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https://www.readbyqxmd.com/read/28088109/carbetocin-versus-oxytocin-for-prevention-of-post-partum-haemorrhage-at-caesarean-section-in-the-united-kingdom-an-economic-impact-analysis
#1
Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28087554/how-prepared-are-uk-medical-graduates-for-practice-a-rapid-review-of-the-literature-2009-2014
#2
Lynn V Monrouxe, Lisa Grundy, Mala Mann, Zoe John, Eleni Panagoulas, Alison Bullock, Karen Mattick
OBJECTIVE: To understand how prepared UK medical graduates are for practice and the effectiveness of workplace transition interventions. DESIGN: A rapid review of the literature (registration #CRD42013005305). DATA SOURCES: Nine major databases (and key websites) were searched in two timeframes (July-September 2013; updated May-June 2014): CINAHL, Embase, Educational Resources Information Centre, Health Management Information Consortium, MEDLINE, MEDLINE in Process, PsycINFO, Scopus and Web of Knowledge...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28087548/early-lens-extraction-with-intraocular-lens-implantation-for-the-treatment-of-primary-angle-closure-glaucoma-an-economic-evaluation-based-on-data-from-the-eagle-trial
#3
Mehdi Javanbakht, Augusto Azuara-Blanco, Jennifer M Burr, Craig Ramsay, David Cooper, Claire Cochran, John Norrie, Graham Scotland
OBJECTIVE: To investigate the cost-effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle closure glaucoma (PACG) compared to standard care. DESIGN: Cost-effectiveness analysis alongside a multicentre pragmatic two-arm randomised controlled trial. Patients were followed-up for 36 months, and data on health service usage and health state utility were collected and analysed within the trial time horizon. A Markov model was developed to extrapolate the results over a 5-year and 10-year time horizon...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28079417/the-experiences-of-black-and-minority-ethnic-nurses-working-in-the-uk
#4
John Pendleton
Evidence suggests that black and minority ethnic (BME) midwives are more likely to face fitness to practise hearings than white registrants and BME NHS staff are less likely to be in senior positions. This literature review critically evaluates the literature published since a systematic review on the topic was conducted in 2005. It found that BME nurses and midwives, especially those who registered abroad and subsequently came to live and work in the UK are 'underemployed' and consequently expressed feelings of loss of self-confidence...
January 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28069627/what-aspects-of-intentional-rounding-work-in-hospital-wards-for-whom-and-in-what-circumstances-a-realist-evaluation-protocol
#5
Ruth Harris, Sarah Sims, Ros Levenson, Stephen Gourlay, Fiona Ross Cbe, Nigel Davies, Sally Brearley, Giampiero Favato, Robert Grant
INTRODUCTION: Intentional rounding (IR) is a structured process whereby nurses in hospitals carry out regular checks, usually hourly, with individual patients using a standardised protocol to address issues of positioning, pain, personal needs and placement of items. The widespread implementation of IR across the UK has been driven by the recommendations of the Francis Inquiry although empirical evidence of its effectiveness is poor. This paper presents a protocol of a multimethod study using a realist evaluation approach to investigate the impact and effectiveness of IR in hospital wards on the organisation, delivery and experience of care from the perspective of patients, their family members and staff...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069626/paramedics-views-on-their-seizure-management-learning-needs-a-qualitative-study-in-england
#6
Frances C Sherratt, Darlene Snape, Steve Goodacre, Mike Jackson, Mike Pearson, Anthony G Marson, Adam J Noble
INTRODUCTION: The UK ambulance service often attends to suspected seizures. Most persons attended to will not require the facilities of a hospital emergency department (ED) and so should be managed at scene or by using alternative care pathways. Most though are transported to ED. One factor that helps explain this is paramedics can have low confidence in managing seizures. OBJECTIVES: With a view to ultimately developing additional seizure management training for practicing paramedics, we explored their learning needs, delivery preferences and potential drivers and barriers to uptake and effectiveness...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069625/cost-effectiveness-of-a-pragmatic-structured-education-intervention-for-the-prevention-of-type-2-diabetes-economic-evaluation-of-data-from-the-let-s-prevent-diabetes-cluster-randomised-controlled-trial
#7
J Leal, D Ahrabian, M J Davies, L J Gray, K Khunti, T Yates, A M Gray
OBJECTIVES: Prevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle and behaviour change to prevent progression to T2DM in people with prediabetes. DESIGN: Cost-effectiveness analysis alongside randomised controlled trial. SETTING: 44 general practices in Leicestershire, England...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28063084/methodological-issues-surrounding-the-use-of-baseline-health-related-quality-of-life-data-to-inform-trial-based-economic-evaluations-of-interventions-within-emergency-and-critical-care-settings-a-systematic-literature-review
#8
REVIEW
Melina Dritsaki, Felix Achana, James Mason, Stavros Petrou
BACKGROUND: Trial-based cost-utility analyses require health-related quality of life data that generate utility values in order to express health outcomes in terms of quality-adjusted life years (QALYs). Assessments of baseline health-related quality of life are problematic where trial participants are incapacitated or critically ill at the time of randomisation. This review aims to identify and critique methods for handling non-availability of baseline health-related quality of life data in trial-based cost-utility analyses within emergency and critical illness settings...
January 6, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28059054/randomised-controlled-trial-evaluating-the-effectiveness-and-cost-effectiveness-of-families-for-health-a-family-based-childhood-obesity-treatment-intervention-delivered-in-a-community-setting-for-ages-6-to-11-years
#9
Wendy Robertson, Joanna Fleming, Atiya Kamal, Thomas Hamborg, Kamran A Khan, Frances Griffiths, Sarah Stewart-Brown, Nigel Stallard, Stavros Petrou, Douglas Simkiss, Elizabeth Harrison, Sung Wook Kim, Margaret Thorogood
BACKGROUND: Effective programmes to help children manage their weight are required. 'Families for Health' focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health version 1 showed sustained reductions in mean body mass index (BMI) z-score after 2 years in a pilot project. OBJECTIVE: The aim was to evaluate its effectiveness and cost-effectiveness in a randomised controlled trial (RCT)...
January 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28050679/value-for-money-an-evaluation-of-health-spending-in-canada
#10
Ruolz Ariste, Livio Di Matteo
The long-term increase in international health spending sparked concerns about sustainability of health care systems but also the impact of such spending and the value for money from health spending. The period since 1975 has witnessed an increase in per capita health spending in Canada along with improvements in health outcomes. This paper is an economic evaluation of health spending in Canada-an analysis of the cost-effectiveness of aggregate health spending. Estimates of the cost per quality-adjusted life-year (QALY) are made for the whole 1980-2012 period and for four sub-periods of time-1980-1989; 1989-1998; 1998-2007 and 2007-2012...
January 3, 2017: Int J Health Econ Manag
https://www.readbyqxmd.com/read/28048554/th-ab-202-03-a-novel-tool-for-computing-deliverable-doses-in-dynamic-mlc-tracking-treatments
#11
M Fast, C Kamerling, S Crijns, M Menten, S Nill, B Raaymakers, U Oelfke
PURPOSE: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. METHODS: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphed initial plans from (A) are further optimised ("warm-started") in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047731/su-f-t-672-a-novel-kernel-based-dose-engine-for-kev-photon-beams
#12
M Reinhart, M F Fast, S Nill, U Oelfke
PURPOSE: Mimicking state-of-the-art patient radiotherapy with high precision irradiators for small animals allows advanced dose-effect studies and radiobiological investigations. One example is the implementation of pre-clinical IMRT-like irradiations, which requires the development of inverse planning for keV photon beams. As a first step, we present a novel kernel-based dose calculation engine for keV x-rays with explicit consideration of energy and material dependencies. METHODS: We follow a superposition-convolution approach adapted to keV x-rays, based on previously published work on micro-beam therapy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047221/we-ab-209-08-novel-beam-specific-adaptive-margins-for-reducing-organ-at-risk-doses
#13
H Tsang, C P Kamerling, P Ziegenhein, S Nill, U Oelfke
PURPOSE: Current practice of using 3D margins in radiotherapy with high-energy photon beams provides larger-than-required target coverage. According to the photon depth-dose curve, target displacements in beam direction result in minute changes in dose delivered. We exploit this behavior by generating margins on a per-beam basis which simultaneously account for the relative distance of the target and adjacent organs-at-risk (OARs). METHODS: For each beam, we consider only geometrical uncertainties of the target location perpendicular to beam direction...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046472/th-cd-202-12-online-inter-beam-replanning-based-on-real-time-dose-reconstruction
#14
C P Kamerling, M F Fast, P Ziegenhein, S Nill, U Oelfke
PURPOSE: This work provides a proof-of-concept study for online replanning during treatment delivery for step-and-shoot prostate SBRT, based on real-time dose reconstruction. Online replanning is expected to improve the trade-off between target coverage and organ-at-risk dose in the presence of intra-fractional motion. METHODS: We have implemented an online replanning workflow on top of our previously reported real-time dose reconstruction software which connects to an Elekta research linac...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28029070/an-exploration-of-factors-influencing-physical-activity-levels-amongst-a-cohort-of-people-living-in-the-community-after-stroke-in-the-south-of-england
#15
Sharon Jackson, Christopher Mercer, Barbara Jennifer Singer
PURPOSE: To explore factors influencing physical activity (PA) reported by people living in rural/semi-rural communities in the south of England post-stroke, and to understand relationships between personal, interpersonal and environmental barriers and self-reported levels of PA. METHOD: A survey was mailed to patients of NHS Trusts who were identified as potential participants. Self-reported PA levels, type, and frequency of reported barriers were tabulated. Spearman's rank correlation coefficient was used to explore associations between self-reported PA level and: age, gender, level of physical function, fear of falling, beliefs regarding PA, available supports, and socioeconomic status...
December 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28027419/a-retrospective-cohort-study-of-the-influence-of-lifestyle-factors-on-survival-of-patients-undergoing-surgery-for-colorectal-cancer
#16
Dayna Alexander, Gwen M Allardice, Susan J Moug, David S Morrison
AIM: Several modifiable and non-modifiable health related behaviours are associated with the incidence of Colorectal Cancer (CRC), but there is little research on their association with survival. The project aimed to investigate possible relationships between modifiable behavioural factors and outcomes on a study cohort of CRC patients undergoing potentially curative surgery. METHOD: A retrospective cohort study was carried out of patients diagnosed with non-metastatic CRC undergoing elective curative surgery (January 2011 - December 2012), residing in the NHS Greater Glasgow & Clyde (NHSGGC) area, UK...
December 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28011758/ambulance-telephone-triage-using-nhs-pathways-to-identify-adult-cardiac-arrest
#17
Charles D Deakin, Simon England, Debbie Diffey
BACKGROUND: UK ambulance services are called to 30 000 cardiac arrests (CAs) annually where resuscitation is attempted. Correct identification by the ambulance service trebles survival by facilitating bystander-cardiopulmonary resuscitation (CPR) and immediate ambulance dispatch. Identification of CA by telephone is challenging and involves algorithms to identify key features. 'NHS Pathways' is now used for triage by six of 12 UK ambulance services, covering a population of 20 million...
December 23, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28008769/a-discrete-event-simulation-to-model-the-cost-utility-of-fingolimod-and-natalizumab-in-rapidly-evolving-severe-relapsing-remitting-multiple-sclerosis-in-the-uk
#18
Stephen Montgomery, Maciej Maruszczak, David Slater, Jeanette Kusel, Richard Nicholas, Nicholas Adlard
OBJECTIVE: Two disease modifying therapies are licensed in the EU for use in rapidly-evolving severe (RES) relapsing-remitting multiple sclerosis (RRMS), fingolimod and natalizumab. Here a discrete event simulation (DES) model to analyse the cost-effectiveness of natalizumab and fingolimod in the RES population, from the perspective of the National Health Service (NHS) in the UK, is reported. METHODS: A DES model was developed to track individual RES patients, based on Expanded Disability Status Scale scores...
December 23, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/28003288/protocol-for-a-multicentre-study-to-assess-feasibility-acceptability-effectiveness-and-direct-costs-of-triumph-treatment-and-recovery-in-psychosis-integrated-care-pathway-for-psychosis
#19
Shanaya Rathod, Christie Garner, Alison Griffiths, Borislav D Dimitrov, Katherine Newman-Taylor, Chris Woodfine, Lars Hansen, Paul Tabraham, Karen Ward, Carolyn Asher, Peter Phiri, Farooq Naeem, Pippa North, Tariq Munshi, David Kingdon
INTRODUCTION: Duration of untreated psychosis (time between the onset of symptoms and start of treatment) is considered the strongest predictor of symptom severity and outcome. Integrated care pathways that prescribe timeframes around access and interventions can potentially improve quality of care. METHODS AND ANALYSIS: A multicentre mixed methods study to assess feasibility, acceptability, effectiveness and analysis of direct costs of an integrated care pathway for psychosis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27993145/pressure-relieving-support-surfaces-a-randomised-evaluation-2-pressure-2-study-protocol-for-a-randomised-controlled-trial
#20
Sarah Brown, Isabelle L Smith, Julia M Brown, Claire Hulme, Elizabeth McGinnis, Nikki Stubbs, E Andrea Nelson, Delia Muir, Claudia Rutherford, Kay Walker, Valerie Henderson, Lyn Wilson, Rachael Gilberts, Howard Collier, Catherine Fernandez, Suzanne Hartley, Moninder Bhogal, Susanne Coleman, Jane E Nixon
BACKGROUND: Pressure ulcers represent a major burden to patients, carers and the healthcare system, affecting approximately 1 in 17 hospital and 1 in 20 community patients. They impact greatly on an individual's functional status and health-related quality of life. The mainstay of pressure ulcer prevention practice is the provision of pressure redistribution support surfaces and patient repositioning. The aim of the PRESSURE 2 study is to compare the two main mattress types utilised within the NHS: high-specification foam and alternating pressure mattresses, in the prevention of pressure ulcers...
December 20, 2016: Trials
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