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dc.contributor.authorMerkle, Florian Tobias
dc.contributor.authorGhosh, Sulagna
dc.contributor.authorKamitaki, Nolan
dc.contributor.authorMitchell, Jana Marie
dc.contributor.authorAvior, Yishai
dc.contributor.authorMello, Curtis Jay
dc.contributor.authorKashin, Seva
dc.contributor.authorMekhoubad, Shila
dc.contributor.authorIlic, Dusko
dc.contributor.authorSweetnam, Maura Charlton
dc.contributor.authorSaphier Belfer, Genevieve C
dc.contributor.authorHandsaker, Robert E
dc.contributor.authorGenovese, Giulio
dc.contributor.authorBar, Shiran
dc.contributor.authorBenvenisty, Nissim
dc.contributor.authorMcCarroll, Steven A.
dc.contributor.authorEggan, Kevin Carl
dc.date.accessioned2017-06-12T19:01:23Z
dash.embargo.terms2017-11-12
dc.date.issued2017
dc.identifierQuick submit: 2017-03-27T13:38:46-0400
dc.identifier.citationMerkle, Florian T., Sulagna Ghosh, Nolan Kamitaki, Jana Mitchell, Yishai Avior, Curtis Mello, Seva Kashin, et al. 2017. “Human Pluripotent Stem Cells Recurrently Acquire and Expand Dominant Negative P53 Mutations.” Nature (April 26). doi:10.1038/nature22312.en_US
dc.identifier.issn0028-0836en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:33010384
dc.description.abstractBackground: Depressive disorders are the second-leading cause of global disability, and an area of increasing focus in international health efforts. We describe a community health worker (CHW) program rolled out in a stepped-wedge design during the course of routine patient care to 74 patients with depression in 4 communities in rural Mexico. Methods: We used random effects models to calculate the change in Patient Health Questionnaire-9 (PHQ-9) scores, an internationally validated measure of depression, before and after the CHW program was introduced. As a secondary outcome, we also examined the change pre- and post-intervention in the proportion of patients who had a mean of at least one visit per month for depression follow-up, in accordance with clinic visit guidelines. Results: In multivariate mixed-effects regression, the introduction of the CHW program was associated with a 2.1-point decrease in PHQ-9 score (95% CI: -3.7 to -0.50) followed by a decrease in PHQ-9 score of 0.19 points per month (95% CI: -0.41 to 0.02), beyond standard care. There was strong evidence that patients were far more likely to attend a mean of at least one visit per month (adjusted OR = 8.5, 95% CI: 7.2 to 9.7) after the intervention was introduced in a community. Conclusions: Our results suggest an association between the introduction of a CHW program and improved depression outcomes and appointment adherence. Our findings are limited by missing data. Future research is necessary to develop evidence-based mental health interventions implementable in low-resource settings.en_US
dc.description.sponsorshipStem Cell and Regenerative Biologyen_US
dc.language.isoen_USen_US
dc.publisherSpringer Natureen_US
dc.relation.isversionofdoi:10.1038/nature22312en_US
dash.licenseLAA
dc.subjectdepressionen_US
dc.subjectCHWen_US
dc.subjectcommunity healthen_US
dc.subjectMexicoen_US
dc.subjectLMICen_US
dc.titleHuman pluripotent stem cells recurrently acquire and expand dominant negative P53 mutationsen_US
dc.typeJournal Articleen_US
dc.date.updated2017-03-27T17:39:05Z
dc.description.versionAccepted Manuscripten_US
dc.relation.journalNatureen_US
dash.depositing.authorEggan, Kevin Carl
dash.waiver2017-03-27
dc.date.available2017-11-13T08:30:42Z
dc.identifier.doi10.1038/nature22312*
dash.authorsorderedfalse
dash.contributor.affiliatedSweetnam, Maura
dash.contributor.affiliatedMitchell, Jana
dash.contributor.affiliatedMello, Curtis
dash.contributor.affiliatedGhosh, Sulagna
dash.contributor.affiliatedMekhoubad, Shila
dash.contributor.affiliatedKamitaki, Nolan
dash.contributor.affiliatedSaphier Belfer, Genevieve
dash.contributor.affiliatedMerkle, Florian
dash.contributor.affiliatedGenovese, Giulio
dash.contributor.affiliatedHandsaker, Robert
dash.contributor.affiliatedMcCarroll, Steven
dash.contributor.affiliatedEggan, Kevin


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