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health administration

Krista Lundelin, Tuija Poussa, Seppo Salminen, Erika Isolauri
BACKGROUND: Societies worldwide are faced with a progressive increase in immune-mediated health problems such as allergic, autoimmune and inflammatory diseases, as well as obesity. Perinatal administration of specific probiotic bacteria is an attractive approach in reducing the risk of these conditions, but long-term efficacy and safety data are lacking. The aim here was to evaluate the clinical benefit and long-term safety of specific probiotics administered during the perinatal period...
October 25, 2016: Pediatric Allergy and Immunology
Teresa T Vo, Sheeba Varghese Gupta
For treatment-naïve patients with human immunodeficiency virus infection, efavirenz (EFV) together with tenofovir and emtricitabine were once widely prescribed given its efficacy and ease of administration in a combination pill. However, the high rate of central nervous system toxicities from EFV prompted the United States Department of Health and Human Services to move the EFV-based regimen from the recommended to the alternative category. For patients who do meet the criteria for newer recommended antiretroviral treatments, EFV is a viable option and is often the mainstay of treatment outside the United States, as newer antiretroviral treatments are more expensive...
October 25, 2016: Pharmacotherapy
P P T Jeurissen, B A Ravesteijn, R T J M Janssen, M A C Tanke
After a decade of robust growth in spending, Dutch mental healthcare is on a more stricter budgetary path since 2012. High prevalence of illness and limited spending, imply the need for efficient mental healthcare delivery.<br/> AIM: To advise how mental health care can be managed more efficiently. There will also have to be more differentiation between mild and serious psychiatric illnesses.<br/> METHOD: Review of academic articles and policy studies.<br/> RESULTS: With regard to the treatment of fairly common disorders, more attention needs to be given to integrated basic care and e-health...
2016: Tijdschrift Voor Psychiatrie
Anthony J Hatswell, Nick Freemantle, Gianluca Baio
BACKGROUND: Pharmaceuticals are usually granted a marketing authorisation on the basis of randomised controlled trials (RCTs). Occasionally the efficacy of a treatment is assessed without a randomised comparator group (either active or placebo). OBJECTIVE: To identify and develop a taxonomic account of economic modelling approaches for pharmaceuticals licensed without RCT data. METHODS: We searched PubMed, the websites of UK health technology assessment bodies and the International Society for Pharmacoeconomics and Outcomes Research Scientific Presentations Database for assessments of treatments granted a marketing authorisation by the US Food and Drug Administration or European Medicines Agency from January 1999 to May 2014 without RCT data (74 indications)...
October 24, 2016: PharmacoEconomics
Enas Mamdouh Hefzy, Ahmed Ashraf Wegdan, Radwa Ahmed Elhefny, Samar Hassan Nasser
Aim: Latent tuberculosis infections (LTBI) contain a significant reservoir for future epidemics. Screening of health care workers (HCWs) in a high-risk tuberculosis (TB) environment is an important strategy in TB control. The study aimed to assess the prevalence of LTBI among high risk Egyptian HCWs and to assess infection associated risk factors. Methods: Fifty-two HCWs who work at intensive care unit (ICU), bronchoscopy unit, and chest diseases department were tested for LTBI using both tuberculin skin test (TST) and Quantiferon TB Gold in-tube test (QFT)...
2016: GMS Hygiene and Infection Control
Jeremy Jost, Adeline Raharivelo, Voa Ratsimbazafy, Mandy Nizard, Emilie Auditeau, Charles R Newton, Pierre-Marie Preux
BACKGROUND: The prevalence of epilepsy is high in Madagascar (23.5/1000), as is the treatment gap (estimated at 92 %). The health system of the country is underfunded; some AEDs are used, and the national drug policy does not encourage price regulation or the administration of generic agents. We conducted a cross-sectional study to assess the availability and cost of solid oral AED formulations in Antananarivo, capital of Madagascar. Data were gathered from all officially registered pharmacies (according to the drug agency list, updated in 2015) by means of telephone interviews lasting no more than 10 min and conducted by a native Malagasy speaker...
2016: SpringerPlus
Daniel J Livorsi, Michihiko Goto, Margaret Carrel, Makoto M Jones, Jennifer McDanel, Rajeshwari Nair, Bruce Alexander, Brice Beck, Kelly K Richardson, Eli N Perencevich
OBJECTIVES: We sought to define regional variations in fluoroquinolone non-susceptibility (FQ-NS) among bloodstream isolates of Escherichia coli across the Veterans Health Administration (VHA) in the United States. METHODS: We analyzed a retrospective cohort of patients managed at 136 VHA hospitals who had a blood culture positive for E.coli between 2003 and 2013. Hospitals were classified based on US Census Divisions, and regional variations in FQ-NS were analyzed...
2016: Antimicrobial Resistance and Infection Control
Kate Brameld, Katrina Spilsbury, Lorna Rosenwax, Kevin Murray, James Semmens
BACKGROUND: Studies aiming to identify palliative care populations have used data from death certificates and in some cases hospital records. The size and characteristics of the identified populations can show considerable variation depending on the data sources used. It is important that service planners and researchers are aware of this. AIM: To illustrate the differences in the size and characteristics of a potential palliative care population depending on the differential use of linked hospital records and death certificate data...
October 24, 2016: Palliative Medicine
Stacy Cooper Bailey, Michael K Paasche-Orlow, William G Adams, Samantha A Brokenshire, Ryan P Hickson, Christine U Oramasionwu, Laura M Curtis, Mary J Kwasny, Michael S Wolf
BACKGROUND: Adverse drug events (ADEs) affect millions of patients annually and place a significant burden on the healthcare system. The Food and Drug Administration (FDA) has developed patient safety information for high-risk medications that pose serious public health concerns. However, there are currently few assurances that patients receive this information or are able to identify or respond correctly to ADEs. OBJECTIVE: To compare the effectiveness of the Electronic Medication Complete Communication (EMC(2)) Strategy to promote safe medication use and reporting of ADEs in comparison to usual care...
October 21, 2016: Contemporary Clinical Trials
Dušan Petrić, Tamaš Petrović, Ivana Hrnjaković Cvjetković, Marija Zgomba, Vesna Milošević, Gospava Lazić, Aleksandra Ignjatović Ćupina, Diana Lupulović, Sava Lazić, Dragan Dondur, Slavica Vaselek, Aleksandar Živulj, Bratislav Kisin, Tibor Molnar, Djordje Janku, Dubravka Pudar, Jelena Radovanov, Mihaela Kavran, Gordana Kovačević, Budimir Plavšić, Aleksandra Jovanović Galović, Milan Vidić, Svetlana Ilić, Mina Petrić
Efforts to detect West Nile virus (WNV) in the Vojvodina province, northern Serbia, commenced with human and mosquito surveillance in 2005, followed by horse (2009) and wild bird (2012) surveillance. The knowledge obtained regarding WNV circulation, combined with the need for timely detection of virus activity and risk assessment resulted in the implementation of a national surveillance programme integrating mosquito, horse and bird surveillance in 2014. From 2013, the system showed highly satisfactory results in terms of area specificity (the capacity to indicate the spatial distribution of the risk for human cases of West Nile neuroinvasive disease - WNND) and sensitivity to detect virus circulation even at the enzootic level...
October 21, 2016: Molecular and Cellular Probes
M Tortajada-Girbés, M Mesa Del Castillo, H Larramona, J M Lucas, M Álvaro, A I Tabar, M J Jerez, A Martínez-Cañavate
Allergic respiratory diseases are major health problems in paediatric population due their high level of prevalence and chronicity, and to their relevance in the costs and quality of life. One of the most important risk factors for the development of airway diseases in children and adolescents is atopy. The mainstays for the treatment of these diseases are avoiding allergens, controlling symptoms, and preventing them through sustained desensitization by allergen immunotherapy (AIT). AIT is a treatment option that consists in the administration of increasing amounts of allergens to modify the biological response to them, inducing long-term tolerance even after treatment has ended...
October 21, 2016: Allergologia et Immunopathologia
Don C Des Jarlais, Kamyar Arasteh, Jonathan Feelemyer, Courtney McKnight, David M Barnes, Susan Tross, David C Perlman, Aimee N C Campbell, Hannah L F Cooper, Holly Hagan
OBJECTIVES: Transitioning from injecting to non-injecting routes of drug administration can provide important individual and community health benefits. We assessed characteristics of persons who had ceased injecting while continuing to use heroin and/or cocaine in New York City. METHODS: We recruited subjects entering Mount Sinai Beth Israel detoxification and methadone maintenance programs between 2011 and 2015. Demographic information, drug use histories, sexual behaviors, and "reverse transitions" from injecting to non-injecting drug use were assessed in structured face-to-face interviews...
December 2016: Journal of Substance Abuse Treatment
Rubén Martín-Payo, Javier Suárez-Álvarez, María E Amieva Fernández, María J Duaso, Estela Álvarez Gómez
BACKGROUND: The aim of this study is to explore the psychometric properties of the Motiva.Diaf questionnaire, which assesses the adherence to healthy diet and physical activity in clinical patients. METHOD: Participants were 230 patients, who attended hospital services, with a mean age of 49.28 years (SD = 12.34). Women constituted 55.7% of the patients. Two weeks after initial administration, 40 participants, from those who had another hospital appointment scheduled, were selected at random to complete again the questionnaire in order to assess test–retest reliability...
November 2016: Psicothema
A Daftary, N Padayatchi
OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss...
November 2016: International Journal of Tuberculosis and Lung Disease
Dale Fisher, Paul Wicks, Zaheer-Ud-Din Babar
The development of new therapies has a rich history, evolves quickly with societal trends, and will have an exciting future. The last century has seen an exponential increase in complex interactions between medical practitioners, pharmaceutical companies, governments and patients. We believe technology and societal expectations will open up the opportunity for more individuals to participate as information becomes more freely available and inequality less acceptable. Corporations must recognize that usual market forces do not function ideally in a setting where health is regarded as a human right, and as modern consumers, patients will increasingly take control of their own data, wellbeing, and even the means of production for developing their own treatments...
October 25, 2016: BMC Medicine
P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
Cathy Joanna Jensen, Frauke Demol, Romy Bauwens, Ron Kooijman, Ann Massie, Agnès Villers, Laurence Ris, Jacques De Keyser
In vitro and in vivo studies suggest that the astrocytic adrenergic signalling enhances glycogenolysis which provides energy to be transported to nearby cells and in the form of lactate. This energy source is important for motor and cognitive functioning. While it is suspected that the β2-adrenergic receptor on astrocytes might contribute to this energy balance, it has not yet been shown conclusively in vivo. Inducible astrocyte specific β2-adrenergic receptor knock-out mice were generated by crossing homozygous β2-adrenergic receptor floxed mice (Adrb2flox) and mice with heterozygous tamoxifen-inducible Cre recombinase-expression driven by the astrocyte specific L-glutamate/L-aspartate transporter promoter (GLAST-CreERT2)...
2016: PloS One
Caleb Mpyet, Nasiru Muhammad, Mohammed Dantani Adamu, Habila Muazu, Murtala Mohammad Umar, Musa Goyol, Uwazoeke Onyebuchi, Ima Chima, Haliru Idris, Adamani William, Sunday Isiyaku, Benjamin Nwobi, Rebecca Mann Flueckiger, Rebecca Willis, Alexandre Pavluck, Brian K Chu, Nicholas Olobio, Anthony W Solomon
PURPOSE: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. METHODS: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation-follicular (TF), trachomatous inflammation-intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme...
October 24, 2016: Ophthalmic Epidemiology
Upendo J Mwingira, George Kabona, Mathias Kamugisha, Edward Kirumbi, Bernard Kilembe, Alistidia Simon, Andreas Nshala, Deogratias Damas, Alphonsina Nanai, Mwelecele Malecela, Maria Chikawe, Christina Mbise, Harran Mkocha, Patrick Massae, Humphrey R Mkali, Lisa Rotondo, Kathryn Crowley, Rebecca Willis, Anthony W Solomon, Jeremiah M Ngondi
PURPOSE: Following surveys in 2004-2006 in 50 high-risk districts of mainland Tanzania, trachoma was still suspected to be widespread elsewhere. We report on baseline surveys undertaken from 2012 to 2014. METHODS: A total of 31 districts were surveyed. In 2012 and 2013, 12 at-risk districts were selected based on proximity to known trachoma endemic districts, while in 2014, trachoma rapid assessments were undertaken, and 19 of 55 districts prioritized for baseline surveys...
October 24, 2016: Ophthalmic Epidemiology
Fatma J Omar, George Kabona, Khalfan M Abdalla, Saleh J Mohamed, Said M Ali, Shaali M Ame, Abel Ngwalle, Christina Mbise, Lisa Rotondo, Rebecca Willis, Rebecca M Flueckiger, Patrick A Massae, Ana Bakhtiari, Anthony W Solomon, Jeremiah M Ngondi
PURPOSE: Based on health care records and trachoma rapid assessments, trachoma was suspected to be endemic in Kaskazini A and Micheweni districts of Zanzibar. This study aimed to investigate the prevalence of trachomatous inflammation-follicular (TF), and trachomatous trichiasis (TT) in each of those districts. METHODS: The survey was undertaken in Kaskazini A and Micheweni districts on Unguja and Pemba Islands, respectively. A multi-stage cluster random sampling design was applied, whereby 25 census enumeration areas (clusters) and 30 households per cluster were included...
October 24, 2016: Ophthalmic Epidemiology
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