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Time to delivery: Transfers for threatened preterm labour and prelabour rupture of membranes in Western Australia
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Jade Hollingworth MBBS BSc Rachel Pietsch MBBS BSc Mathias Epee‐Bekima MD MRCOG FRANZCOG Elizabeth Nathan M.Biostat 《The Australian journal of rural health》2018,26(1):42-47
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. 相似文献4.
The use of haematopoietic stem cell transplantation in Fanconi anaemia patients: a survey of decision making among families in the US and Canada
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Sadie P. Hutson PhD RN WHNP BC Paul K. J. Han MD MA MPH Jada G. Hamilton PhD MPH Sean C. Rife MA Mohamad M. Al‐Rahawan MD MPH Richard P. Moser PhD Seth P. Duty RN BSN Sheeba Anand MPH Blanche P. Alter MD MPH 《Health expectations》2015,18(5):929-941
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. 相似文献5.
Alein Y. Haro-Ramos MPH Timothy T. Brown PhD Julianna Deardorff PhD Adrian Aguilera PhD Keshia M. Pollack Porter PhD MPH Hector P. Rodriguez PhD MPH 《Health services research》2023,58(Z2):186-197
Objective
To assess the magnitude of racial–ethnic disparities in pandemic-related social stressors and examine frontline work's moderating relationship on these stressors.Data Sources
Employed Californians' responses to the Institute for Governmental Studies (IGS) poll from April 16–20, 2020, were analyzed. The Pandemic Stressor Scale (PSS) assessed the extent to which respondents experienced or anticipated problems resulting from the inability to pay for basic necessities, job instability, lacking paid sick leave, unavailability of childcare, and reduced wages or work hours due to COVID-19.Study Design
Mixed-effects generalized linear models estimated (1) racial–ethnic disparities in pandemic stressors among workers during the first COVID-19 surge, adjusting for covariates, and (2) tested the interaction between race–ethnicity and frontline worker status, which includes a subset of essential workers who must perform their job on-site, to assess differential associations of frontline work by race–ethnicity.Data Collection
The IGS poll data from employed workers (n = 4795) were linked to the 2018 Centers for Disease Control and Prevention Social Vulnerability Index at the zip code level (N = 1068).Principal Findings
The average PSS score was 37.34 (SD = 30.49). Whites had the lowest PSS score (29.88, SD = 26.52), and Latinxs had the highest (50.74, SD = 32.61). In adjusted analyses, Black frontline workers reported more pandemic-related stressors than White frontline workers (PSS = 47.73 vs. 36.96, p < 0.001). Latinxs reported more pandemic stressors irrespective of frontline worker status. However, the 5.09-point difference between Latinx frontline and non-frontline workers was not statistically different from the 4.6-point disparity between White frontline and non-frontline workers.Conclusion
Latinx workers and Black frontline workers disproportionately reported pandemic-related stressors. To reduce stress on frontline workers during crises, worker protections like paid sick leave, universal access to childcare, and improved job security are needed, particularly for those disproportionately affected by structural inequities, such as racially minoritized populations. 相似文献6.
Jinjiao Wang PhD RN Jenny Y. Shen MD Yeates Conwell MD Eric J. Podsiadly BA Thomas V. Caprio MD MPH MS Kobi Nathan PharmD Fang Yu PhD RN GNP-BC FGSA FAAN Erika E. Ramsdale MD Donna M. Fick PhD FAAN Amanda S. Mixon MD MS MSPH Sandra F. Simmons PhD 《Health services research》2023,58(Z1):123-138
Objective
To assess how age-friendly deprescribing trials are regarding intervention design and outcome assessment. Reduced use of potentially inappropriate medications (PIMs) can be addressed by deprescribing—a systematic process of discontinuing and/or reducing the use of PIMs. The 4Ms—“Medication”, “Mentation”, “Mobility”, and “What Matters Most” to the person—can be used to guide assessment of age-friendliness of deprescribing trials.Data Source
Published literature.Study Design
Scoping review.Data Extraction Methods
The literature was identified using keywords related to deprescribing and polypharmacy in PubMed, EMBASE, Web of Science, ProQuest, CINAHL, and Cochrane and snowballing. Study characteristics were extracted and evaluated for consideration of 4Ms.Principal Findings
Thirty-seven of the 564 trials identified met the review eligibility criteria. Intervention design: “Medication” was considered in the intervention design of all trials; “Mentation” was considered in eight trials; “Mobility” (n = 2) and “What Matters Most” (n = 6) were less often considered in the design of intervention. Most trials targeted providers without specifying how matters important to older adults and their families were aligned with deprescribing decisions. Outcome assessment: “Medication” was the most commonly assessed outcome (n = 33), followed by “Mobility” (n = 13) and “Mentation” (n = 10) outcomes, with no study examining “What Matters Most” outcomes.Conclusions
“Mentation” and “Mobility”, and “What Matters Most” have been considered to varying degrees in deprescribing trials, limiting the potential of deprescribing evidence to contribute to improved clinical practice in building an age-friendly health care system. 相似文献7.
S. Hirayama K. Terasawa R. Rabeler T. Hirayama T. Inoue Y. Tatsumi M. Purpura R. Jäger 《Journal of human nutrition and dietetics》2014,27(Z2):284-291
Background
Attention‐deficit hyperactivity disorder (ADHD) is the most commonly diagnosed behavioural disorder of childhood, affecting 3–5% of school‐age children. The present study investigated whether the supplementation of soy‐derived phosphatidylserine (PS), a naturally occurring phospholipid, improves ADHD symptoms in children.Methods
Thirty six children, aged 4–14 years, who had not previously received any drug treatment related to ADHD, received placebo (n = 17) or 200 mg day–1 PS (n = 19) for 2 months in a randomised, double‐blind manner. Main outcome measures included: (i) ADHD symptoms based on DSM‐IV‐TR; (ii) short‐term auditory memory and working memory using the Digit Span Test of the Wechsler Intelligence Scale for Children; and (iii) mental performance to visual stimuli (GO/NO GO task).Results
PS supplementation resulted in significant improvements in: (i) ADHD (P < 0.01), AD (P < 0.01) and HD (P < 0.01); (ii) short‐term auditory memory (P < 0.05); and (iii) inattention (differentiation and reverse differentiation, P < 0.05) and inattention and impulsivity (P < 0.05). No significant differences were observed in other measurements and in the placebo group. PS was well‐tolerated and showed no adverse effects.Conclusions
PS significantly improved ADHD symptoms and short‐term auditory memory in children. PS supplementation might be a safe and natural nutritional strategy for improving mental performance in young children suffering from ADHD. 相似文献8.
Christopher AKY Chong Sicong Li Geoffrey C Nguyen Andrew Sutton Michael H Levy Tony Butler Murray D Krahn Hla-Hla Thein 《Health and quality of life outcomes》2009,7(1):78-7
Background
Health-state utilities for prisoners have not been described. 相似文献9.
Sayoki G Mfinanga Beatrice K Mutayoba Amos Kahwa Godfather Kimaro Rugola Mtandu Esther Ngadaya Said Egwaga Andrew Y Kitua 《BMC health services research》2008,8(1):158
Objective
To assess the magnitude and factors responsible for delay in TB management. 相似文献10.
Developing and testing a brief clinic‐based lung cancer screening decision aid for primary care settings
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Karen Kane McDonnell PhD RN OCN Scott M. Strayer MD MPH Erica Sercy MSPH Callie Campbell BA Daniela B. Friedman PhD Kathleen B. Cartmell PhD MPH Jan M. Eberth PhD 《Health expectations》2018,21(4):796-804
Background
Cancer screening‐related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM).Objective
To develop and test a decision aid (DA) and SDM strategy for PCPs and high‐risk patients.Design
The DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one‐group, mixed‐method study design measured fidelity, patient values, screening intention, acceptability and satisfaction.Results
Four PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%).Conclusions
Evidence supports the value of lung cancer screening with LDCT for select high‐risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain‐language, culturally sensitive, theory‐based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting. 相似文献11.
K. Simpson D. Keen D. Adams C. Alston‐Knox J. Roberts 《Child: care, health and development》2018,44(1):99-107
Background
Children on the autism spectrum participate less frequently, and in a narrower range of activities, than their nonautistic peers, but little is known about exact participation patterns across contexts or how this is perceived by caregivers. This study aimed to document patterns of participation and caregiver views with regard to frequency and intensity of activities.Method
Caregivers of children on the spectrum aged 5 (n = 90) and 9–10 years (n = 128) completed the Participation and Environment Measure for Children and Youth for home, school, and community. Caregivers reported on frequency of child's participation, level of involvement, and caregivers' desire for change in participation patterns.Results
Item‐level analyses revealed similar patterns of participation across home, school, and community for both cohorts with some small age‐appropriate differences. Caregivers generally desired increased diversity, frequency, and involvement in activities but a decreased use of electronics (computers, games, TV, and DVDs).Conclusion
The possibility of autism‐specific participation patterns could inform future interventions aimed at enhancing social inclusion. This warrants further investigation through multiinformant designs that seek the perspectives of the child and caregivers. 相似文献12.
Background
Sickness certification is a frequent and sometimes problematic task for orthopaedic surgeons. 相似文献13.
Objective
To illustrate the association between the sociodemographic characteristics of hospital markets and the geographic patterns of Medicare hospital value-based purchasing (HVBP) scores.Data Sources and Study Setting
This is a secondary analysis of United States hospitals with a HVBP Total Performance Score (TPS) for 2019 in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database (4/2021 release) and American Community Survey (ACS) data for 2015–2019.Study Design
This is a cross-sectional study using spatial multivariable autoregressive models with HVBP TPS and component domain scores as dependent variables and hospital market demographics as the independent variables.Data Collection/Extraction Methods
We calculated hospital market demographics using ZIP code level data from the ACS, weighted the 2019 CMS inpatient Hospital Service Area file.Principal Findings
Spatial autoregressive models using eight nearest neighbors with diversity index, race and ethnicity distribution, families in poverty, unemployment, and lack of health insurance among residents ages 19–64 years provided the best model fit. Diversity index had the highest statistically significant contribution to lower TPS (ß = −12.79, p < 0.0001), followed by the percent of the population coded to “non-Hispanic, some other race” (ß = −2.59, p < 0.0023), and the percent of families in poverty (ß = −0.26, p < 0.0001). Percent of the population was non-Hispanic American Indian/Alaskan Native (ß = 0.35, p < 0.0001) and percent non-Hispanic Asian (ß = 0.12, p < 0.02071) were associated with higher TPS. Lower predicted TPS was observed in large urban cities throughout the US as well as in states throughout the Southeastern US. Similar geographic patterns were observed for the predicted Patient Safety, Person and Community Engagement, and Efficiency and Cost Reduction domain scores but are not for predicted Clinical Outcomes scores.Conclusions
The lower predicted scores seen in cities and in the Southeastern region potentially reflect an inherent—that is, structural—association between market sociodemographics and HVBP scores. 相似文献14.
Kristina Roth Sonja Mauer Matthias Obinger Dorothea Lenz Helge Hebestreit 《Zeitschrift fur Gesundheitswissenschaften》2011,19(4):293-303
Aim
To establish an effective and feasible physical activity intervention programme for preschools. 相似文献15.
Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review
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Ali M. K. Hindi BPharm MSc Ellen I. Schafheutle PhD MRes MSc FFRPS Sally Jacobs BSc PhD 《Health expectations》2018,21(2):409-428
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. 相似文献16.
Purpose
To validate the FACT-G scale for measuring quality of life of patients with cancer in Colombia. 相似文献17.
Purpose
To validate the treatment-specific Treatment Satisfaction Survey for Intraocular Pressure (TSS-IOP). 相似文献18.
Jayaram Srinivasan James W. Holsinger Jr. 《Zeitschrift fur Gesundheitswissenschaften》2012,20(1):95-98
Aim
To examine an innovative leadership model for public health professionals and for public health systems. 相似文献19.
Maitreyi Mazumdar David C Bellinger Matthew Gregas Kathleen Abanilla Janine Bacic Herbert L Needleman 《Environmental health : a global access science source》2011,10(1):24
Background
Early life lead exposure might be a risk factor for neurocognitive impairment in adulthood. 相似文献20.
Beauchet O Dubost V Revel Delhom C Berrut G Belmin J;French Society of Geriatrics Gerontology 《The journal of nutrition, health & aging》2011,15(1):79-84