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Strategic adherence

Ana Morais, Joseph Kelly, James E Bost, Susma Shanti Vaidya
This study identified and characterized the rates of documentation and guideline-based management of overweight and obese children within an academic pediatric clinic through a retrospective electronic medical record review of 7422 well-child visits in 2016. Diagnosis and treatment were analyzed by patient's weight diagnosis, sex, age, and provider training level. The percentages of correctly identified severely obese (90.2%), obese (77.0%), and overweight (42.0%) children were much higher than in previous retrospective chart reviews; however, less than 30% of children were referred for more intensive weight management to a dietitian or pediatric obesity weight management program...
March 1, 2018: Clinical Pediatrics
M Durán-Poveda, P Jimenez-Fonseca, M Sirvent-Ochando, P P García-Luna, J L Pereira-Cunill, B Lema-Marqués, M T Parejo-Arrondo, C Belda-Iniesta
INTRODUCTION: Malnutrition is a common complication in cancer patients and can negatively affect the outcome of treatments. This study aimed to reach a consensus on nutritional needs and optimize nutritional care in the management of cancer patients at a national level. METHODS: A qualitative, multicenter, two-round Delphi study involving 52 specialists with experience in nutritional support in cancer patients was conducted. RESULTS: Regarding the presence of malnutrition, 57...
March 2, 2018: Clinical & Translational Oncology
Asghar Ebadifar, Monir Baradaran Eftekhari, Parviz Owlia, Elham Habibi, Elham Ghalenoee, Mohammad Reza Bagheri, Katayoun Falahat, Masoumeh Eltemasi, Zahra Sobhani, Shahin Akhondzadeh
BACKGROUND: Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. METHODS: This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact...
November 1, 2017: Archives of Iranian Medicine
El Kebir Ghandour, Marie-Pierre Gagnon, Jean-Paul Fortin
INTRODUCTION: We aimed to describe and analyse the factors and conditions influencing ePHR adoption by primary healthcare professionals for the follow-up and management of chronic diseases, as perceived by healthcare professionals and health organization managers. METHODS: A qualitative study was conducted in the context of an ePHR experimentation project in Quebec. In-depth semi-structured individual interviews were conducted with 11 professionals and three managers directly involved in ePHR implementation in a primary healthcare organization...
January 30, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
André Janse van Rensburg, Inge Petersen, Edwin Wouters, Michelle Engelbrecht, Gladys Kigozi, Pieter Fourie, Dingie van Rensburg, Piet Bracke
The Life Esidimeni tragedy in South Africa showed that, despite significant global gains in recognizing the salience of integrated public mental health care during the past decade, crucial gaps remain. State and non-state mental health service collaboration is a recognized strategy to increase access to care and optimal use of community resources, but little evidence exist about how it unfolds in low- to middle-income countries. South Africa's Mental Health Policy Framework and Strategic Plan 2013-20 (MHPF) underlines the importance of collaborative public mental health care, though it is unclear how and to what extent this happens...
February 15, 2018: Health Policy and Planning
Jacqui Webster, Arti Pillay, Arleen Suku, Paayal Gohil, Joseph Alvin Santos, Jimaima Schultz, Jillian Wate, Kathy Trieu, Silvia Hope, Wendy Snowdon, Marj Moodie, Stephen Jan, Colin Bell
This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low...
January 30, 2018: Nutrients
B G Damien, B Aguemon, D Abdoulaye Alfa, D Bocossa, A Ogouyemi-Hounto, F Remoue, J-Y Le Hesran
BACKGROUND: Artemisinin-based combination therapy (ACT), used to treat uncomplicated malaria cases, is one of the main strategies of malaria control and elimination. One of the main objectives of the Benin National Malaria Control Program's (NMCP) strategic plan is to ensure that at least 80% of uncomplicated malaria is treated with ACT within 24 h. Therefore, it was of great interest to measure whether the country case management of fever amongst children under five, adhered to the NMCP's strategic plan and look into the barriers to the use of ACT...
January 22, 2018: BMC Public Health
Biz R Turnell, Kerry L Shaw, H Kern Reeve
Two major challenges exist when empirically testing the predictions of sperm allocation theory. First, the study species must adhere to the assumptions of the model being tested. Unfortunately, the common assumption of sperm allocation models that females mate a maximum of once or twice does not hold for many, if not most, multiply and sequentially mating animals. Second, a model's parameters, which dictate its predictions, must be measured in the study species. Common examples of such parameters, female mating frequency and sperm precedence patterns, are unknown for many species used in empirical tests...
January 13, 2018: Evolution; International Journal of Organic Evolution
Derek Stewart, Kathrine Gibson-Smith, Katie MacLure, Alpana Mair, Albert Alonso, Carles Codina, Antonio Cittadini, Fernando Fernandez-Llimos, Glenda Fleming, Dimitra Gennimata, Ulrika Gillespie, Cathy Harrison, Ulrike Junius-Walker, Przemysław Kardas, Thomas Kempen, Moira Kinnear, Pawel Lewek, Joao Malva, Jennifer McIntosh, Claire Scullin, Birgitt Wiese
BACKGROUND: Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. METHODS: Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at ≥ 80% agreement...
2017: PloS One
Marc Miravitlles, Juan José Soler-Cataluña, Bernardino Alcázar, José Luis Viejo, Francisco García-Río
BACKGROUND: This study aimed to identify the relevant factors for the choice of an inhaler device by physicians and the selection of the most important characteristics of a device according to different characteristics of patients with COPD. METHOD: In this two-round Delphi survey, 96 Spanish COPD-expert pulmonologists completed an internet-based, self-administered questionnaire, which consisted of a first part with 19 items related to the prioritization of the drug or the device, the experience, ability and preference of the patient, and the experience and preferences of the healthcare professional...
October 12, 2017: Pulmonary Pharmacology & Therapeutics
Gunes Avci, David P Sheppard, Savanna M Tierney, Victoria M Kordovski, Kelli L Sullivan, Steven Paul Woods
OBJECTIVE: Prospective memory (PM) is described as the capacity to form and maintain an intention that is executed in response to a specific cue. Neural injury and associated neurocognitive disorders are common among persons living with HIV disease, who might therefore be susceptible to impairment in PM. METHOD: This literature review utilized a structured qualitative approach to summarize and evaluate our current understanding of PM functioning in people living with HIV disease...
September 27, 2017: Clinical Neuropsychologist
Rishi Mandavia, Alec Knight, John Phillips, Elias Mossialos, Peter Littlejohns, Anne Schilder
OBJECTIVE: The regulation of surgical implants is vital to patient safety, and there is an international drive to establish registries for all implants. Hearing loss is an area of unmet need, and industry is targeting this field with a growing range of surgically implanted hearing devices. Currently, there is no comprehensive UK registry capturing data on these devices; in its absence, it is difficult to monitor safety, practices and effectiveness. A solution is developing a national registry of all auditory implants...
September 24, 2017: BMJ Open
Robin S Mickelson, Richard J Holden
BACKGROUND: Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood...
September 1, 2017: European Journal of Cardiovascular Nursing
Howard Peter Greenwald
Purpose The purpose of this paper is to identify the operational and management challenges in a globally budgeted, regionalized healthcare system and their implications for public service. Design/methodology/approach Concentrating on British Columbia's regional health authorities (RHAs) and hospitals, this study utilized data from interviews of key informants, documents (histories, legislation, agreements between RHAs and provincial government, and RHA organizational charts), news reports, and participant observation at board meetings...
June 19, 2017: Journal of Health Organization and Management
Chiara Zecca, Giulio Disanto, Sarah Mühl, Claudio Gobbi
BACKGROUND: Patient adherence to treatment is key to preventing the worsening of neurological disability in multiple sclerosis (MS). The RebiSmart® autoinjector facilitates self-administration of subcutaneous interferon β-1a (sc IFN β-1a) and records objective adherence data. The CORE study was undertaken to evaluate the relationship between subjectively reported and objective adherence of MS patients using RebiSmart® in Switzerland and explore variables associated with objective adherence...
September 4, 2017: BMC Neurology
C Reeder, V Huddy, M Cella, R Taylor, K Greenwood, S Landau, T Wykes
BACKGROUND: Cognitive remediation (CR) is a psychological therapy, which improves cognitive and social functioning in people with schizophrenia. It is now being implemented within routine clinical services and mechanisms of change are being explored. We designed a new generation computerised CR programme, CIRCuiTS (Computerised Interactive Remediation of Cognition - a Training for Schizophrenia), to enhance strategic and metacognitive processing, with an integrated focus on the transfer of cognitive skills to daily living...
September 4, 2017: Psychological Medicine
Young Sun Suh, Yun-Hong Cheon, Hyun-Ok Kim, Rock-Bum Kim, Ki Soo Park, Sang-Hyon Kim, Seung-Geun Lee, Eun-Kyoung Park, Jian Hur, Sang-Il Lee
Background/Aims: To investigate medication nonadherence in Korean patients with rheumatoid arthritis (RA) and analyze related factors. Methods: A total of 292 patients with RA participated in this study. Medication nonadherence, intentional or unintentional, was gauged via self-reported questionnaire. Patient perceptions of illness, treatment beliefs, and moods were measured via Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Patient Health Questionnaire-2, respectively...
April 20, 2017: Korean Journal of Internal Medicine
Oladele Vincent Adeniyi, Anthony Idowu Ajayi, Nonkosi Selanto-Chairman, Daniel Ter Goon, Gerry Boon, Yusimi Ordaz Fuentes, George Justus Hofmeyr, Gordana Avramovic, Craig Carty, John Lambert
OBJECTIVES: Drawing from a baseline sample of a cohort study, the study examines the extent and correlates of serostatus non-disclosure to sex partners and family members, and reasons for non-disclosure among HIV-infected pregnant women in the Eastern Cape Province, South Africa. METHODS: This longitudinal cohort study recruited 1709 pregnant women living with HIV who attended three of the largest maternity centres in the Eastern Cape, South Africa, for delivery between September 2015 and May 2016...
2017: PloS One
Dan Liu, Zhen-Shun Gan, Wan Ma, Hai-Tao Xiong, Yun-Qing Li, Yi-Zhen Wang, Hua-Hua Du
Hepcidin, an antimicrobial peptide, was discovered to integrate diverse signals from iron status and an infection threat and orchestrate a series of host-protective responses. Several studies have investigated the antimicrobial role of hepcidin, but the results have been controversial. Here, we aimed to examine the role of hepcidin in bacterial adherence and invasion in vitro We found that porcine hepcidin could decrease the amount of the extracellular pathogen enterotoxigenic Escherichia coli (ETEC) K88 that adhered to cells because it caused the aggregation of the bacteria...
October 2017: Antimicrobial Agents and Chemotherapy
Qiong Wu, Yanfeng Zhang, Suying Chang, Wei Wang, Michelle Helena van Velthoven, Huijun Han, Min Xing, Li Chen, Xiaozhen Du, Robert W Scherpbier
BACKGROUND: Large investments are currently made in community-based complementary food supplement (Ying Yang Bao, YYB) programs to improve nutrition of young children in rural areas in China. However, there is a lack of knowledge about the experience and challenges of implementing YYB programs in China. We aimed to: 1) monitor distribution of YYB; 2) assess children's adherence to and acceptability of YYB; and 3) evaluate community-based strategies to improve the program. METHODS: This mixed methods evaluation study combined data from surveys and focus groups that took place during a controlled interventional evaluation trial...
June 2017: Journal of Global Health
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