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https://www.readbyqxmd.com/read/27892723/optimization-and-stratification-of-multiple-sclerosis-treatment-in-fast-developing-economic-countries-a-perspective-from-qatar
#1
Dirk Deleu, Boulenouar Mesraoua, Hisham El Khider, Beatriz Canibano, Gayane Melikyan, Hassan Al Hail, Noha Mhjob, Anjushri Bhagat, Faiza Ibrahim, Yolande Hanssens
OBJECTIVE: The introduction of disease-modifying therapies (DMTs) - with varying degrees of efficacy for reducing annual relapse rate and disability progression - has considerably transformed the therapeutic landscape of relapsing-remitting multiple sclerosis (RRMS). We aim to develop rational evidence-based treatment recommendations and algorithms for the management of clinically isolated syndrome (CIS) and RRMS conform to the healthcare system in a fast-developing economic country such as Qatar...
November 28, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27874840/an-integrated-narrative-nursing-model-towards-a-new-healthcare-paradigm
#2
Giovanna Artioli, Chiara Foà, Chiara Taffurelli
In the traditional biomedical model of clinical practice, which assumes a medicine focused on disease, diseases are considered as biological or psycho-physiological universal entities. This explanation, although necessary, is not enough. Several authors have recently become interested in the use of narrative practices in the medical care setting, underlining the increasing importance of "a patient-centered approach", a "relationship -centered care" and "narrative medicine". Even in Nursing, the challenge was to combine two models that seemed incompatible: the Evidence-Based Nursing Model and the Narrative-Based Nursing Model...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27861259/tailored-perioperative-antimicrobial-prophylaxis-in-urological-surgery-myth-or-reality
#3
Magnus J Grabe, Karl-Johan Lundström
PURPOSE OF THE REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed...
November 24, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27842635/the-hospital-costs-associated-with-acute-paediatric-burn-injuries
#4
E W Ter Meulen, M J Poley, M Van Dijk, A D Rogers, H Rode
BACKGROUND: Ongoing rationing of healthcare threatens services that are well established, and cripples others that desperately require investment. Burn, for one, remains a neglected epidemic in South Africa (SA), despite the magnitude of the problem. OBJECTIVE: To identify the prominent components contributing to the cost of hospital admission with paediatric burn injury. Determining the true costs of specialist services is important, so that resources can be allocated appropriately to achieve the greatest possible impact...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27836999/quality-of-child-healthcare-at-primary-healthcare-facilities-a-national-assessment-of-the-integrated-management-of-childhood-illnesses-in-afghanistan
#5
Ghulam Farooq Mansoor, Paata Chikvaidze, Sherin Varkey, Ariel Higgins-Steele, Najibullah Safi, Adela Mubasher, Khaksar Yusufi, Sayed Alisha Alawi
OBJECTIVE: To assess quality of the national Integrated Management of Childhood Illness (IMCI) program services provided for sick children at primary health facilities in Afghanistan. DESIGN: Mixed methods including cross-sectional study. SETTING: Thirteen (of thirty-four) provinces in Afghanistan. PARTICIPANTS: Observation of case management and re-examination of 177 sick children, exit interviews with caretakers and review of equipment/supplies at 44 health facilities...
November 10, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27821181/geographic-distribution-of-hospital-beds-throughout-china-a-county-level-econometric-analysis
#6
Jay Pan, David Shallcross
BACKGROUND: Geographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns. METHODS: Using national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. We performed Gini coefficient analysis to measure inequalities and ordinary least squares regression with fixed provincial effects and additional spatial specifications to assess key determinants...
November 8, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27818327/an-educational-intervention-optimizes-the-utilization-of-arterial-blood-gases-across-intensive-care-units-from-different-specialties-a-quality-improvement-study
#7
Carlos D Martínez-Balzano, Paulo Oliveira, Michelle O'Rourke, Luanne Hills, Andrés F Sosa
BACKGROUND: Arterial blood gas (ABG) overutilization leads to increased costs, inefficient use of staff work-hours, patient discomfort and blood loss. We developed guidelines to optimize ABG utilization in the intensive care unit (ICU). METHODS: ABG utilization guidelines were implemented on all adult ICUs in our institution: three medical, two trauma-surgery, one cardiovascular and one neurosurgical ICU. While relying on pulse oximetry, we encouraged the utilization of ABGs after an acute respiratory event or for a rational clinical concern, and discouraged obtaining ABGs for routine surveillance, after planned changes of PEEP or FiO2 on the mechanical ventilator, for spontaneous breathing trials, or when a disorder was not suspected...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27813115/the-articulation-of-neoliberalism-narratives-of-experience-of-chronic-illness-management-in-bulgaria-and-the-uk
#8
Ivaylo Vassilev, Anne Rogers, Elka Todorova, Anne Kennedy, Poli Roukova
The shift from social democratic to a neoliberal consensus in modern welfare capitalist states is characterised by an emphasis on individual responsibility, consumer choice, market rationality and growing social inequalities. There has been little exploration of how neoliberalism has shaped the environment within which chronic illness is experienced and managed. This article explores the different articulations of neoliberalism manifest in the arena of personal illness management in Bulgaria and the UK. People with type 2 diabetes discussed their experiences in terms of struggling with diet, diabetes as a personal failure, integrating illness management and valued activities, and the trustworthiness of the healthcare system...
November 4, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27806588/source-modeling-for-monte-carlo-dose-calculation-of-ct-examinations-with-a-radiotherapy-treatment-planning-system
#9
Hans-Erik Källman, Rickard Holmberg, Jonas Andersson, Love Kull, Erik Tranéus, Anders Ahnesjö
PURPOSE: Radiation dose to patients undergoing examinations with Multislice Computed Tomography (MSCT) as well as Cone Beam Computed Tomography (CBCT) is a matter of concern. Risk management could benefit from efficient replace rational dose calculation tools. The paper aims to verify MSCT dose calculations using a Treatment Planning System (TPS) for radiotherapy and to evaluate four different variations of bow-tie filter characterizations for the beam model used in the dose calculations...
November 2016: Medical Physics
https://www.readbyqxmd.com/read/27793212/the-newfoundland-and-labrador-bariatric-surgery-cohort-study-rational-and-study-protocol
#10
Laurie K Twells, Deborah M Gregory, William K Midodzi, Carla Dillon, Christopher S Kovacs, Don MacDonald, Kendra K Lester, David Pace, Chris Smith, Darrell Boone, Raleen Murphy
BACKGROUND: In Canada, there has been a disproportionate increase in adults with Class II (BMI 35.0-39.9 kg/m(2)) or Class III obesity (BMI ≥ 40 kg/m(2)) affecting 9 % of Canadians with increases projected. Individuals affected by severe obesity (BMI ≥ 35) are at increased risk of high blood pressure, cardiovascular disease, diabetes, cancer, impaired quality of life, and premature mortality. Bariatric surgery is the most effective treatment for severe obesity. Laparoscopic sleeve gastrectomy (LSG), a relatively new type of bariatric surgery, is growing in popularity as a treatment...
October 28, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27780495/information-for-mental-health-systems-an-instrument-for-policy-making-and-system-service-quality
#11
A Lora, A Lesage, S Pathare, I Levav
AIMS: Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward...
October 26, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/27779725/nya-l%C3%A3-kemedel-kan-nomineras-f%C3%A3-r-introduktionsfinansiering-prioriteringen-bygger-p%C3%A3-medicinsk-och-vetenskaplig-v%C3%A3-rdering-%C3%A2-goda-erfarenheter-fr%C3%A3-n-process-i-v%C3%A3-stra-g%C3%A3-talandsregionen
#12
Susanna Wallerstedt
Medical and scientific assessments as the basis for prioritization and resource allocation for new drug treatment - experiences from five years of systematic workIn this study, the process for introduction of new drug treatment in Region Västra Götaland (second largest region in Sweden encompassing 1.6 million inhabitants, 17% of all inhabitants in Sweden) is described. A working group, consisting of persons with relevant expertise and declared conflicts of interest, contributes with medical and scientific assessments as the basis for prioritization and resource allocation...
October 18, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27771612/oncology-drug-costs-the-imaginary-crisis
#13
R Turck
Complaints about cancer drug costs are manifold. While there is excess in some cases and a significant financial burden for patients it appears that the outrage is not always well informed. In recent years innovative cancer drugs have improved patient' survival while better maintaining quality of life. Cancer drug costs represent less than 1% of overall healthcare costs, yet it is estimated that 83% of increased cancer survival can be attributed to new treatments. The challenge is to provide those cancer drugs that best address a patient's needs in the most cost-effective manner...
October 22, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27752299/why-do-we-need-pharmacists-in-pharmacovigilance-systems
#14
(no author information available yet)
Pharmacovigilance is the science and activity relating to the collection, detection, assessment, monitoring, and prevention of adverse effects with pharmaceutical products. Pharmacovigilance basically targets safety of medicine. Pharmacists have crucial role in health systems to maintain the rational and safe use of medicine for they are drug experts who are specifically trained in this field. Effective use of pharmacists' workforce will improve the outcome of the pharmacotherapy as well as decrease global health costs...
2016: Online Journal of Public Health Informatics
https://www.readbyqxmd.com/read/27747832/general-practitioners-prescribing-patterns-at-primary-healthcare-centers-in-national-health-insurance-gezira-sudan
#15
Bashir Mohamed Elmahi Yousif, Siripen Supakankunti
BACKGROUND: The appropriate use of medicines is essential for the provision of quality health services, patient safety, and the rational use of health resources. In Sudan, general practitioners (GPs) provide 80 % of insured patients' health services. Pharmaceutical service costs have been increasing since 2010. OBJECTIVES: We aimed to use the World Health Organization (WHO) and International Network for the Rational Use of Drugs prescribing indicators to assess prescription quality among GPs in different types of primary healthcare centers (PHCCs) within the National Health Insurance Fund (NHIF) in Gezira State, Sudan...
September 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27733437/rationing-conscience
#16
Dominic Wilkinson
Decisions about allocation of limited healthcare resources are frequently controversial. These decisions are usually based on careful analysis of medical, scientific and health economic evidence. Yet, decisions are also necessarily based on value judgements. There may be differing views among health professionals about how to allocate resources or how to evaluate existing evidence. In specific cases, professionals may have strong personal views (contrary to professional or societal norms) that treatment should or should not be provided...
October 12, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27707891/employing-imaginative-rationality-using-metaphor-when-discussing-death
#17
Rebecca Llewellyn, Chrystal Jaye, Richard Egan, Wayne Cunningham, Jessica Young, Peter Radue
The prevalence of metaphors in medicine is widely acknowledged. In a qualitative study exploring expectations of longevity, we observed repeated recourse to the imaginative rationality provided by metaphors to express perspectives on longevity and death. Bafflement, acceptance, uncertainty and distress were conveyed through metaphors, providing valuable insight into the internal healthcare frameworks of participants. Skilful use of imaginative rationality in the healthcare setting may illuminate the elusive and often eschewed topic of death in a way that fosters clarity and new understandings, and pave the way towards a better life, and death for patients...
October 5, 2016: Medical Humanities
https://www.readbyqxmd.com/read/27690694/complications-of-invasive-mycoses-in-organ-transplant-recipients
#18
Palash Samanta, Nina Singh
Opportunistic mycoses remain a significant complication in organ recipients. Areas covered: This review is an evidence-based presentation of current state-of-knowledge and our perspective on recent developments in the field Expert commentary: Invasive fungal infections are associated with reduced allograft and patient survival, increase in healthcare resource utilization, and newly appreciated but largely unrecognized immunologic sequelae, such as immune reconstitution syndrome. Given adverse outcomes associated with established infections, prophylaxis is a widely used strategy for the prevention of these infections...
October 3, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27688887/assessment-of-who-inrud-core-drug-use-indicators-in-two-tertiary-care-hospitals-of-bahawalpur-punjab-pakistan
#19
Muhammad Atif, Muhammad Rehan Sarwar, Muhammad Azeem, Danial Umer, Abdul Rauf, Arslan Rasool, Muhammad Ahsan, Shane Scahill
BACKGROUND: Medicines are a main therapeutic intervention provided within hospitals and their proper use in the outpatient setting is important for patients and the community. The objective of this study was to evaluate drug use patterns in the outpatient departments (OPDs) of two tertiary care hospitals (Bahawal Victoria Hospital and Civil Hospital) in the Bahawalpur district of the Punjab province of Pakistan by employing the standard World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators...
2016: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/27686020/cardiac-pacing-and-defibrillation-devices-cost-and-effectiveness
#20
Peter W Groeneveld, Sanjay Dixit
Implantable cardiac pacing and defibrillation devices are effective and commonly used therapies for patients with cardiac rhythm disorders. Because device implantation is not easily reversible, as well as the high healthcare costs inherent in device use, a clear understanding of the clinical benefits relative to costs is essential for both appropriate clinical use and rational policy making. Cardiac implantable electronic devices (CIEDs) have been among the best-investigated therapies in medicine; these devices have been the topic of numerous clinical and economic evaluations during the past 30 years...
September 21, 2016: Annual Review of Medicine
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