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Hasty R.T.,Campbell University | Barbato V.A.,Nova Southeastern University | Valdes Jr. P.J.,Nova Southeastern University | Powers D.W.,Nova Southeastern University | And 13 more authors.
Journal of the American Osteopathic Association | Year: 2014

Context: Since its launch in 2001, Wikipedia has become the most popular general reference site on the Internet and a popular source of health care information. To evaluate the accuracy of this resource, the authors compared Wikipedia articles on the most costly medical conditions with standard, evidence-based, peer-reviewed sources. Methods: The top 10 most costly conditions in terms of public and private expenditure in the United States were identified, and a Wikipedia article corresponding to each topic was chosen. In a blinded process, 2 randomly assigned investigators independently reviewed each article and identified all assertions (ie, implication or statement of fact) made in it. The reviewer then conducted a literature search to determine whether each assertion was supported by evidence. The assertions found by each reviewer were compared and analyzed to determine whether assertions made by Wikipedia for these conditions were supported by peer-reviewed sources. Results: For commonly identified assertions, there was statistically significant discordance between 9 of the 10 selected Wikipedia articles (coronary artery disease, lung cancer, major depressive disorder, osteoarthritis, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, back pain, and hyperlipidemia) and their corresponding peer-reviewed sources (P<.05) and for all assertions made by Wikipedia for these medical conditions (P<.05 for all 9). Conclusion: Most Wikipedia articles representing the 10 most costly medical conditions in the United States contain many errors when checked against standard peer-reviewed sources. Caution should be used when using Wikipedia to answer questions regarding patient care. © 2014 American Osteopathic Association.


RESULTS: Overall, 56 of 199 (28%) women suffered 70 complications, of which hematoma, skin necrosis, cellulitis, or seroma accounted for 53 (76%) of the complications. The start date of adjuvant therapy was known in 116 (58%) of the women with invasive cancer. Overall, patients that underwent immediate breast reconstruction did not have delay in adjuvant treatment when compared to patients with no reconstruction (41 days vs 42 days, P = 0.61). Women with a complication did have a significantly longer interval to adjuvant chemotherapy when compared to those with no complications (47 days vs 41 days, P = 0.027). When further stratified by type of reconstruction, although there were differences in time to adjuvant chemotherapy, none of these reached significance (tissue expanders: 45 days vs 41 days, P = 0.063; flap reconstruction: 72 days vs 49 days, P = 0.25).CONCLUSIONS: Immediate reconstruction after mastectomy does not delay additional cancer treatment. Overall, when complications do occur, adjuvant therapy is significantly delayed, though the median delay was only 6 days.BACKGROUND: Recent studies have shown that patients undergoing immediate breast reconstruction after mastectomy have a higher rate of complications relative to patients undergoing mastectomy alone. Conflicting data exist on how these complications impact adjuvant treatment. We sought to quantify the additional risk associated with immediate breast reconstruction after mastectomy and determine how these risks influence adjuvant chemotherapy.METHODS: A retrospective review of women undergoing mastectomy for breast cancer and immediate breast reconstruction between January 2007 and December 2012 was conducted. We abstracted clinicopathological variables and stratified women according to the type of reconstruction and presence of surgical complications. Additionally, time to adjuvant chemotherapy was assessed. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Trudnak T.E.,Academy Health in Washington | Arboleda E.,FL | Kirby R.S.,University of South Florida | Perrin K.,University of South Florida
Journal of Midwifery and Women's Health | Year: 2013

Introduction: CenteringPregnancy is a client-centered model of group prenatal care that brings women together into small groups to receive care through assessment, education, and support. As Spanish-speaking CenteringPregnancy groups become more common, outcomes of Latinas who attend these groups must be assessed. The purpose of this retrospective cohort study was to compare pregnancy outcomes of Latina women who completed CenteringPregnancy in a public health clinic with women who completed individual care in the same clinic during the same time. Methods: Medical charts were reviewed retrospectively to examine differences in pregnancy outcomes and maternal factors in both prenatal care groups. Latina Spanish-speaking women who completed CenteringPregnancy were matched with Latina Spanish-speaking women who completed individual care within the same time frame. Logistic regression analysis was conducted to examine maternal and birth outcomes. Results: A total of 487 patient charts were obtained for data collection (CenteringPregnancy n = 247, individual n = 240). No differences in low-birth-weight or preterm births were observed between the groups. Compared with women in individual care, women in CenteringPregnancy had higher odds of giving birth vaginally (adjusted odds ratio [aOR], 2.57; 95% confidence interval [CI], 1.23-5.36), attending prenatal care visits (aOR, 11.03; 95% CI, 4.53-26.83), attending postpartum care visits (aOR, 2.20; 95% CI, 1.20-4.05), and feeding their infants formula only (aOR, 6.07; 95% CI, 2.57-14.3). Women in CenteringPregnancy also had lower odds of gaining below the recommended amount of gestational weight (aOR, 0.41; 95% CI, 0.22-0.78). Discussion: Women in CenteringPregnancy had higher health care utilization, but there were no differences in preterm birth or low birth weight. Randomized studies are needed to eliminate selection bias. © 2013 by the American College of Nurse-Midwives.


Mcleod D.S.,FL | Elefteriadou L.,University of Florida
ITE Journal (Institute of Transportation Engineers) | Year: 2012

The Florida Department of Transportation (FDOT) developed a travel time reliability model, applied it to all freeways in Florida, US, and began reporting reliability. The model and development methodology adopted by the FDOT was introduced and potential planning uses for system-wide reporting and project priority were explored. Travel time reliability had the potential to be used to analyze traffic operations and systems planning. Transportation agencies had the ability to evaluate the impact of a new incident identification and removal program over a year in systems planning and assess benefits and costs when such a program was implemented. The FDOT considered travel time reliability to be one of the primary mobility performance measures to evaluate its intelligent transportation system (ITS)program, for statewide reporting and for system-level project prioritization. FDOT had funded several research projects to develop, implement, and refine a model for predicting travel time reliability for freeways and signalized arterials.


Porter D.,Creating Healthy Communities Program | Washam R.,FL | Li J.,Environmental Health and Health and Disability | Johnson R.,Environmental Health and Health and Disability
Journal of Public Health Management and Practice | Year: 2014

Strong state-local relationships within the Environmental Public Health Tracking Program (Tracking Program) can enhance the ability of the Centers for Disease Control and Prevention and state and local health departments to collect and analyze data that would help determine links between environmental exposure and health. Since the National Association of County & City Health Officials is particularly interested in how local-state partnerships could benefit the Environmental Public Health Tracking Network, this article features strategies to engage local health departments. First, state-local facilitated discussions have been shown to positively impact the public's health. Second, Martin County conducted a program that taught women to avoid overconsumption of high-mercury seafood, which was also implemented in other Florida counties. Finally, the Cincinnati Health Department initiated a project that promoted data sharing with the state, and the results have also been promising. Such efforts indicate that state-local partnerships have the potential to support and enrich the Tracking Program. Copyright © 2014 Wolters Kluwer Health/Lippincott Williams & Wilkins.

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