Time to delivery: Transfers for threatened preterm labour and prelabour rupture of membranes in Western Australia

Objective

To describe the outcomes of patients transferred to King Edward Memorial Hospital (KEMH) with signs of labour at preterm gestations.

Design

A retrospective observational study of the 69 cases transferred to KEMH during 2015.

Setting

Patient transfers from all locations across Western Australia (WA) to the sole tertiary perinatal centre in Perth.

Participants

Pregnant women within WA with threatened or actual preterm labour (PTL) or preterm prelabour rupture of membranes (PPROM) between 23 and 32 weeks gestation.

Main outcome measures

The occurrence of delivery during the admission and time‐to‐delivery as well as length of admission and association between clinical factors and time‐to‐delivery.

Results

The percentage of the study population delivered during the admission following transfer was 72.5%. Eighty‐six per cent of those who delivered did so within 72 hours of transfer. The median time from transfer to delivery was 1 day. Sixty‐three per cent of those who did not deliver during the admission progressed to 36 weeks gestation. Patients transferred with PPROM were less likely to deliver during the admission compared to those with uterine activity (50% versus 19.6%, P = 0.007) and nulliparas were more likely to deliver (93.5% versus 55.3%, P < 0.001).

Conclusion

The majority of women transferred with signs of PTL progress to delivery during the same admission with the highest risk of delivery being the first 72 hours following transfer. If the pregnancy is ongoing at 72 hours, there is a reasonable chance of progression to late preterm gestation supporting the return of woman to their place of origin for antenatal care following discharge.     

The use of haematopoietic stem cell transplantation in Fanconi anaemia patients: a survey of decision making among families in the US and Canada

Background

Fanconi anaemia (FA) is a rare genetic disorder associated with bone marrow failure (BMF), congenital anomalies and cancer susceptibility. Stem cell transplantation (SCT) offers a potential cure for BMF or leukaemia, but incurs substantial risks. Little is known about factors influencing SCT decision making.

Objective

The study objective was to explore factors influencing patients' with FA and family members' decision making about SCT.

Design

Using a mixed‐methods exploratory design, we surveyed US and Canadian patients with FA and family members who were offered SCT.

Main variables studied

Closed‐ended survey items measured respondents' beliefs about the necessity, risks and concerns regarding SCT; multivariable logistic regression was used to examine the association between these factors and the decision to undergo SCT. Open‐ended survey items measured respondents' perceptions of factors important to the SCT decision; qualitative analysis was used to identify emergent themes.

Results

The decision to undergo SCT was significantly associated with greater perceived necessity (OR = 2.81, P = 0.004) and lower concern about harms of SCT (OR = 0.31, P = 0.03). Qualitative analysis revealed a perceived lack of choice among respondents regarding the use of SCT, which was related to physician influence and respondent concerns about patients' quality of life.

Conclusions

Overall, study results emphasize the importance of the delicate interplay between provider recommendation of a medical procedure and patient/parental perceptions and decision making. Findings can help providers understand the need to acknowledge family members' perceptions of SCT decision making and offer a comprehensive discussion of the necessity, risks, benefits and potential outcomes.     

Determinants of within-country variation in traffic accident mortality in Italy: a geographical analysis

Objective  

To identify determinants of regional differences in traffic accident mortality in Italy.     

Cognitive function and tea consumption in community dwelling older Chinese in Singapore

Objectives  

We aimed to examine the relationship between tea consumption and cognitive function in older adults.     

The magnitude and factors associated with delays in management of smear positive tuberculosis in Dar es Salaam,Tanzania

Objective  

To assess the magnitude and factors responsible for delay in TB management.     

Erosive Arthropathy in systemic sclerosis

Background  

To determine radiological features of arthropathy in systemic sclerosis patients with polyarthritis.     

A field study on clinical signs and symptoms in cleaners at floor polish removal and application in a Swedish hospital

Aim  

To study health effects in hospital cleaners (N = 21) at floor polish removal and application.     

Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review

Background

The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited.

Objective

To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services.

Search strategy

Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings.

Inclusion criteria

UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016.

Data extraction and synthesis

Data were extracted into a grid and subjected to narrative synthesis following thematic analysis.

Main results

From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi‐structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes “public cognizance” and “attitudes towards services” each with 4 subthemes.

Discussion and conclusions

Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists’ clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness.     

Television viewing and food consumption in Flemish adolescents in Belgium

Objectives:  

To examine associations of television viewing with overall food consumption     

An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain

Objective  

This study explores socio-economic inequalities in health among Mediterranean people aged 50 or higher.     

Time trends in cancer mortality in Central Serbia

Objective  

To examine cancer mortality trends in Central Serbia (1985–2002).     

Validation of the EQ-5D in a general population sample in urban China

Purpose  

To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China.     

Gender and ethnic disparities contributing to overweight in California adolescents

Purpose  

To explore differences in health behaviors and factors contributing to overweight among 12 to 17 year olds in California.     

Racial differences in smoking abstinence rates in a multicenter,randomized, open-label trial in the United States

Background  

This study evaluates differences in smoking abstinence between white and minority smokers using pharmaceutical aids.     

Validation of the FACT-G scale for evaluating quality of life in cancer patients in Colombia

Purpose  

To validate the FACT-G scale for measuring quality of life of patients with cancer in Colombia.     

Severity of self-reported diseases and symptoms in Denmark

Objective  

To estimate and rank the relative severity of self-reported diseases and symptoms in Denmark.     

Antioxidant biomarkers and food intake in elderly women

Objective  

To investigate the relationship between antioxidant biomarkers and food intake in elderly women.     

Prevalence and demographic factors of smoking in Morocco

Objectives  

To study the prevalence and determinants of cigarette smoking in Morocco.     

The construct validity of the health utilities index mark 3 in assessing health status in lung transplantation

Purpose  

To assess the cross-sectional construct validity of the Health Utilities Index Mark 3 (HUI3) in lung transplantation.