Additionally, we found an almost zero probability ( less then 0.001) that the reduction in dental POHS was at least as large as the expansion in medical POHS (full substitution) and a 0.50 probability that increased medical POHS was associated with an increase in dental POHS of at least 6.6% of the expansion of medical POHS. Results were similar when receipt of dental visits was examined. This study failed to find evidence that medical POHS replaced dental visits for young children enrolled in Medicaid and, in fact, offers evidence that increased medical POHS was associated with increased utilization of dental care. Given lower-than-desired rates of dental visits for this population, delivery of medical POHS should be expanded.Background Individuals with mental illness use social media to share treatment experiences and anecdotal information. Despite the significant impact of social media on individuals with mental illness, posts related to antidepressants have not been studied systematically.Aims This study evaluates public sentiments and content posted on Instagram regarding the use of antidepressants.Methods Instagram posts from July 2010 to June 30, 2018 containing hashtags of commonly prescribed antidepressants and anxiety/depression-related terms were gathered (n = 13,096). Approximately 1,000 posts were randomly selected and evaluated for photo content, anecdotal experiences, sentiments towards antidepressants, and mentions of psychotherapy, comorbidities, polypharmacy, or adverse effects.Results Instagram posts describing antidepressant use have increased exponentially from 2010, and 43% provided anecdotal experiences. Among these posts, 58% expressed negative sentiments towards antidepressant usage, citing adverse effects and lack of improvement. Posts that also mentioned psychotherapy, comorbidities, or polypharmacy differed in their collective sentiments. Misinformation was present in analyzed posts, and none mentioned recovery-oriented materials (i.e., mental health facility, hotline, etc.).Conclusions Instagram is a useful resource for exploring public sentiments related to antidepressant use. Mental health professionals should be cognizant of these sentiments/perceptions in order to tailor communication with patients and should consider increasing their social media presence.RATIONALE Idiopathic pulmonary fibrosis (IPF) is a deadly disease with increasingly impaired health-related quality of life (HRQOL). EHealth technologies facilitate collection of physiological outcomes and patient reported-outcomes (PROMs) at home, but randomized controlled trials (RCTs) on the effects of eHealth are scarce.  https://www.selleckchem.com/products/ziritaxestat.html  We investigated whether a home monitoring program improved HRQOL and medication use for IPF patients. METHODS We performed a multicenter RCT in newly treated patients with IPF. Patients were randomly assigned to standard care or a home monitoring program on top of standard care for 24 weeks. The home monitoring program included home spirometry, reporting of symptoms and side-effects, PROMs, information, a medication coach and eConsultations. The primary endpoint was between-group difference in change in Kings Brief Interstitial Lung disease (K-BILD) questionnaire score at 24 weeks. RESULTS 90 patients were randomized (46 patients home monitoring, 44 standard care). After 24 weeks, no statistically significant differences were found in K-BILD total score (home monitoring group+2.7 points, standard care+0.03, p=0.24) and psychological domain score (home monitoring group+5.1, standard care-0.5, p=0.1). In the home monitoring group medication was more often adjusted (1 vs 0.3 adjustments per patient, p=0.027). Patient satisfaction with the home monitoring program was high. Home-based spirometry was highly correlated with hospital-based spirometry over time. CONCLUSIONS The results of this first-ever eHealth RCT in IPF showed that a comprehensive home monitoring program did not improve overall HRQOL measured with K-BILD, but tended to improve psychological wellbeing. Home monitoring was greatly appreciated by patients and allowed for individually-tailored medication adjustments. Clinical trial registration available at www.clinicaltrials.gov, ID NCT03420235.RATIONALE The role of inspiratory effort has still to be determined as a potential predictors of non-invasive mechanical ventilation (NIV) failure in acute hypoxic de novo respiratory failure (AHRF). OBJECTIVES We explore the hypothesis that inspiratory effort might be a major determinant of NIV failure in these patients. METHODS Thirty consecutive patients with AHRF admitted to a single center and candidates for a 24-hour NIV trial were enrolled. Clinical features, tidal changes in esophageal (ΔPes) and dynamic transpulmonary pressure (ΔPL), expiratory tidal volume, and respiratory rate were recorded on admission and 2-4-12-24 hours after NIV start, and were tested for correlation with outcomes. MEASUREMENTS AND MAIN RESULTS ΔPes and ΔPes/ΔPL were significantly lower 2 hours after NIV start in patients who successfully completed the NIV trial (n=18) compared to those who needed endotracheal intubation (n=12) [median=11 (IQR=8-15) cmH2O vs 31.5 (30-36) cmH2O, p less then 0.0001] while other variables differed later. ΔPes was not related to other predictors of NIV failure at baseline. NIV-induced reduction in ΔPes of 10 cmH2O or more after 2 hours of treatment was strongly associated to avoidance of intubation, and represented the most accurate predictor of treatment success (OR=15, 95%CI 2.8-110, p=0.001, AUC=0.97, 95%CI 0.91-1, p less then 0.0001). CONCLUSIONS The magnitude of inspiratory effort relief as assessed by ΔPes variation within the first 2 hours of NIV was an early and accurate predictor of NIV outcome at 24 hours. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http//creativecommons.org/licenses/by-nc-nd/4.0/).Background The devastation of the Syrian war can lead to a drastic re-evaluation of oneself and alteration in self-capacities. Yet, little is known regarding its impact on these domains among Syrian refugees.Aims To investigate the inter-relationship between trauma characteristics, trauma centrality, self-efficacy, emotional suppression, PTSD and psychiatric co-morbidity among Syrian refugees.Methods 1197 refugees from Turkey and Sweden completed the Harvard Trauma Questionnaire, General Health Questionnaire-28, Centrality of Event Scale, Generalized Self-Efficacy Scale and Courtauld Emotional Control Scale.Results Using the DSM-IV criteria for PTSD from the Harvard Trauma Questionnaire, 43% met the criteria. The PTSD group reported significantly higher levels of trauma characteristics, trauma centrality and psychiatric co-morbidity but a lower level of self-efficacy than the non-PTSD group. Trauma characteristics were positively associated with trauma centrality; trauma centrality was negatively correlated with self-efficacy.