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.     

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.     

The economic costs and health-related quality of life of people with HIV/AIDS in the Canary Islands, Spain

Background  

The objective was to determine the economic burden, as well as the impact on HRQOL for people with HIV/AIDS in Spain in 2003.     

The geography of Medicare's hospital value-based purchasing in relation to market demographics

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.     

A prospective cohort study of biomarkers of prenatal tobacco smoke exposure: the correlation between serum and meconium and their association with infant birth weight

Background  

The evaluation of infant meconium as a cumulative matrix of prenatal toxicant exposure requires comparison to established biomarkers of prenatal exposure.     

Effectiveness of guidelines in treatment of allergic rhinitis: an analysis of individual patient data

Aim  

The objective of the present analysis was to assess the effectiveness of national and international guidelines in the treatment of patients with allergic rhinitis as well as rhinitis and asthma.     

Dose and time-dependent hypercholesterolemic effects of iodine excess via TRβ1-mediated down regulation of hepatic LDLr gene expression

Background  

With the global improvement of iodine nutrition, iodine excess is emerging as a new concern.     

Personal strengths reported by people with chronic illness: A qualitative study

Background

Self‐management of chronic illness can be highly demanding and people need to mobilize their personal strengths to live well with their condition. More knowledge is needed about how people with chronic illness perceive and use their personal strengths as a basis for better integrating empowering person‐centred approaches into health care.

Objective

To explore what people with chronic illness describe as their strengths relevant to their health and well‐being.

Setting and Participants

Thirty‐nine participants (11 men) from 4 outpatient self‐management programmes were recruited to individual or group interviews. Participants included patients with chronic respiratory disease (n = 7), chronic pain (n = 18) and morbid obesity (n = 14). Interviews were analysed using content analysis.

Results

A number of personal strengths were reported and categorized into 3 domains: (i) Internal strengths, (ii) External strengths and (iii) Self‐management strategies. Internal strengths included being persistent, having a positive outlook, being kind and caring, experiencing positive emotions, being kind towards oneself, reconciling oneself with the situation, having courage and having knowledge and insight. External strengths included support from family, friends, peers and health‐care providers. Self‐management strategies included being active, planning and prioritizing, reducing stress, goal setting and seeking knowledge and help.

Discussion and Conclusion

The study provides insights into personal strengths as reported by people with chronic illness. The results complement prior findings on strengths in people with health challenges and can aid in incorporating person‐centred approaches into health care.     

Somatically ill persons’ self-nominated quality of life domains: review of the literature and guidelines for future studies

Objective  

To review which domains somatically ill persons nominate as constituting their QoL. Specific objective is to examine whether the method of enquiry affect these domains.     

Practice and professional development plans (PPDPs): results of a feasibility study

Background  

Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development.     

The role of cumulative physical work load in symptomatic knee osteoarthritis – a case-control study in Germany

Objectives  

To examine the dose-response relationship between cumulative exposure to kneeling and squatting as well as to lifting and carrying of loads and symptomatic knee osteoarthritis (OA) in a population-based case-control study.     

Older people with diabetes have higher risk of depression, cognitive and functional impairments: implications for diabetes services

Objectives  

To examine the relationship between diabetes and impairments in functional and cognitive status as well as depression in older people.     

Synthesis of lipophilic tyrosyl esters derivatives and assessment of their antimicrobial and antileishmania activities

Background  

Preparation of tyrosyl lipophilic derivatives was carried out as a response to the food, cosmetic and pharmaceutical industries' increasing demand for new lipophilic antioxidants.     

Association between bone mineral density and lifestyle factors or vitamin D receptor gene polymorphism in adult male workers: a cross-sectional study

Objectives  

The aim of this cross-sectional study was to investigate the association between bone mineral density (BMD) and lifestyle factors, as well as the influence of vitamin D receptor (VDR) gene polymorphism, in adult male workers.     

Validation of the respiratory toxics exposure score (RTES) for chronic obstructive pulmonary disease screening

Objective  

Our aim is to evaluate the validity of exhaled carbon monoxide (CO) and of a newly-created score as markers of Chronic Obstructive Pulmonary Disease (COPD).     

Biological pathways and genetic variables involved in pain

Purpose  

This paper summarizes current knowledge of pain-related and analgesic-related pathways as well as genetic variations involved in pain perception and management.     

Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance

Purpose  

The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol.     

Physical and psychological symptoms and learning difficulties in children of women exposed and non-exposed to violence: a population-based study

Objectives  

To analyse the association between violence against mothers and the health of their children as reported by the mothers.     

Validating the Time and Change test to screen for dementia in elderly Koreans

Background  

We assessed the applicability of the T&C test as an accurate and convenient means to screen for dementia in primary care and community settings.