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71.
Maite Cruz Piqueras Ainhoa Rodríguez García de Cortazar Joaquín Hortal Carmona Javier Padilla Bernáldez 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(1)
Objective
To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters.Methods
Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain).Results
Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule.Conclusions
These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term “anti-vaccines” from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built. 相似文献72.
Amanda Leal Rocha Alessandra Figueiredo De Souza Laiz Fernandes Mendes Nunes Nayara Dias de Souza Cunha Clia Regina Moreira Lanza Denise Vieira Travassos Tarcília Aparecida da Silva 《Pediatric dermatology》2019,36(1):e27-e30
Drug‐induced reactions are complications associated with high mortality and significant morbidity. Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are examples of these conditions, which are characterized by skin and mucous lesions. Here, we report a case of a 9‐year‐old girl who presented with blisters associated with an extensive vesicular rash and multiple ulcerations on the lips and oral cavity. A drug‐induced hypersensitivity reaction to antibiotics was suspected, and a diagnosis of TEN was made. The patient was managed with withdrawal of the suspected causative agent, and the oral lesions were treated with low‐level laser therapy (LLLT) and oral hygiene. This case highlights that TEN requires interdisciplinary intervention with dental assistance and follow‐up to improve symptoms, nutrition, systemic condition, and quality of life. 相似文献
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75.
Maria C. Chammas Andre C. Oliveira Mario J. D´Ávilla Pedro H. Moraes Marcelo Straus Takahashi 《Ultrasound in medicine & biology》2019,45(1):50-55
We prospectively evaluated the effectiveness of contrast-enhanced ultrasonography (CEUS) for differentiation of benign versus malignant portal vein thrombosis (PVT). We studied a total of 43 patients with chronic liver disease, hepatocellular carcinoma-suggestive nodules and confirmed PVT, in whom the nature of the PVT was confirmed by follow-up imaging (US, computed tomography and/or magnetic resonance imaging) performed up to 6 mo after CEUS. PVT was assessed by US, Doppler US and CEUS with respect to vessel wall disruption and/or invasion, color Doppler vascularization, pulsed Doppler vascularization pattern and CEUS enhancement and vascularization pattern, and thrombi were classified as benign or malignant based on these findings. Follow-up studies revealed malignant PVT in 22 of the 43 patients (51%) and benign PVT in 21 patients (49%). CEUS findings were consistent with follow-up studies in 41 of the 43 patients (95%), with κ?=?0.903 (p < 0.0001), sensitivity?=?91% and specificity?=?100%, indicating that CEUS can be confidently used to differentiate benign from malignant portal vein thrombosis in the setting of chronic liver disease. 相似文献
76.
Background Context
Long-term follow-up of patient-reported outcome measures (PROM) is essential in both modern spinal care and research. Lack of time and staff are commonly reported barriers to implementing long-term follow-up of PROM. Automated and digital follow-up systems for PROM collection are seeing widespread use, yet their validity and comparative effectiveness have never been evaluated.Purpose
The present study aimed to assess the validity of digital follow-up systems in comparison with the conventional paper-based follow-up (PB-FU).Study Design
This is a retrospective analysis of prospectively collected double follow-up data.Patient Sample
Patients who underwent lumbar spinal fusion for spondylolisthesis or degenerative disc disease between 2013 and 2016 were included in the study.Outcome Measures
The study determined the Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for back and leg pain severity at baseline, 6 weeks, 12 months, and 24 months.Materials and Methods
After lumbar spinal fusion surgery, a double follow-up of PROM was carried out by conventional PB-FU during clinical visits, while simultaneously completing an automatically dispatched digital follow-up questionnaire. As the primary end point, we assessed the intraindividual discrepancy in PROM between PB-FU and automated digital follow-up (AD-FU).Results
Forty patients completed all parts of the dual follow-up trajectory and were analyzed. We detected no discrepancy in ODI or NRS for back and leg pain severity at any of the baseline, 6-week, 12-month, or 24 month follow-ups (all p>.05). This was confirmed in a sensitivity analysis.Conclusions
In an analysis of dual paper-based and digital follow-up after lumbar fusion surgery, patients report highly similar values using either method of follow-up. It appears that AD-FU without incentives produces lower response rates. To reassess the validity of these systems for data collection in spinal patient care, a prospective validation with higher statistical power is warranted. 相似文献77.
78.
Jeroen M. van de Pol Jurjen G. Geljon Svetlana V. Belitser Geert W.J. Frederix Anke M. Hövels Marcel L. Bouvy 《Research in social & administrative pharmacy》2019,15(1):70-76
Introduction
The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice.Methods
Self-reporting work sampling was used to register the activities of community pharmacists. A smartphone application, designed specifically for this purpose, alerted participants to register their current activity five times per working day for 6 weeks. Participants also completed an online survey about baseline characteristics.Results
Ninety-one Dutch community pharmacists provided work-sampling data (7848 registered activities). Overall, 51.5% of their time was spent on professional activities, 35.4% on semi-professional activities, and 13.1% on non-professional activities. The proportion of time devoted to CPS decreased during the workweek, whereas the time spent on traditional task increased.Discussion and conclusion
This study shows it is feasible to collect work-sampling data using smartphone technology. Community pharmacists spent almost half of their time on semi-professional and non-professional activities, activities that could be delegated to other staff members. In practice, the transition to CPS is hampered by competing traditional tasks, which prevents community pharmacists from profiling themselves as pharmaceutical experts in daily practice. 相似文献79.
Luana Lopes Padilha Elcio Oliveira Vianna Andressa Talícia Machado Vale Joelma Ximenes Prado Teixeira Nascimento Antônio Augusto Moura da Silva Cecilia Claudia Costa Ribeiro 《Pediatric allergy and immunology》2020,31(5):480-488
Studies on the exposure of children to sugar-sweetened beverages (SSBs) at an early age may contribute to better understand the common causes and the temporal order of the relationships between obesity and asthma in early childhood. The objective of this study was to estimate the association between SSB and child asthma traits in the 2nd year of life, modeling direct and indirect pathways mediated by the highest BMI-z of the child and allergic inflammation. Data from the BRISA cohort, São Luís-MA, Brazil (n = 1140), were obtained from the baseline and from the follow-up performed at the 2nd year of life. The main explanatory variable was the calories from added sugars in SSBs as a percentage of the total daily energy intake. The outcome child asthma traits was a latent variable deduced from four indicators: medical diagnosis of asthma, wheezing, emergency visit due to intense wheezing, and medical diagnosis of rhinitis. A high percentage of daily calories from sugars added to SSBs was directly associated with higher values of child asthma traits (standardized coefficient (SC = 0.073; P = .030)). High levels of eosinophils were also directly associated with child asthma traits (SC = 0.118; P = .049). No mediation pathways were observed via greater BMI-z or eosinophil counts. Therefore, early exposure of children to SSB may contribute to increased risk of childhood asthma, preceding the link between sugar consumption and overweight/obesity, not yet evident in children in the first 2 years of life. 相似文献
80.