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41.
Interventions targeting absences increase adherence and reduce abandonment of childhood cancer treatment in El Salvador
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42.
Perception of nurse prescribing among nurses and psychiatrists in a developing country: A cross‐sectional survey
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Ashish Badnapurkar RN MSc Daniel Bressington RN PhD Martin Jones RN DProf Deborah Nelson RN MSc Dona Thomas RN MSc Mohammed Mehndi RN MSc Richard Gray RN PhD 《International journal of mental health nursing》2018,27(2):866-876
Nurse prescribing has the potential to improve patients’ access to, and experiences of, treatment. The aim of the present study was to examine nurse and psychiatrist attitudes about this extended role in a developing country. We conducted a cross‐sectional survey using a previously‐used, 65‐item, seven subscale measure of attitudes to nurse prescribing in mental health. We achieved a 79% response rate. The majority of participants had trained in developing countries where nurse prescribing has yet to be implemented. Across five subscales (general beliefs, impact, uses, training, and supervision), both groups reported positive attitudes about nurse prescribing. Both groups scored the training subscale particularly highly. Compared with psychiatrists, nurses were more confident about the range of clinical settings where nurse prescribing could be applied (e.g. acute inpatient and substance use). Although both groups had less favourable attitudes on the two subscales relating to clinical and legal responsibility, compared to nurses, psychiatrists were more undesirable. Although, overall, clinician attitudes do not seem to represent a barrier towards the potential implementation of nurse prescribing in the study setting, clarity about clinical and legal responsibility needs to be addressed. 相似文献
43.
Katherine Smith Carmen Washington Jennifer Brown Alison Vadnais Laura Kroart Jacqueline Ferguson Joanna Cohen 《JMIR Public Health and Surveillance》2015,1(2)
Background
Tobacco remains the world’s leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack.Objective
The objective of this study was to establish a surveillance system for tobacco packs in the 14 low- and middle-income countries with the greatest number of smokers. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended, and identifies pack designs and appeals that might violate or detract from the communication of harm-related information and undermine the impact of a country’s tobacco packaging laws. The protocol outlined is intended to be applicable or adaptable for surveillance efforts in other countries.Methods
Tobacco packs were collected in 14 countries during 2013. The intention was, to the extent possible, to construct a census of “unique” pack presentations available for purchase in each country. The TPackSS team partnered with in-country field staff to implement a standardized protocol for acquiring packs from 36 diverse neighborhoods across three cities in each country. At the time of purchase, data on price and place of acquisition of each pack was recorded. The field staff, according to a standardized protocol, then photographed packs before they were shipped to the United States for coding and archiving.Results
Each pack was coded for compliance with the country-specific health warning label laws, as well as for key design features of the pack and appeals of the branding elements. The coding protocols were developed based upon prior research, expert opinion, and communication theories. Each pack was coded by two independent coders, with consistency of personnel across the project. We routinely measured intercoder reliability, and only retained variables for which a good level of reliability was achieved. Variables where reliability was too low were not included in final analyses, and any inconsistencies in coding were resolved on a daily basis.Conclusions
Across the 14 countries, the TPackSS team collected 3307 tobacco packs. We have established a publicly accessible, Internet archive of these packs that is intended for use by the tobacco control policy advocacy and research community. 相似文献44.
Dr. R. B. Fraser 《Diabetologia》1982,22(1):21-24
Summary A six-year survey of pregnancies complicated by diabetes has been performed at the Kenyatta National Hospital, Nairobi. Fifty-five babies were delivered with 14 perinatal deaths — a perinatal mortality rate of 254/1000, which was five times that of the nondiabetic population. There was one maternal death. Diabetes tended to be of short duration compared with similar series reported from developed countries. There were no perinatal deaths within a small sub-group managed according to a simple plan based on early referral for antenatal care, monitoring of diabetic control by blood glucose, and timing of delivery by use of the shake test. 相似文献
45.
Eric Bénéfice 《Annals of human biology》2013,40(3):366-382
Background: A high level of activity is commonplace in traditional subsistence societies. Physiological characteristics of individuals, including body composition and physical fitness, could be limiting factors when performing daily tasks.Objectives: The study investigated the relationships between cardiorespiratory fitness, nutritional status and physical activity patterns, so as to test the hypothesis that these relationships are less straightforward in children than in adults.Study design: Four different groups of individuals from rural Senegal were investigated: 99 10–13-year-old children of both sexes (11.1?±?1.5 years old) from two settings in Senegal (Lambaye and Podor), 43 adolescent girls (15.5?±?0.5 years), and 30 adult women (17–40 years).Methods: Subjects undertook a step test, and anthropometric measurements were collected. Continuous heart rate (HR) monitoring was performed for 8–12?h. The flex-HR method was used to estimate levels of activity (per?cent of time spent under or over the flex-HR).Results: Ten to 13-year-old children and adolescent girls presented slight degrees of malnutrition. Adult women were apparently not nutritionally deprived. Differences in cardiorespiratory fitness were found among 10–13-year-old children, while adult women performed better than adolescent girls. Children from Lambaye had a higher level of activity than children from Podor. Similarly, adult women were more active than adolescent girls. No relationships were found between cardiorespiratory or anthropometric measurements and per?cent of time spent above the flex-HR (>flex-HR) in 10–13-year-old children. In contrast, in adult women and adolescent girls, body composition and cardiorespiratory indices were significant predictors of activity levels.Conclusion: Our data support the hypothesis that activity levels are less dependent upon physiological characteristics in children than in adults in traditional subsistence societies. 相似文献
46.
SHEILA L. Klassen ROBERT J.H. MILLER ROBIN HAO J. WAYNE WARNICA NOWELL M. FINE MAHENDRA CARPEN DEBRA L. ISAAC 《Journal of cardiac failure》2018,24(12):835-841
Background
Guyana is a small developing country with a high burden of cardiovascular disease and extensive barriers to optimal care delivery. We investigated the effectiveness of a newly established multidisciplinary inpatient cardiology service in this setting.Methods
We performed an interrupted time-series cohort study of heart failure (HF) patients admitted to the Georgetown Public Hospital Corporation from January to December 2015 and July 2016 to December 2017. The primary outcome was discharge on guideline-directed medical therapy (GDMT). Secondary outcomes included length of hospitalization and all-cause mortality.Results
We identified 740 patients, 347 (46.9%) of whom were admitted after service implementation. The postimplementation cohort was more likely to be discharged on a beta-blocker (66.6% vs 41.7%; P < .01) and mineralocorticoid receptor antagonist (31.7% vs 15.3%; P?=?.01). They were also more likely to undergo echocardiography (60.8% vs 40.5%; P < .01) and chest x-rays (70.6% vs 46.6%; P < .01). Hospitalization length (10.0 ± 13.1 vs 9.8 ± 10.1 days) and readmissions within 90 days (19.0% vs 19.1%) were not significantly different. There were fewer deaths in the postimplementation cohort compared with the preimplementation cohort (12/347 vs 28/393).Conclusions
Establishment of a multidisciplinary inpatient cardiology service demonstrated increased adherence to GDMT without extending length of hospitalization. 相似文献47.
Patterns of antimicrobial use and antimicrobial resistance among healthy children in Bolivia 总被引:1,自引:1,他引:1
Alessandro Bartoloni Felicity Cutts Silvia Leoni Christopher C. Austin Antonia Mantella Paolo Guglielmetti Mimmo Roselli Esteban Salazar & Franco Paradisi 《Tropical medicine & international health : TM & IH》1998,3(2):116-123
Summary
objective To determine the incidence of antimicrobial-resistant, nonpathogenic Escherichia coli among healthy children aged 6–72 months in Camiri town and a rural village, Javillo, in south-eastern Bolivia.
method A community-based survey: stool samples were obtained from 296 healthy children selected by modified cluster sampling in Camiri and all 25 eligible children in Javillo. E. coli isolates were tested for antimicrobial susceptibility according to the standard disc diffusion method. By a questionnaire survey of 12 pharmacies and by using simulated patients, we investigated the antimicrobial availability and the usage patterns in Camiri town.
results In Camiri, over 90%, and in Javillo over 70% of children carried E. coli resistant to ampicillin, trimethoprim-sulphamethoxazole (TMP/SMX) or tetracycline. Overall, 63% of children carried E. coli with multiple resistance to ampicillin, TMP/SMX, tetracycline and chloramphenicol. In the simulated patients study, antimicrobials were dispensed inappropriately for 92% of adults and 40% of children with watery diarrhoea, and were under-prescribed for males with urethral discharge (67%) or females with fever and dysuria (58%). The dose and/or duration of antimicrobials dispensed was almost always too low.
conclusion Our study showed a disturbingly high prevalence of carriage of nonpathogenic E. coli resistant to antimicrobials. The prevalence of resistance to ampicillin and TMP/SMX was higher than that previously reported in developing countries. The existence of a large reservoir of resistance genes in healthy individuals in developing countries represents a threat to the success of antimicrobial therapy throughout the world. Programmes to improve rational and effective drug use in developing countries are urgently needed. 相似文献
objective To determine the incidence of antimicrobial-resistant, nonpathogenic Escherichia coli among healthy children aged 6–72 months in Camiri town and a rural village, Javillo, in south-eastern Bolivia.
method A community-based survey: stool samples were obtained from 296 healthy children selected by modified cluster sampling in Camiri and all 25 eligible children in Javillo. E. coli isolates were tested for antimicrobial susceptibility according to the standard disc diffusion method. By a questionnaire survey of 12 pharmacies and by using simulated patients, we investigated the antimicrobial availability and the usage patterns in Camiri town.
results In Camiri, over 90%, and in Javillo over 70% of children carried E. coli resistant to ampicillin, trimethoprim-sulphamethoxazole (TMP/SMX) or tetracycline. Overall, 63% of children carried E. coli with multiple resistance to ampicillin, TMP/SMX, tetracycline and chloramphenicol. In the simulated patients study, antimicrobials were dispensed inappropriately for 92% of adults and 40% of children with watery diarrhoea, and were under-prescribed for males with urethral discharge (67%) or females with fever and dysuria (58%). The dose and/or duration of antimicrobials dispensed was almost always too low.
conclusion Our study showed a disturbingly high prevalence of carriage of nonpathogenic E. coli resistant to antimicrobials. The prevalence of resistance to ampicillin and TMP/SMX was higher than that previously reported in developing countries. The existence of a large reservoir of resistance genes in healthy individuals in developing countries represents a threat to the success of antimicrobial therapy throughout the world. Programmes to improve rational and effective drug use in developing countries are urgently needed. 相似文献
48.
Yasunobu Nohara Eiko Kai Partha Pratim Ghosh Rafiqul Islam Ashir Ahmed Masahiro Kuroda Sozo Inoue Tatsuo Hiramatsu Michio Kimura Shuji Shimizu Kunihisa Kobayashi Yukino Baba Hisashi Kashima Koji Tsuda Masashi Sugiyama Mathieu Blondel Naonori Ueda Masaru Kitsuregawa Naoki Nakashima 《Journal of medical Internet research》2015,17(1)
49.
50.