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Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Stephen Honeybul, David Anthony Morrison, Kwok M Ho, Christopher R P Lind, Elizabeth Geelhoed
OBJECTIVE: To compare the long-term outcomes of patients who had been randomly allocated to receive primary titanium cranioplasty or autologous bone graft following decompressive craniectomy. METHODS: Sixty-four patients had been previously enrolled and randomised to receive either their own bone graft or a primary titanium cranioplasty. Functional and cosmetic outcomes had previously been assessed at 1-year following the cranioplasty procedure. Hospital records and the Picture Archiving communication system were reviewed to determine how many patients had cranioplasty failure or associated complications such as seizures beyond 1 year-with a minimum of 24-month follow-up...
March 15, 2018: Acta Neurochirurgica
Shadi Saleh, Mohamad Alameddine, Angie Farah, Nour El Arnaout, Hani Dimassi, Carles Muntaner, Christo El Morr
OBJECTIVES: Assess the effect of selected low-cost eHealth tools on diabetes/hypertension detection and referrals rates in rural settings and refugee camps in Lebanon and explore the barriers to showing-up to scheduled appointments at Primary Healthcare Centers (PHC). METHODS: Community-based screening for diabetes and hypertension was conducted in five rural and three refugee camp PHCs using an eHealth netbook application. Remote referrals were generated based on pre-set criteria...
March 15, 2018: International Journal of Public Health
Augustine Tee, Wai Leng Chow, Colin Burke, Guruprasad Basavarajaiah
INTRODUCTION: In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations in the Singapore healthcare setting. METHODS: A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs...
March 16, 2018: Singapore Medical Journal
Alberto Pilotto, Raffaella Boi, Jean Petermans
Recently, the interest of industry, government agencies and healthcare professionals in technology for aging people has increased. The challenge is whether technology may play a role in enhancing independence and quality of life and in reducing individual and societal costs of caring. Information and communication technologies, i.e. tools aimed at communicating and informing, assistive technologies designed to maintain older peoples' independence and increasing safety, and human-computer interaction technologies for supporting older people with motility and cognitive impairments as humanoid robots, exoskeletons, rehabilitation robots, service robots and companion-type are interdisciplinary topics both in research and in clinical practice...
March 13, 2018: Age and Ageing
Ignacio Aznar-Lou, Anton Pottegård, Ana Fernández, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Ramón Sabés-Figuera, Montserrat Gil-Girbau, Marta Fajó-Pascual, Patricia Moreno-Peral, Maria Rubio-Valera
OBJECTIVE: Copayment policies aim to reduce the burden of medication expenditure but may affect adherence and generate inequities in access to healthcare. The objective was to evaluate the impact of two copayment measures on initial medication non-adherence (IMNA) in several medication groups and by income level. DESIGN: A population-based study was conducted using real-world evidence. SETTING: Primary care in Catalonia (Spain) where two separate copayment measures (fixed copayment and coinsurance) were introduced between 2011 and 2013...
March 15, 2018: BMJ Quality & Safety
Chiara Anna Parente, Domenico Salvatore, Giampiero Maria Gallo, Fabrizio Cipollini
BACKGROUND: In almost all healthcare systems, no-shows (scheduled appointments missed without any notice from patients) have a negative impact on waiting lists, costs and resource utilization, impairing the quality and quantity of cares that could be provided, as well as the revenues from the corresponding activity. Overbooking is a tool healthcare providers can resort to reduce the impact of no-shows. METHODS: We develop an overbooking algorithm, and we assess its effectiveness using two methods: an analysis of the data coming from a practical implementation in an healthcare center; a simulation experiment to check the robustness and the potential of the strategy under different conditions...
March 15, 2018: BMC Health Services Research
Hendramoorthy Maheswaran, Stavros Petrou, Danielle Cohen, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
INTRODUCTION: Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence...
2018: PloS One
Tassia Cristina Decimoni, Roseli Leandro, Luciana Martins Rozman, Dawn Craig, Cynthia P Iglesias, Hillegonda Maria Dutilh Novaes, Patrícia Coelho de Soárez
Background: Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting. Methods: We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde ); citation indexes (SCOPUS, Web of Science), and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde ...
2018: Frontiers in Public Health
Sara Guerri, Daniele Mercatelli, Maria Pilar Aparisi Gómez, Alessandro Napoli, Giuseppe Battista, Giuseppe Guglielmi, Alberto Bazzocchi
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs...
February 2018: Quantitative Imaging in Medicine and Surgery
Fredrik Dahl, Olle Ericsson, Olof Karlberg, Filip Karlsson, Mathias Howell, Fredrik Persson, Fredrik Roos, Johan Stenberg, Tarja Ahola, Ida Alftrén, Björn Andersson, Emelie Barkenäs, Birgit Brandner, Jenny Dahlberg, Sara Elfman, Magnus Eriksson, Per-Ola Forsgren, Niels Francois, Anna Gousseva, Faizan Hakamali, Åsa Janfalk-Carlsson, Henrik Johansson, Johanna Lundgren, Atefeh Mohsenchian, Linus Olausson, Simon Olofsson, Atif Qureshi, Björn Skarpås, Anna Sävneby, Eva Åström, Ove Öhman, Magnus Westgren, Helena Kopp-Kallner, Aino Fianu-Jonasson, Argyro Syngelaki, Kypros Nicolaides
Cell-free DNA analysis is becoming adopted for first line aneuploidy screening, however for most healthcare programs, cost and workflow complexity is limiting adoption of the test. We report a novel cost effective method, the Vanadis NIPT assay, designed for high precision digitally-enabled measurement of chromosomal aneuploidies in maternal plasma. Reducing NIPT assay complexity is achieved by using novel molecular probe technology that specifically label target chromosomes combined with a new readout format using a nanofilter to enrich single molecules for imaging and counting without DNA amplification, microarrays or sequencing...
March 14, 2018: Scientific Reports
Jacqueline Murphy, Mark G Pritchard, Lok Yin Cheng, Roshni Janarthanan, José Leal
INTRODUCTION: Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways...
March 14, 2018: BMJ Open
Catriona Crossan, Hakim-Moulay Dehbi, Hilarie Williams, Neil Poulter, Anthony Rodgers, Stephen Jan, Simon Thom, Joanne Lord
INTRODUCTION: The 'Use of a Multi-drug Pill in Reducing cardiovascular Events' (UMPIRE) trial was a randomised controlled clinical trial evaluating the impact of a polypill strategy on adherence to indicated medication in a population with established cardiovascular disease (CVD) of or at high risk thereof. The aim of Researching the UMPIRE Processes for Economic Evaluation in the National Health Service (RUPEE NHS) is to estimate the potential health economic impact of a polypill strategy for CVD prevention within the NHS using UMPIRE trial and other relevant data...
March 14, 2018: BMJ Open
Darren Svirskis, Sairam Behera, Neera Naidoo, Joanne Beachman, Tarsha Raina, Yongzhi Zhou, Leanne Berkahn, Ian Costello, Yongchuan Gu
Background The EPOCH regimen, consisting of vincristine sulfate, doxorubicin hydrochloride, and etoposide phosphate, is typically administered by continuous infusion over four days to oncology inpatients. If the EPOCH regimen was available to be administered through portable elastomeric pumps, chemotherapy could be transitioned to an outpatient setting, reducing inpatient bed days and overall healthcare costs. However, a lack of stability data for the admixtures in the elastomeric infusion devices currently prevents the transition of the regime to an outpatient setting...
January 1, 2018: Journal of Oncology Pharmacy Practice
Maria Lucia Specchia, Giuseppe La Torre, Giovanna Elisa Calabrò, Paolo Villari, Roberto Grilli, Antonio Federici, Walter Ricciardi, Chiara de Waure
Background: The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods: On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care...
March 12, 2018: European Journal of Public Health
Steven Habbous, Eric McArthur, Stephanie N Dixon, Susan McKenzie, Carlos Garcia-Ochoa, Ngan N Lam, Krista L Lentine, Christine Dipchand, Kenneth Litchfield, Mehmet A Begen, Sisira Sarma, Amit X Garg
BACKGROUND: Preemptive kidney transplants result in better outcomes and patient experiences than transplantation after dialysis onset. It is unknown how often a person initiates maintenance dialysis prior to living kidney donor transplantation when their donor candidate evaluation is well underway. METHODS: Using healthcare databases, we retrospectively studied 478 living donor kidney transplants from 2004-2014 across 5 transplant centres in Ontario, Canada where the recipients were not receiving dialysis when their donor's evaluation was well underway...
March 10, 2018: Transplantation
Carole Therasse, Isabelle Fusier, Anne-Laure Cordonnier, Florence Bérard, Olivier Parent de Curzon, François Bocquet, Pascal Paubel
AIM: Erythropoiesis-stimulating agents (ESAs) are particularly used to treat dialysis patients suffering from anemia due to renal failure. Since March 2014, ESAs have no longer been funded on top-of-diagnosis-related groups (DRGs) in French hospitals and are funded via DRGs. There are two ways to fund dialysis in French hospitals: the 'DRG for dialysis in session' and the 'off-dialysis DRG', which is not a DRG and consists in a supplement tariff specific to dialysis for patients hospitalized for another main reason than dialysis...
March 14, 2018: Journal of Comparative Effectiveness Research
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Shivanjali Kumar, Kamal Kumar, Sarita Bajaj, Ranjana Kumar, Atul Gogia, Atul Kakar, Shrishti Paul Byotra
Introduction: Diabetes is a major world-wide healthcare problem. Cost effective markers for screening and diagnosis of T2DM are the need of the day especially in developing and under-developed countries. Simple anthropometric measurements may help us in identifying individuals likely to have diabetes. Material and Methods: Data from 1055 North-Indian subjects was analysed. Results: Out of several anthropometric measurements studied, Waist-Thigh ratio (WTR) correlated significantly and positively with all three measures of diabetes i...
January 2018: Indian Journal of Endocrinology and Metabolism
Rikinkumar S Patel, Priya Patel, Kaushal Shah, Mandeep Kaur, Zeeshan Mansuri, Ramkrishna Makani
Objective To determine the impact of cannabis use disorder (CUD) on the inpatient outcomes of attention deficit hyperactivity disorder (ADHD) in adolescents Background Previous studies have evaluated the impact of CUD on the health-related quality of life in ADHD patients. Methods We used the nationwide inpatient sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2010--2014. We identified ADHD and cannabis use (CU) as the primary and the other diagnosis, respectively, using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9--CM) codes...
January 7, 2018: Curēus
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