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Anna N Chard, Matthew C Freeman
Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children's Fund (UNICEF) Laos WinS project on child health and education...
March 22, 2018: International Journal of Environmental Research and Public Health
(no author information available yet)
In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper describes the background to the context of PRM services and comprises the following: - Epidemiological Aspects of Functioning and Disability - Ethical Aspects and Human Rights - Rehabilitation and Health Systems - Economic Burden of Disability - Effects of Lack of Rehabilitation Health care service planning accounts for the burden of disability among society and the chapter describes the justification for specialist rehabilitation, the background of PRM and why making a functional diagnosis and a management plan based on function is its core competence...
April 2018: European Journal of Physical and Rehabilitation Medicine
Brad Bolman
Cold War curiosities about the dangers of radiation generated significant funding for an array of biomedical projects as enticing as they were unpredictable, introducing newly standardized experimental animals into laboratories and a novel merging of scientific disciplines. The desire to understand radiation's effects on human longevity spurred a multi-sited, multi-decade project that subjected beagle dogs to varying degrees of irradiation. One of those laboratories, located at the southern tip of the campus of the University of California, Davis, eventually hosted an elaborate experimental breeding kennel and a population of 'control' dogs that set new milestones for canine longevity...
March 1, 2018: Social Studies of Science
Jannette Maree Blennerhassett, Karen Nancy Borschmann, Ruby Adelaide Lipson-Smith, Julie Bernhardt
AIM: To explore the use of a rehabilitation-focused behavioral mapping method to identify changes in patient physical activity, location, and social interaction following the relocation of a rehabilitation ward. BACKGROUND: Rehabilitation wards are unique healthcare environments where patient activity is encouraged to improve recovery. Little is known about the impact of building design on patient behavior within a rehabilitation setting. We examined this issue when a rehabilitation ward was relocated without altering other aspects of the healthcare service...
January 1, 2018: HERD
Jing-Jy Wang, Yueh-Ying Yang, Mei-Yin Liu
Advancing medical technology continues to extend the average human life span, resulting in population aging globally as well as in Taiwan. The challenges posed by aging society increase not only medical and care costs but also the burden on pension funds and the social welfare system. In addition, there is currently a desperate need for many well-trained health providers as well as a friendly and comprehensive long-term care system. However, attention should not simply focus on medical payments and long-term care, as this may prolong the length of unhealthy living years for the aged and further strain national finances...
April 2018: Hu Li za Zhi the Journal of Nursing
Vijay Kumar Chattu, Mario O Laplume, Soosanna Kumary
Minority populations in the world are permanently challenged with unequal living and working conditions in their daily lives that compromise their access to needed clinical and preventive services. When we discuss the health-care conditions for minorities, we must address the social determinants of access that are ultimately determined by the policies and politics of the governments. Renowned experts of quality in healthcare have been critical of the current design and implementation of randomized clinical trials, the gold standard of clinical research because they believe that they often, but not always, presume a linear, mechanistic system when in fact improvement in health care takes place within complex adaptive systems that evolve...
October 2017: Journal of Family Medicine and Primary Care
Chris Moore, Jenna Bulger, Matt Morgan, Timothy Driscoll, Alison Porter, Saiful Islam, Mike Smyth, Gavin Perkins, Bernadette Sewell, Timothy Rainer, Prabath Nanayakkara, Chukwudi Okolie, Susan Allen, Greg Fegan, Jan Davies, Theresa Foster, Nick Francis, Fang Gao Smith, Gemma Ellis, Tracy Shanahan, Robin Howe, Helen Snooks
Background: Sepsis is a common condition which kills between 36,000 and 64,000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce mortality and improve the health and well-being of people with sepsis. Paramedics frequently come into contact with patients with sepsis and are well placed to provide early diagnosis and treatment.We aim to determine the feasibility of undertaking a fully powered randomised controlled trial (RCT) to test the clinical and cost-effectiveness of paramedics obtaining blood cultures from and administering IV antibiotics to patients with sepsis, so we can make a decision about whether to proceed to a fully powered randomised controlled trial, which will answer questions regarding safety and effectiveness for patients and benefit to the National Health Service (NHS)...
2018: Pilot and Feasibility Studies
Ensaf M Al-Hujaily, Tanvir Khatlani, Zeyad Alehaideb, Rizwan Ali, Bader Almuzaini, Bahauddeen M Alrfaei, Jahangir Iqbal, Imadul Islam, Shuja Malik, Bader A Marwani, Salam Massadeh, Atef Nehdi, Barrak Alsomaie, Bader Debasi, Ibraheem Bushnak, Saeed Noibi, Syed Hussain, Wahid Abdul Wajid, Jean-Pierre Armand, Sheraz Gul, Julen Oyarzabal, Rana Rais, Chas Bountra, Ahmed Alaskar, Bander Al Knawy, Mohamed Boudjelal
The 'Therapeutics discovery: From bench to first in-human trials' conference, held at the King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), Kingdom of Saudi Arabia (KSA) from October 10-12, 2017, provided a unique opportunity for experts worldwide to discuss advances in drug discovery and development, focusing on phase I clinical trials. It was the first event of its kind to be hosted at the new research center, which was constructed to boost drug discovery and development in the KSA in collaboration with institutions, such as the Academic Drug Discovery Consortium in the United States of America (USA), Structural Genomics Consortium of the University of Oxford in the United Kingdom (UK), and Institute of Materia Medica of the Chinese Academy of Medical Sciences in China...
March 2018: Biomedical Reports
Stefanie Schütte, Paula N Marin Acevedo, Antoine Flahault
Background: Existing health systems all over the world are different due to the different combinations of components that can be considered for their establishment. The ranking of health systems has been a focal points for many years especially the issue of performance. In 2000 the World Health Organization (WHO) performed a ranking to compare the Performance of the health system of the member countries. Since then other health system rankings have been performed and it became an issue of public discussion...
June 2018: Journal of Global Health
Tatiana A Karakasheva, George A Dominguez, Ayumi Hashimoto, Eric W Lin, Christopher Chiu, Kate Sasser, Jae W Lee, Gregory L Beatty, Dmitry I Gabrilovich, Anil K Rustgi
BACKGROUND: Myeloid-derived suppressor cells (MDSCs) are a population of immature immune cells with several protumorigenic functions. CD38 is a transmembrane receptor-ectoenzyme expressed by MDSCs in murine models of esophageal cancer. We hypothesized that CD38 could be expressed on MDSCs in human colorectal cancer (CRC), which might allow for a new perspective on therapeutic targeting of human MDSCs with anti-CD38 monoclonal antibodies in this cancer. METHODS: Blood samples were collected from 41 CRC patients and 8 healthy donors, followed by peripheral blood mononuclear cell (PBMC) separation...
March 22, 2018: JCI Insight
Farhaan S Vahidy, Ellie G Meyer, Arvind B Bambhroliya, Jennifer R Meeks, Charles E Begley, Tzu-Ching Wu, Jon E Tyson, Charles C Miller, Ritvij Bowry, Wamda O Ahmed, Gretchel A Gealogo, Louise D McCullough, Steven Warach, Sean I Savitz
BACKGROUND: Intracerebral hemorrhage is a devastating disease with no specific treatment modalities. A significant proportion of patients with intracerebral hemorrhage are transferred to large stroke treatment centers, such as Comprehensive Stroke Centers, because of perceived need for higher level of care. However, evidence of improvement in patient-centered outcomes for these patients treated at larger stroke treatment centers as compared to community hospitals is lacking. METHODS / DESIGN: "Efficient Resource Utilization for Patients with Intracerebral Hemorrhage (EnRICH)" is a prospective, multisite, state-wide, cohort study designed to assess the impact of level of care on long-term patient-centered outcomes for patients with primary / non-traumatic intracerebral hemorrhage...
March 21, 2018: BMC Neurology
Celeste Schultz, Janet Thorlton
Consumption of fresh fruits and vegetables helps to reduce childhood obesity and improves academic achievement and attendance. However, providing fresh fruits and vegetables is challenging for some schools due to cost, administrative burden, and concern for food waste. To address these challenges, the Fruit and Vegetable Access for Children Act proposes to allow federally funded programs to substitute fresh fruits and vegetables with canned, frozen, or pureed versions. In this policy analysis, we propose options for providing fresh fruits and vegetables to children enrolled in the National School Lunch Program...
January 1, 2018: Journal of School Nursing: the Official Publication of the National Association of School Nurses
Maureen Mackintosh, Julius Mugwagwa, Geoffrey Banda, Paula Tibandebage, Jires Tunguhole, Samuel Wangwe, Mercy Karimi Njeru
The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies...
March 19, 2018: Health Policy and Planning
Mi-Young Lee, Sung Hoon Kim, Young Sang Oh, Seung-Ho Heo, Kang-Hyun Kim, Hee Dong Chae, Chung-Hoon Kim, Byung Moon Kang
STUDY QUESTION: Does interleukin-32 (IL-32) play a role in the pathogenesis of endometriosis? SUMMARY ANSWER: IL-32 might be involved in the pathogenesis of endometriosis through increased viability, proliferation and invasion of endometrial cells. WHAT IS KNOWN ALREADY: Endometriosis is characterized as a chronic inflammatory disease and several proinflammatory cytokines are suggested to be involved in its pathogenesis and pathophysiology...
March 19, 2018: Human Reproduction
Noura S Abul-Husn, Xiping Cheng, Alexander H Li, Yurong Xin, Claudia Schurmann, Panayiotis Stevis, Yashu Liu, Julia Kozlitina, Stefan Stender, G Craig Wood, Ann N Stepanchick, Matthew D Still, Shane McCarthy, Colm O'Dushlaine, Jonathan S Packer, Suganthi Balasubramanian, Nehal Gosalia, David Esopi, Sun Y Kim, Semanti Mukherjee, Alexander E Lopez, Erin D Fuller, John Penn, Xin Chu, Jonathan Z Luo, Uyenlinh L Mirshahi, David J Carey, Christopher D Still, Michael D Feldman, Aeron Small, Scott M Damrauer, Daniel J Rader, Brian Zambrowicz, William Olson, Andrew J Murphy, Ingrid B Borecki, Alan R Shuldiner, Jeffrey G Reid, John D Overton, George D Yancopoulos, Helen H Hobbs, Jonathan C Cohen, Omri Gottesman, Tanya M Teslovich, Aris Baras, Tooraj Mirshahi, Jesper Gromada, Frederick E Dewey
BACKGROUND: Elucidation of the genetic factors underlying chronic liver disease may reveal new therapeutic targets. METHODS: We used exome sequence data and electronic health records from 46,544 participants in the DiscovEHR human genetics study to identify genetic variants associated with serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Variants that were replicated in three additional cohorts (12,527 persons) were evaluated for association with clinical diagnoses of chronic liver disease in DiscovEHR study participants and two independent cohorts (total of 37,173 persons) and with histopathological severity of liver disease in 2391 human liver samples...
March 22, 2018: New England Journal of Medicine
John F Seymour, Thomas J Kipps, Barbara Eichhorst, Peter Hillmen, James D'Rozario, Sarit Assouline, Carolyn Owen, John Gerecitano, Tadeusz Robak, Javier De la Serna, Ulrich Jaeger, Guillaume Cartron, Marco Montillo, Rod Humerickhouse, Elizabeth A Punnoose, Yan Li, Michelle Boyer, Kathryn Humphrey, Mehrdad Mobasher, Arnon P Kater
BACKGROUND: Venetoclax inhibits BCL2, an antiapoptotic protein that is pathologically overexpressed and that is central to the survival of chronic lymphocytic leukemia cells. We evaluated the efficacy of venetoclax in combination with rituximab in patients with relapsed or refractory chronic lymphocytic leukemia. METHODS: In this randomized, open-label, phase 3 trial, we randomly assigned 389 patients to receive venetoclax for up to 2 years (from day 1 of cycle 1) plus rituximab for the first 6 months (venetoclax-rituximab group) or bendamustine plus rituximab for 6 months (bendamustine-rituximab group)...
March 22, 2018: New England Journal of Medicine
Donna Franklin, Franz E Babl, Luregn J Schlapbach, Ed Oakley, Simon Craig, Jocelyn Neutze, Jeremy Furyk, John F Fraser, Mark Jones, Jennifer A Whitty, Stuart R Dalziel, Andreas Schibler
BACKGROUND: High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. METHODS: In this multicenter, randomized, controlled trial, we assigned infants younger than 12 months of age who had bronchiolitis and a need for supplemental oxygen therapy to receive either high-flow oxygen therapy (high-flow group) or standard oxygen therapy (standard-therapy group)...
March 22, 2018: New England Journal of Medicine
Il Ju Choi, Myeong-Cherl Kook, Young-Il Kim, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Boram Park, Byung-Ho Nam
BACKGROUND: Patients with early gastric cancers that are limited to gastric mucosa or submucosa usually have an advanced loss of mucosal glandular tissue (glandular atrophy) and are at high risk for subsequent (metachronous) development of new gastric cancer. The long-term effects of treatment to eradicate Helicobacter pylori on histologic improvement and the prevention of metachronous gastric cancer remain unclear. METHODS: In this prospective, double-blind, placebo-controlled, randomized trial, we assigned 470 patients who had undergone endoscopic resection of early gastric cancer or high-grade adenoma to receive either H...
March 22, 2018: New England Journal of Medicine
Robert J Motzer, Nizar M Tannir, David F McDermott, Osvaldo Arén Frontera, Bohuslav Melichar, Toni K Choueiri, Elizabeth R Plimack, Philippe Barthélémy, Camillo Porta, Saby George, Thomas Powles, Frede Donskov, Victoria Neiman, Christian K Kollmannsberger, Pamela Salman, Howard Gurney, Robert Hawkins, Alain Ravaud, Marc-Oliver Grimm, Sergio Bracarda, Carlos H Barrios, Yoshihiko Tomita, Daniel Castellano, Brian I Rini, Allen C Chen, Sabeen Mekan, M Brent McHenry, Megan Wind-Rotolo, Justin Doan, Padmanee Sharma, Hans J Hammers, Bernard Escudier
Background Nivolumab plus ipilimumab produced objective responses in patients with advanced renal-cell carcinoma in a pilot study. This phase 3 trial compared nivolumab plus ipilimumab with sunitinib for previously untreated clear-cell advanced renal-cell carcinoma. Methods We randomly assigned adults in a 1:1 ratio to receive either nivolumab (3 mg per kilogram of body weight) plus ipilimumab (1 mg per kilogram) intravenously every 3 weeks for four doses, followed by nivolumab (3 mg per kilogram) every 2 weeks, or sunitinib (50 mg) orally once daily for 4 weeks (6-week cycle)...
March 21, 2018: New England Journal of Medicine
Jan T Wollenberg, Jeff Ollerhead, Gail L Chmura
Salt marshes are highly effective carbon (C) sinks and have higher rates of soil C burial (per square meter) than terrestrial ecosystems. Marsh reclamation and anthropogenic impacts, however, have resulted in extensive losses of salt marshes. Restoration of marshes drained and "reclaimed" for agriculture (referred to in Canada as dykelands) and degraded marshes can generate C credits, but only if C burial is reliably quantified. To date, studies reporting on C burial rates have been limited primarily to restored marshes which are more than 10 years old...
2018: PloS One
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