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https://www.readbyqxmd.com/read/29667952/useful-pharmacodynamic-endpoints-in-children-selection-measurement-and-next-steps
#1
REVIEW
Lauren E Kelly, Yashwant Sinha, Charlotte I S Barker, Joseph F Standing, Martin Offringa
Pharmacodynamic (PD) endpoints are essential for establishing the benefit-to-risk ratio for therapeutic interventions in children and neonates. This article discusses the selection of an appropriate measure of response, the PD endpoint, which is a critical methodological step in designing pediatric efficacy and safety studies. We provide an overview of existing guidance on the choice of PD endpoints in pediatric clinical research. We identified several considerations relevant to the selection and measurement of PD endpoints in pediatric clinical trials, including the use of biomarkers, modeling, compliance, scoring systems, and validated measurement tools...
April 18, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29666504/no-prophylactic-antibiotic-use-for-young-children-s-intussusception-with-low-risk-infection-after-successful-air-enema-reduction
#2
Yuan Zhang, Wen Zou, Lemeng Ren, Yinghui Zhang, Zhaohui Sun, Huandi Liu, Qian Liu, Chunfeng Si, Hongying Jia
The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013...
April 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29665724/the-promise-of-complementarity-using-the-methods-of-foresight-for-health-workforce-planning
#3
Gareth H Rees, Peter Crampton, Robin Gauld, Stephen MacDonell
Health workforce planning aims to meet a health system's needs with a sustainable and fit-for-purpose workforce, although its efficacy is reduced in conditions of uncertainty. This PhD breakthrough article offers foresight as a means of addressing this uncertainty and models its complementarity in the context of the health workforce planning problem. The article summarises the findings of a two-case multi-phase mixed method study that incorporates actor analysis, scenario development and policy Delphi. This reveals a few dominant actors of considerable influence who are in conflict over a few critical workforce issues...
January 1, 2018: Health Services Management Research
https://www.readbyqxmd.com/read/29665716/prevalence-of-physical-inactivity-and-associated-factors-among-older-caregivers-of-older-adults
#4
Grace Angélica de Oliveira Gomes, Bruna Moretti Luchesi, Aline Cristina Martins Gratão, Fabiana de Souza Orlandi, Karina Gramani Say, Keika Inouye, Tiago da Silva Alexandre, Allan Gustavo Brigola, Sofia Cristina Iost Pavarini
OBJECTIVE: The aim of this study is to analyze the prevalence of physical inactivity (PI) and associated factors in older caregivers of older adults. METHOD: A cross-sectional study was conducted including 312 older caregivers. Sociodemographic, clinical, and care-related characteristics were considered the independent variables for the determination of associated factors with PI in the logistic regression model. RESULTS: The prevalence of PI was 75...
April 1, 2018: Journal of Aging and Health
https://www.readbyqxmd.com/read/29665558/prevalence-of-clostridium-difficile-infection-in-hospitalized-patients-with-diarrhoea-results-of-a-polish-multicenter-prospective-biannual-point-prevalence-study
#5
Hanna Pituch, Piotr Obuch-Woszczatyński, Dominika Lachowicz, Robert Kuthan, Katarzyna Dzierżanowska-Fangrat, Agnieszka Mikucka, Katarzyna Jermakow, Aleksandra Pituch-Zdanowska, Kerrie Davies
PURPOSE: We aimed to measure the underdiagnosis of Clostridium difficile infection across Poland and the distribution of PCR-ribotypes of C. difficile. MATERIAL AND METHODS: Twenty seven Polish healthcare facilities (HCFs) participated in this prospective study. Each HCF systematically sent all diarrhoeal stools received from inpatients at their laboratories on two days (one in January 2013 and one in July 2013), independently of CDI test request, to the National Coordinating Laboratory (NCL) for standardized testing of CDI...
April 13, 2018: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#6
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29665053/the-determinants-of-the-technical-efficiency-of-acute-inpatient-care-in-canada
#7
Li Wang, Michel Grignon, Sheril Perry, Xi-Kuan Chen, Alison Ytsma, Sara Allin, Katerina Gapanenko
OBJECTIVE: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. DATA SOURCES/STUDY SETTING: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. STUDY DESIGN: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only)...
April 17, 2018: Health Services Research
https://www.readbyqxmd.com/read/29664951/universal-versus-conditional-day-3-follow-up-for-children-with-non-severe-unclassified-fever-at-the-community-level-in-the-democratic-republic-of-the-congo-a-cluster-randomized-community-based-non-inferiority-trial
#8
Luke C Mullany, Elburg W van Boetzelaer, Julie R Gutman, Laura C Steinhardt, Pascal Ngoy, Yolanda Barbera Lainez, Alison Wittcoff, Steven A Harvey, Lara S Ho
BACKGROUND: The World Health Organization's integrated community case management (iCCM) guidelines recommend that all children presenting with uncomplicated fever and no danger signs return for follow-up on day 3 following the initial consultation on day 1. Such fevers often resolve rapidly, however, and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aimed to determine if a conditional follow-up visit was non-inferior to a universal follow-up visit for these children...
April 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29663658/understanding-consumers-initial-expectations-of-community-based-residential-mental-health-rehabilitation-in-the-context-of-past-experiences-of-care-a-mixed-methods-pragmatic-grounded-theory-analysis
#9
Stephen Parker, Carla Meurk, Ellie Newman, Clayton Fletcher, Isabella Swinson, Frances Dark
This study explores how consumers expect community-based residential mental health rehabilitation to compare with previous experiences of care. Understanding what consumers hope to receive from mental health services, and listening to their perspectives about what has and has not worked in previous care settings, may illuminate pathways to improved service engagement and outcomes. A mixed-methods research design taking a pragmatic approach to grounded theory guided the analysis of 24 semi-structured interviews with consumers on commencement at three Community Care Units (CCUs) in Australia...
April 16, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29663452/seroprevalence-and-risk-factors-of-hepatitis-e-virus-infection-among-pregnant-women-attending-antenatal-care-in-health-facilities-of-tigray-northern-ethiopia
#10
Selam Niguse, Haftamu Hailekiros, Gerezgiher Buruh, Tadese Dejene, Nega Berhe, Tsehaye Asmelash
Existing literatures from developing countries show an increased mortality and morbidity related to hepatitis E virus during pregnancy as compared to the general population. Studies focusing on pregnant women are required for policy makers to improve maternal and child health. Therefore this study is aimed at determining the prevalence and associated risk factors of hepatitis E virus infection among pregnant women attending the health facilities of Tigray region, Northern Ethiopia. In this cross sectional study 846 pregnant women were included consecutively from April 2014 to February 2016...
April 16, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29662299/clinical-characteristics-and-causes-of-visual-impairment-in-a-low-vision-clinic-in-northern-jordan
#11
May M Bakkar, Eman A Alzghoul, Mera F Haddad
Aim: The aim of the study was to identify causes of visual impairment among patients attending a low vision clinic in the north of Jordan and to study the relevant demographic characteristics of these patients. Subjects and methods: The retrospective study was conducted through a review of clinical records of 135 patients who attended a low vision clinic in Irbid. Clinical characteristics of the patients were collected, including age, gender, primary cause of low vision, best corrected visual acuity, and current prescribed low vision aids...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29661914/trends-geographical-variation-and-factors-associated-with-prescribing-of-gluten-free-foods-in-english-primary-care-a-cross-sectional-study
#12
Alex J Walker, Helen J Curtis, Seb Bacon, Richard Croker, Ben Goldacre
OBJECTIVES: There is substantial disagreement about whether gluten-free foods should be prescribed on the National Health Service. We aim to describe time trends, variation and factors associated with prescribing gluten-free foods in England. SETTING: English primary care. PARTICIPANTS: English general practices. PRIMARY AND SECONDARY OUTCOME MEASURES: We described long-term national trends in gluten-free prescribing, and practice and Clinical Commissioning Group (CCG) level monthly variation in the rate of gluten-free prescribing (per 1000 patients) over time...
April 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29661853/towards-prevention-of-breast-cancer-what-are-the-clinical-challenges
#13
Signe Borgquist, Per Hall, Isaac Lipkus, Judy E Garber
The dramatic increase in breast cancer incidence compels a paradigm shift in our preventive efforts. There are several barriers to overcome before prevention becomes an established part of breast cancer management. The objective of this review is to identify the clinical challenges for improved breast cancer prevention and discuss current knowledge on breast cancer risk assessment methods, risk communication, ethics, and interventional efforts with the aim of covering the aspects relevant for a breast cancer prevention trial...
April 16, 2018: Cancer Prevention Research
https://www.readbyqxmd.com/read/29661541/ckd-and-esrd-in-us-hispanics
#14
REVIEW
Nisa Desai, Claudia M Lora, James P Lash, Ana C Ricardo
Hispanics are the largest racial/ethnic minority group in the United States, and they experience a substantial burden of kidney disease. Although the prevalence of chronic kidney disease (CKD) is similar or slightly lower in Hispanics than non-Hispanic whites, the age- and sex-adjusted prevalence rate of end-stage renal disease is almost 50% higher in Hispanics compared with non-Hispanic whites. This has been attributed in part to faster CKD progression among Hispanics. Furthermore, Hispanic ethnicity has been associated with a greater prevalence of cardiovascular disease risk factors, including obesity and diabetes, as well as CKD-related complications...
April 13, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29661363/the-effect-of-commercial-insurance-policies-on-outcomes-of-venous-ablation
#15
Cassius Iyad Ochoa Chaar, Afsha Aurshina, Yawei Zhang, Fang Wang, Jonathan Cardella, Kristine Orion, Bauer Sumpio, Timur Sarac
OBJECTIVE: The use of venous ablation (VA) for treatment of chronic venous insufficiency has exponentially increased. To limit cost and overuse, insurance companies have adopted aleatory policies. The goal of this study was to compare the policies of five major local insurance carriers and to determine whether treatment within the criteria of a certain policy is associated with improved patient outcomes. METHODS: A retrospective single-center review of patients treated with VA was performed...
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29661247/informing-implementation-of-quality-improvement-in-australian-primary-care
#16
Charlotte Hespe, Lucie Rychetnik, David Peiris, Mark Harris
BACKGROUND: Quality Improvement (QI) initiatives in primary care are effective at improving uptake of evidence based guidelines, but are difficult to implement and sustain. In Australia meso-level health organisations such as Primary health care Organisations (PHCO) offer new opportunities to implement area-wide QI programs. This study sought to identify enablers and barriers to implementation of an existing Australian QI program and to identify strategic directions that PHCOs can use in the ongoing development of QI in this environment...
April 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29661168/working-to-improve-the-management-of-sarcoma-patients-across-europe-a-policy-checklist
#17
Bernd Kasper, Estelle Lecointe-Artzner, Suzanne Wait, Shannon Boldon, Roger Wilson, Alessandro Gronchi, Claudia Valverde, Mikael Eriksson, Sarah Dumont, Nora Drove, Athanasia Kanli, Markus Wartenberg
BACKGROUND: The Sarcoma Policy Checklist was created by a multidisciplinary expert group to provide policymakers with priority areas to improve care for sarcoma patients. MAIN BODY: This paper draws on this research, by looking more closely at how France, Germany, Italy, Spain, Sweden and the United Kingdom are addressing each of these priority areas. It aims to highlight key gaps in research, policy and practice, as well as ongoing initiatives that may impact the future care of sarcoma patients in different European countries...
April 16, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29659793/good-practices-and-challenges-in-addressing-poliomyelitis-and-measles-in-the-european-union
#18
John Kinsman, Svenja Stöven, Fredrik Elgh, Pilar Murillo, Michael Sulzner
Background: All European Union (EU) and European Economic Area (EEA) Member States have pledged to ensure political commitment towards sustaining the region's poliomyelitis-free status and eliminating measles. However, there remain significant gaps between policy and practice in many countries. This article reports on an assessment conducted for the European Commission that aimed to support improvements in preparedness and response to poliomyelitis and measles in Europe. Methods: A documentary review was complemented by qualitative interviews with professionals working in International and EU agencies, and in at-risk or recently affected EU/EEA Member States (six each for poliomyelitis and measles)...
April 6, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29659476/prospective-evaluation-of-low-health-literacy-and-its-impact-on-outcomes-in-trauma-patients
#19
Tianyi Swartz, Faisal Jehan, Andrew Tang, Lynn Gries, Muhammad Zeeshan, Narong Kulvatunyou, Mohammad Hamidi, Terence O'Keeffe, Bellal Joseph
INTRODUCTION: Health-literacy is emerging focus of interest in public health and is evolving as an important component of national health policy. Low-health-literacy (LHL) is associated with poor outcomes. We aimed to identify factors associated with LHL and its relationship with health outcomes in trauma patients. METHODS: We prospectively enrolled all adult trauma patients (age>18y) in our analysis. Patients were surveyed at discharge and followed up at 4-weeks post-discharge...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29658846/tobacco-free-policies-and-tobacco-cessation-systems-at-health-centers-serving-lesbian-gay-bisexual-and-transgender-clients
#20
Joseph G L Lee, Megan E DeMarco, Matthew R Beymer, Chelsea L Shover, Robert K Bolan
PURPOSE: LGBT populations have high rates of tobacco use. Health centers serving LGBT clients are an important source of care. The researchers aimed to assess the implementation of recommended systems-level tobacco cessation interventions at these health centers. METHODS: Using systematic searching, directories, and expert review, we identified health centers serving LGBT clients that provide primary care. We conducted phone-based, semi-structured interviews with administrators (n = 11) between September 2016 and March 2017 regarding implementation of the Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update (the Guideline)...
April 16, 2018: LGBT Health
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