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Organisational effectiveness

A R Giuliani, A Mattei, A Appetiti, D Pompei, F Di Donna, F Fiasca, L Fabiani
When the meningococcus B vaccine was introduced into Italy in 2017, it was recommended for newborns based on national epidemiological data indicating that they were at greater risk. However, the vaccination service of the local health authority of L'Aquila had already been receiving spontaneous parental requests to provide vaccination for children in lower-risk age groups from the beginning of 2016. We therefore decided to use a self-administered questionnaire in order to investigate the parents' socio-demographic data; their children's history of other recommended vaccinations (against measles, mumps and rubella, varicella, meningococcus C and, for females, human papilloma virus); the information sources concerning meningococcal vaccination; and the timing of its administration...
June 21, 2018: Human Vaccines & Immunotherapeutics
Dimitri Van de Perre, Ivo Roessink, Colin R Janssen, Erik Smolders, Frederik De Laender, Paul J Van den Brink, Karel A C De Schamphelaere
Ecotoxicological studies mainly consist of single-species experiments evaluating the effects of a single stressor. However, under natural conditions aquatic communities are exposed to a mixture of stressors. This study was set up to identify how the toxicity of zinc (Zn) is affected by increased temperature (T) and increased phosphorus supply (P) and how these interactions vary among species, functional groups, community structure and function. Aquatic microcosms were subjected to three Zn concentrations (background: no Zn added; 75 µg Zn/L and 300 µg Zn/L), two temperatures (16-19 °C and 21-24 °C) and 2 different P additions (low: 0...
June 21, 2018: Environmental Toxicology and Chemistry
Emily Shepherd, Rehana A Salam, Philippa Middleton, Shanshan Han, Maria Makrides, Sarah McIntyre, Nadia Badawi, Caroline A Crowther
BACKGROUND: Cerebral palsy is an umbrella term that encompasses disorders of movement and posture attributed to non-progressive disturbances occurring in the developing foetal or infant brain. As there are diverse risk factors and aetiologies, no one strategy will prevent cerebral palsy. Therefore, there is a need to systematically consider all potentially relevant interventions for prevention. OBJECTIVES: PrimaryTo summarise the evidence from Cochrane Systematic Reviews regarding effects of neonatal interventions for preventing cerebral palsy (reducing cerebral palsy risk)...
June 20, 2018: Cochrane Database of Systematic Reviews
Oskar Mittag, Toomas Kotkas, Christina Reese, Hanna Kampling, Henning Groskreutz, Wouter de Boer, Felix Welti
OBJECTIVES: Working age disability is a major challenge for policymakers in European countries. This pertains to both occupational reintegration and social benefits for work incapacity. In many states reforms have been initiated aimed at reducing disability scheme inflow and fostering return to work. Our study was motivated by the question as to which aspects of these reforms seem to have been effective. METHODS: Three different approaches were utilized: case vignettes, interviews and expert workshops in the respective countries (Netherlands and Germany in 2012; Finland in 2015), and a systematic search for relevant studies on occupational reintegration was performed...
June 20, 2018: International Journal of Public Health
Andrea Sarrica, Natalja Kirika, Margherita Romeo, Mario Salmona, Luisa Diomede
Magnolia officinalis and Magnolia obovata bark extracts have been used for thousands of years in Chinese and Japanese traditional medicines and are still widely employed as herbal preparations for their sedative, antioxidant, anti-inflammatory, antibiotic, and antispastic effects. Neolignans, particularly magnolol and honokiol, are the main substances responsible for the beneficial properties of the magnolia bark extract (MBE). The content of magnolol and honokiol in MBE depends on different factors, including the Magnolia plant species, the area of origin, the part of the plant employed, and the method used to prepare the extract...
June 20, 2018: Planta Medica
Jane Lloyd, Louise Thomas, Gawaine Powell-Davies, Regina Osten, Mark Harris
Definitions of health literacy have tended to focus on the abilities of patients and communities, rather than on the ability of the health system and its services to respond to patients' different levels of health literacy. However, health literacy is increasingly being recognised as part of a dynamic, two-way relationship, affected by both organisational factors (e.g. tailoring of communication and care to patients' needs) and community factors (e.g. individuals' ability to perceive and seek care). Developing a more comprehensive understanding of health literacy is an important step towards improving health literacy...
June 14, 2018: Public Health Research & Practice
Mary Halter, Carly Wheeler, Ferruccio Pelone, Heather Gage, Simon de Lusignan, Jim Parle, Robert Grant, Jonathan Gabe, Laura Nice, Vari M Drennan
OBJECTIVE: To appraise and synthesise research on the impact of physician assistants/associates (PA) in secondary care, specifically acute internal medicine, care of the elderly, emergency medicine, trauma and orthopaedics, and mental health. DESIGN: Systematic review. SETTING: Electronic databases (Medline, Embase, ASSIA, CINAHL, SCOPUS, PsycINFO, Social Policy and Practice, EconLit and Cochrane), reference lists and related articles. INCLUDED ARTICLES: Peer-reviewed articles of any study design, published in English, 1995-2017...
June 19, 2018: BMJ Open
Natsuka Tohmiya, Etsuko Tadaka, Azusa Arimoto
OBJECTIVE: Stress has major socioeconomic implications for all spheres of employment. It is a trigger for depression, and affects absenteeism, turnover, productivity, morale and suicide. Positive or negative cognitive stress appraisal can be a self-care strategy that affects workers' ability to cope with stress. This study examined cognitive stress appraisal among workers and identified related individual and environmental factors. DESIGN: Cross-sectional study using self-administered postal questionnaires...
June 19, 2018: BMJ Open
José M Quintana, Ane Antón-Ladisla, Nerea González, Santiago Lázaro, Marisa Baré, Nerea Fernández de Larrea, Maximino Redondo, Eduardo Briones, Antonio Escobar, Cristina Sarasqueta, Susana García-Gutierrez
OBJECTIVE: There is limited information on health service use or patient-reported outcomes when comparing the effectiveness of laparoscopic with that of open surgery. The aim was to compare the effectiveness of laparoscopic with that of open surgery up to 2 years after intervention in patients with colon cancer. METHODS: Prospective cohort study of patients with colon cancer who underwent surgery (laparoscopic or open surgery) between June 2010 and December 2012, at 22 hospitals...
June 6, 2018: European Journal of Surgical Oncology
Rebecca Elvey, Simon Bailey, Kath Checkland, Anne McBride, Stephen Parkin, Katy Rothwell, Damian Hodgson
BACKGROUND: Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additional availability' appointments during evenings and at weekends. In Greater Manchester, six 'demonstrator sites' were funded: four sites delivered additional availability appointments, other services included case management and rapid response...
June 19, 2018: BMC Family Practice
Ian J Saldanha, Oluwaseun Akinyede, Karen A Robinson
BACKGROUND: For people with cystic fibrosis and advanced pulmonary damage, lung transplantation is an available and viable option. However, graft rejection is an important potential consequence after lung transplantation. Immunosuppressive therapy is needed to prevent episodes of graft rejection and thus subsequently reduce morbidity and mortality in this population. There are a number of classes of immunosuppressive drugs which act on different components of the immune system. There is considerable variability in the use of immunosuppressive agents after lung transplantation in cystic fibrosis...
June 18, 2018: Cochrane Database of Systematic Reviews
Claire Kelly, Marinos Pericleous, Jane Hendy, Simon de Lusignan, Ayesha Ahmed, Tushna Vandrevala, Aftab Ala
BACKGROUND: Screening programmes are well established in cancer, and are now being implemented in other conditions. An effective screening programme leads to early disease detection and improved outcomes but its impact is dependent on the quality of the test and the proportion of the target population participating. A further consideration is that uptake of screening by minority groups is low. PURPOSE: To determine which interventions have successfully increased screening uptake amongst minorities...
June 19, 2018: International Journal of Clinical Practice
Pauline Occelli, Jean-Luc Quenon, Marion Kret, Sandrine Domecq, Angélique Denis, Florence Delaperche, Olivier Claverie, Benjamin Castets-Fontaine, René Amalberti, Yves Auroy, Pierre Parneix, Philippe Michel
Objective: To assess the impact of a vignette-based analysis of adverse events (AEs) on the safety climate (SC) of care units. Design: Prospective, open, cluster (a unit) randomised controlled trial. Setting: Eighteen acute care units of seven hospitals in France. Participants: Healthcare providers who worked in the units. Intervention: Vignette-based analyses of AEs were conducted with unit's providers once per month for six consecutive months...
June 18, 2018: International Journal for Quality in Health Care
Carlo Lancia, Cristian Spitoni, Jakob Anninga, Jeremy Whelan, Matthew R Sydes, Gordana Jovic, Marta Fiocco
Marginal structural models are causal models designed to adjust for time-dependent confounders in observational studies with dynamically adjusted treatments. They are robust tools to assess causality in complex longitudinal data. In this paper, a marginal structural model is proposed with an innovative dose-delay joint-exposure model for Inverse-Probability-of-Treatment Weighted estimation of the causal effect of alterations to the therapy intensity. The model is motivated by a precise clinical question concerning the possibility of reducing dosages in a regimen...
January 1, 2018: Statistical Methods in Medical Research
Elena Ioana Iconaru, Luminita Georgescu, Constantin Ciucurel
OBJECTIVE: According to Golden ratio (GR) and Fibonacci sequence, models of the organisation of various structures can be encountered in biology, medicine, architecture and engineering. Recent studies indicate that GR can be highlighted in the organisation and physiological functioning of the cardiovascular system. The aim of this study was to investigate the cardiovascular homeostasis during rest and exercise testing by determining the GR validity at the dynamic level of systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) values...
June 18, 2018: Acta Cardiologica
Waqar Hussain, Iqra Qaddir, Sajid Mahmood, Nouman Rasool
Dengue fever is one of the most prevalent disease in tropical and sub-tropical regions of the world. According to the World Health Organisation (WHO), approximately 3.5 billion people have been affected with dengue fever. Four serotypes of dengue virus (DENV) i.e. DENV1, DENV2, DENV3 and DENV4 have up to 65% genetic variations among themselves. dengue virus 4 (DENV4) was first reported from Amazonas, Brazil and is spreading perilously due to lack of awareness of preventive measures, as it is the least targeted serotype...
June 2018: Virusdisease
Astrid Christine Erber, Byron Arana, Issam Bennis, Afif Ben Salah, Aicha Boukthir, Maria Del Mar Castro Noriega, Mamoudou Cissé, Gláucia Fernandes Cota, Farhad Handjani, Mairie Guizaw Kebede, Trudie Lang, Liliana López Carvajal, Kevin Marsh, Dalila Martinez Medina, Emma Plugge, Piero Olliaro
INTRODUCTION: Lack of investments in drug development, lack of standardisation of clinical trials and the complexity of disease presentations contribute to the current lack of effective, safe and adapted treatments for cutaneous leishmaniasis (CL). One aspect concerns outcomes affecting patients' quality of life (QoL): these are hardly assessed in trials, despite potential functional and/or aesthetic impairment caused by CL, which typically affects disadvantaged and vulnerable people living in rural areas...
June 15, 2018: BMJ Open
Betty-Shannon Prevatt, Evan M Lowder, Sarah L Desmarais
OBJECTIVE: Postpartum mood disorders represent a serious problem affecting 10-20% of women and support groups offer a promising intervention modality. The current study examined participant satisfaction with and effectiveness of a peer-facilitated postpartum support group. INTERVENTION: The program consists of a free, peer-support group, developed to increase social support and destigmatise postpartum mood symptoms. The weekly group is co-facilitated by former group attendees and maternal health professionals...
May 31, 2018: Midwifery
Mehmet U Bikkul, Craig S Clements, Lauren S Godwin, Martin W Goldberg, Ian R Kill, Joanna M Bridger
Hutchinson-Gilford progeria syndrome (HGPS) is a rare and fatal premature ageing disease in children. HGPS is one of several progeroid syndromes caused by mutations in the LMNA gene encoding the nuclear structural proteins lamins A and C. In classic HGPS the mutation G608G leads to the formation of a toxic lamin A protein called progerin. During post-translational processing progerin remains farnesylated owing to the mutation interfering with a step whereby the farnesyl moiety is removed by the enzyme ZMPSTE24...
June 15, 2018: Biogerontology
Federica Lucivero, Karin R Jongsma
Mobile health (mHealth) is rapidly being implemented and changing our ways of doing, understanding and organising healthcare. mHealth includes wearable devices as well as apps that track fitness, offer wellness programmes or provide tools to manage chronic conditions. According to industry and policy makers, these systems offer efficient and cost-effective solutions for disease prevention and self-management. While this development raises many ethically relevant questions, so far mHealth has received only little attention in medical ethics...
June 15, 2018: Journal of Medical Ethics
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