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Zakaria Aboulbanine, Naïma El Khayati
The use of phase space in medical linear accelerator Monte Carlo (MC) simulations significantly improves the execution time and leads to results comparable to those obtained from full calculations. The classical representation of phase space stores directly the information of millions of particles, producing bulky files. This paper presents a virtual source model (VSM) based on a reconstruction algorithm, taking as input a compressed file of roughly 800 kb derived from phase space data freely available in the International Atomic Energy Agency (IAEA) database...
March 19, 2018: Physics in Medicine and Biology
Victoria Shelus, Nicki Ashcroft, Sarah Burgess, Monica Giuffrida, Victoria Jennings
CONTEXT: Given the proportion of Kenyan women not using hormonal contraceptives, the country appears to have a substantial need for a modern, natural family planning option. The CycleBeads® mobile phone application (app), a digital platform for the Standard Days Method® of family planning, could help address this issue. METHODS: After the CycleBeads app was promoted in Kenya in May-June 2015, a three-month pilot study was conducted to collect quantitative and qualitative data from 185 female app users...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Julie H Hernandez, Mbadu Muanda, Mélissa Garcia, Grace Matawa
CONTEXT: Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. METHODS: Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Tiziana Leone, Diego Alburez-Gutierrez, Rula Gandour, Ernestina Coast, Rita Giacaman
BACKGROUND: Armed conflicts can undermine a country's health-care capacity and disrupt the delivery of basic health services. Yet the public health consequences of war remain difficult to quantify, mainly because adequate data do not exist. We hypothesised that the ongoing conflict in the occupied Palestinian territory (including the restrictions on free movement and the strain on health-care services) have had detrimental effects on maternal and child health outcomes. METHODS: We reconstructed data on delivery by caesarean section and diphtheria, pertussis, and tetanus vaccination with pooled data from Demographic and Health Surveys for 2000-14...
February 21, 2018: Lancet
Majed Hababeh, Wafaa Zeidan, Mariam Abdel El-Kader, Anwar Al Thaher, Nimer Kassim, Elias Habash, Hasan Arab, Ali Khader, Akihiro Seita
BACKGROUND: UNRWA introduced family planning services in 1994 as an integral part of its expanded maternal and child health-care programme. The main objective of UNRWA's family planning programme is to promote the health of mothers, children, and their families. The aim of this follow-up study was to assess contraceptive practices in the target population 5 years after the 2010 follow-up study and to identify future programme needs. METHODS: This cross-sectional survey was a done by trained nurses from June 1 to Dec 31, 2015...
February 21, 2018: Lancet
Denise D Quigley, Amelia M Haviland, Jacob W Dembosky, David J Klein, Marc N Elliott
OBJECTIVES: To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. STUDY DESIGN: Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. METHODS: Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics...
March 1, 2018: American Journal of Managed Care
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen
OBJECTIVES: A substantial portion of healthcare spending is wasted on services that do not directly improve patient health and that cause harm in some cases. Features of health insurance coverage, including enrollment in high-deductible health plans (HDHPs) or health maintenance organizations (HMOs), may provide financial and nonfinancial mechanisms to potentially reduce overuse of low-value healthcare services. STUDY DESIGN: Using 2009 to 2013 administrative data from 3 large commercial insurers, we examined patient characteristics and health insurance plan types associated with overuse of 6 healthcare services identified by the Choosing Wisely campaign...
March 2018: American Journal of Managed Care
Michael S McLachlan, Emma Undeman, Fangyuan Zhao, Matthew MacLeod
Predicting human exposure to an environmental contaminant based on its emissions is one of the great challenges of environmental chemistry. It has been done successfully on a local or regional scale for some persistent organic pollutants. Here we assess whether it can be done at a global scale, using PCB 153 as a test chemical. The global multimedia fate model BETR Global and the human exposure model ACC-HUMAN were employed to predict the concentration of PCB 153 in human milk for 56 countries around the world from a global historical emissions scenario...
March 19, 2018: Environmental Science. Processes & Impacts
Fen Li, Bifan Zhu, Zhimin He, Xiaoxi Zhang, Changying Wang, Linan Wang, Peipei Song, Lingling Ding, Chunlin Jin
The aim of this study was to use data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) to determine the factors affecting end-of-life hospital costs of patients. A total number of 43,806 decedents who died in medical facilities in 2015 were examined. These individuals, accounted for 34.85% of all deaths in 2015 in Shanghai. Descriptive analysis and multiple linear regression analysis were performed using STATA 13.0. Results indicated that 88.94% of the decedents who died in medical facilities were over age 60...
2018: Bioscience Trends
Bifan Zhu, Fen Li, Changying Wang, Linan Wang, Zhimin He, Xiaoxi Zhang, Peipei Song, Lingling Ding, Chunlin Jin
One aim of the current study was to track end-of-life care using individual data in Shanghai, China to profile hospital costs for decedents and those for the entire population. A second aim of this study was to clarify the effect of proximity to death. Data from the Information Center of the Shanghai Municipal Commission of Health and Family Planning (SMCHFP) were examined. For decedents who died in medical facilities in 2015, inpatient care was tracked for 1 year before death. A total of 43,765 decedents were included in the study, accounting for 35% of total deaths in 2015 in Shanghai...
2018: Bioscience Trends
Sakura Okamoto, Hideo Saka, Masahide Oki, Namie Somiya, Sachiyo Yokoyama, Yoshihiro Mizutani, Akiko Kada, Akira Tomita
Airway stenting is a procedure in which a stent is inserted into a stenotic site in the airway. However, the optimal ventilation for airway stenting remains controversial. We have planned a randomized, unblinded controlled study to compare intraoperative respiratory status by dividing patients, who underwent airway stenting, into spontaneous respiration (SP) and controlled ventilation with muscle relaxants (MR) groups. This study started in April 2016. The subjects, patients aged ≥20 years with airway stenosis caused by malignant neoplasms for which airway stenting was scheduled, are randomly allocated to SP and MR groups...
March 16, 2018: Kurume Medical Journal
Christian Baeumer, Martin Janson, Beate Timmermann, Jörg Wulff
AIM: To assess if apertures shall be mounted upstream or downstream of a range shifting block if these field-shaping devices are combined with the pencil-beam scanning delivery technique (PBS). The lateral dose fall-off served as a benchmark parameter. Both options realizing PBS-with-apertures were compared to the uniform scanning mode. We also evaluated the difference regarding the out-of-field dose caused by interactions of protons in beam-shaping devices.
 Methods: The potential benefit of the downstream configuration over the upstream configuration was estimated analytically...
March 19, 2018: Physics in Medicine and Biology
Scott A Goldberg, Jeremy Maggin, Michael S Molloy, Olesya Baker, Ritu Sarin, Michael Kelleher, Kevin Mont, Adedeji Fajana, Eric Goralnick
OBJECTIVE: Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness. METHODS: A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015. RESULTS: We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Joan M King, Chetan Tiwari, Armin R Mikler, Martin O'Neill
Ebola is a high consequence infectious disease-a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola's first reported cases in the United States in September 2014 led to the development of preparedness capabilities for the mitigation of possible rapid outbreaks, with the Centers for Disease Control and Prevention (CDC) providing guidelines to assist public health officials in infectious disease response planning...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Johanna Tell, Ewy Olander, Peter Anderberg, Johan Sanmartin Berglund
AIM: The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. METHODS: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. RESULTS: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives...
February 2018: Scandinavian Journal of Public Health
Bo J A Haglund, Per Tillgren
Based on the storytelling tradition and analyses of conference material, this article provides an overview of the evolving Nordic Health Promotion Research Network (NHPRN) and its conferences over the last 20 years. The story goes from the planning of the first conference in Bergen, Norway, back in 1996 to the eighth conference in Jyväskylä, Finland, in 2016. There have been three phases of development. During the first phase, 1996-2007, the five first conferences were initiated and implemented by departments of public health in the Nordic countries...
February 2018: Scandinavian Journal of Public Health
Alajos Pár, Gabriella Pár
More than 25 years after the discovery of hepatitis C virus, the development of the direct acting antivirals can lead to the regional or long-term global elimination of the virus with over 90% efficacy. This is the success of basic and clinical translational research. Yet, some unsolved challanges remain, such as the great number of unidentified patients who are not aware of their condition, the limited access to the therapy due to the high prices of the drugs, and the treatment of resistance-associated variants...
March 2018: Orvosi Hetilap
James D Neaton, Birgit Grund, Deborah Wentworth
BACKGROUND: Data monitoring committees for randomized clinical trials have the responsibility of safeguarding interests of trial participants. To do so, the data monitoring committee must receive reports on safety and efficacy to assess risk/benefit and on trial conduct to ensure that the study can achieve its goals. This article outlines the key components of reports to the data monitoring committee and the important role of the unblinded statistician in preparing those reports. METHODS: Most data monitoring committee meetings include open and closed sessions...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
Sabine Landau, Richard Emsley, Graham Dunn
BACKGROUND: Random allocation avoids confounding bias when estimating the average treatment effect. For continuous outcomes measured at post-treatment as well as prior to randomisation (baseline), analyses based on (A) post-treatment outcome alone, (B) change scores over the treatment phase or (C) conditioning on baseline values (analysis of covariance) provide unbiased estimators of the average treatment effect. The decision to include baseline values of the clinical outcome in the analysis is based on precision arguments, with analysis of covariance known to be most precise...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
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