the United States; however, prevalence varied widely based on the setting, type of patients, and detection method.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"9 1","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Small Step by the National Institutes of Health Can be a Giant Leap for Persons With Disability","authors":"Zuhair Niazi,&nbsp;Taimur Sher MBBS, MD","doi":"10.1016/j.mayocpiqo.2024.11.001","DOIUrl":"10.1016/j.mayocpiqo.2024.11.001","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 549-550"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewers for Mayo Clinic Proceedings: Innovations, Quality & Outcomes (2024)","authors":"","doi":"10.1016/j.mayocpiqo.2024.10.003","DOIUrl":"10.1016/j.mayocpiqo.2024.10.003","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Page 548"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"","doi":"10.1016/j.mayocpiqo.2024.10.002","DOIUrl":"10.1016/j.mayocpiqo.2024.10.002","url":null,"abstract":"","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Page 536"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minnesota Hospitals’ Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic","authors":"Kirsten A. Riggan MS, MA ,&nbsp;Sarah Kesler MD ,&nbsp;Debra DeBruin PhD ,&nbsp;Susan M. Wolf JD ,&nbsp;Jonathon P. Leider PhD ,&nbsp;Nneka Sederstrom MPH, PhD ,&nbsp;Jeffrey Dichter MD ,&nbsp;Erin S. DeMartino MD","doi":"10.1016/j.mayocpiqo.2024.09.003","DOIUrl":"10.1016/j.mayocpiqo.2024.09.003","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess hospitals’ plans for implementing Minnesota’s statewide guidance for allocating scarce critical care resources during the COVID-19 pandemic.</div></div><div><h3>Patients and Methods</h3><div>Individuals from 23 hospitals across Minnesota were invited to complete a 25-item survey between July 20, 2020, and September 18, 2020 to understand how hospitals in the state intended to operationalize statewide clinical triage instructions for scarce resources (including mechanical ventilation) and written ethics guidance on the allocation of critical care resources in the event crisis standards of care triggered triage.</div></div><div><h3>Results</h3><div>Of individuals invited from 23 hospitals, 14 hospitals completed the survey (60.9% institutional response rate) and described plans for triage at their respective hospitals. Planned triage team composition and size varied. Hospitals’ plans for which individuals should assign a triage score (reflecting patients’ illness severity) also differed markedly. Most respondents described plans for staff training to address potential bias in triage.</div></div><div><h3>Conclusion</h3><div>Despite explicit state guidance to encourage consistency across hospitals, we found considerable heterogeneity in implementation plans. Plans diverged from Minnesota’s written ethics guidance on whether to consider race during triage to help mitigate health disparities. Inconsistencies between the state’s 2 guidance documents could explain some of these differences. Collaboration between hospitals and committees developing statewide guidance may help identify barriers to effective operationalization. Ongoing review of published guidance and hospital plans can identify issues of clarity and consistency and promote equitable triage.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 537-547"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal Exercise Gas Exchange Before Pulmonary Emboli Diagnosis","authors":"Timothy Edwards MS ,&nbsp;Elisabet Børsheim PhD ,&nbsp;Andrew R. Tomlinson MD","doi":"10.1016/j.mayocpiqo.2024.10.001","DOIUrl":"10.1016/j.mayocpiqo.2024.10.001","url":null,"abstract":"<div><div>A 20-year-old male underwent diagnostic testing due to unexplained shortness of breath and chest discomfort. He had no previous medical problems and was not taking any medications. Initial evaluations included cardiopulmonary exercise testing (CPET), which yielded results that were reported as normal. However, over the following 2 months, his symptoms worsened considerably, including dyspnea with climbing stairs and then hemoptysis. Seeking urgent medical care, he presented to the emergency department, where he underwent further testing and was admitted to the hospital. Computed tomography angiogram reported bilateral pulmonary emboli. His parents requested a second opinion regarding the analysis of the CPET data, which revealed previously overlooked abnormalities. This overlooked data delayed pulmonary embolism diagnosis, and the patient ultimately required bilateral pulmonary thromboendarterectomy. In this case, we describe the hallmark signs of pulmonary vascular disease seen during CPET and offer clinical pearls to aid in timely detection.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 530-535"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Coronavirus Disease 2019 Effects in an Active University Population: A Within-Campus Cross-Sectional Study at a Major Educational Institution","authors":"Marcelo Hernández-Mora MD ,&nbsp;René Arredondo-Hernández PhD ,&nbsp;Carmen A. Castañeda-Camacho MD ,&nbsp;Pamela X. Cervantes-Gutierrez MD ,&nbsp;Gonzalo Castillo-Rojas PhD ,&nbsp;Samuel Ponce de León MD ,&nbsp;Yolanda López-Vidal PhD","doi":"10.1016/j.mayocpiqo.2024.09.004","DOIUrl":"10.1016/j.mayocpiqo.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the associations among post-coronavirus disease 2019 (COVID-19) prevalence; risk factors and comorbidities have not been firmly established within a university outpatient population.</div></div><div><h3>Patients and Methods</h3><div>Records from 881 COVID-19 outpatient patients (504 females [57.9%] and 366 males [42.07%]), most of whom were between 30 and 40 years of age (mean=37.3 years old; 95% CI, 36.5-38.2), with initial infection data from February 2020 to August 2022 were reviewed once, whereas the survey took place during 2 different moments during the pandemic. The first period (April 20, 2021, to June 21, 2021) yielded 279 responses, whereas in the second period (June 23, 2021, to October 4, 2021), 602 responses were recorded. The instrument used contained 20 questions across 3 main domains: general information, data related to infection and adverse effects, and service satisfaction experience.</div></div><div><h3>Results</h3><div>All the patients were positive for immunoglobulin G antibodies against nucleocapsid by the third week. Post-COVID-19 symptoms arose at least 2 weeks after recovery from the initial illness; 654 individuals reported at least one symptom after the acute COVID-19 period, for a post-COVID-19 prevalence of 74.96%. The most frequent symptoms were fatigue (84%), headache (71%), and difficulty concentrating (71%). More than 60% of participants reported at least one comorbidity, among which the most common ones were obesity (35.9%), smoking (17.5%), and hypertension (12.2%).</div></div><div><h3>Conclusion</h3><div>In this study, we assessed post-COVID-19 prevalence among outpatients and found that comorbidities were strongly related to consequences impacting quality of life and mental health burden.</div></div>","PeriodicalId":94132,"journal":{"name":"Mayo Clinic proceedings. Innovations, quality & outcomes","volume":"8 6","pages":"Pages 521-529"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}