Camposware7503

The preferred birth spacing is longer than the actual birth spacing, signifying an unmet need of contraception.Despite the burden of injury associated with motorcycle crashes and injuries in Vietnam, there are no studies investigating health-related quality of life (HRQoL) following a nonfatal motorcycle crash in this country. Therefore, this study aimed to evaluate the change of HRQoL preinjury, and at 6 and 12 months postinjury motorcycle crash in Ho Chi Minh City, Vietnam. Outcome measures were Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12 Health Survey (SF-12) version 2 and the EQ-5D. Multilevel mixed models were undertaken. A total of 352 hospitalized motorcyclists were followed-up. Compared with preinjury, the SF-12 PCS reduced by 6.61 points (95% confidence interval [CI] = -8.21 to -5.03) and 5.12 points (95% CI = -6.74 to -3.51) at 12 months postinjury. MCS also reduced by 4.23 points (95% CI = -5.99 to -2.47) at 6 months but increased by 1.29 points (95% CI = -0.49 to 3.08) at 12 months postinjury. The EQ-5D Visual Analogue Scale score decreased by 10.41 points (95% CI = -11.49 to -9.33) at 6 months and 6.48 points (95% CI = -7.58 to -5.38) at 12 months postinjury. The HRQoL among injured motorcycle riders improved between 6 and 12 months after injury but had not returned to the levels before injury.Objective To review the efficacy and safety of onasemnogene abeparvovec-xioi (Zolgensma) in the treatment of spinal muscular atrophy (SMA). Data Sources An English-language literature search of PubMed, MEDLINE, and Ovid (1946 to December 2019) was completed using the terms onasemnogene, AVXS-101, and spinal muscular atrophy. Manufacturer prescribing information, article bibliographies, and data from ClinicalTrials.gov were incorporated in the reviewed data. Study Selection/Data Extraction All studies registered on ClinicalTrials.gov were incorporated in the reviewed data. Data Synthesis Onasemnogene is the first agent for SMA utilizing gene therapy to directly provide survival motor neuron 1 (SMN1) gene to produce SMN protein. Four publications of 1 clinical trial, 1 comparison study of treatment effects, and 1 combination therapy case series have been published. Relevance to Patient Care and Clinical Practice Onasemnogene is a one time dose approved by the Food and Drug Administration for SMA patients less then 2 years old who possess mutations in both copies of the SMN1 gene. Conclusion Onasemnogene appears to be an efficacious therapy for younger pediatric patients with SMA type 1. Concerns include drug cost and potential liver toxicity. Long-term benefits and risks have not been determined.Attention deficit/hyperactivity disorder (ADHD) is often accompanied by sleep problems in children. Temozolomide Sleep hygiene is defined as a set of behavioural, environmental, or cognitive modifications to improve sleep, and is routinely clinically utilised as first-line treatment for insomnia in ADHD. The objective of this systematic review of the literature is to evaluate the effectiveness of sleep hygiene interventions for sleep difficulties in children with ADHD. Sixteen relevant articles met the inclusion criteria, involving 1,469 participants, with a mean age of 9.6 years, across 6 countries. Fifteen studies found that sleep hygiene interventions were effective in improving sleep, while one did not show any significant improvement. Definite conclusions on the effectiveness of the interventions are difficult to draw due to the limited number of studies and a high risk of bias. There is growing evidence to support the use of sleep hygiene interventions to improve sleep quality in children with ADHD and sleep disturbance. However, well-conducted clinical trials are required to strengthen the evidence.We review the impact of control systems and strategies on the energy efficiency of chemical processes. We show that, in many ways, good control performance is a necessary but not sufficient condition for energy efficiency. The direct effect of process control on energy efficiency is manyfold Reducing output variability allows for operating chemical plants closer to their limits, where the energy/economic optima typically lie. Further, good control enables novel, transient operating strategies, such as conversion smoothing and demand response. Indirectly, control systems are key to the implementation and operation of more energy-efficient plant designs, as dictated by the process integration and intensification paradigms. These conclusions are supported with references to numerous examples from the literature. Expected final online publication date for the Annual Review of Chemical and Biomolecular Engineering, Volume 11 is June 8, 2020. Please see http//www.annualreviews.org/page/journal/pubdates for revised estimates.Purpose From the Audiology Education Summit held in 2017, several working groups were formed to explore ideas about improving the quality and consistency in graduate education in audiology and externship training. The results are described here from one of the working groups formed to examine postgraduate specialization fellowships. Method Over the course of a year, the committee designed and implemented two surveys one directed toward faculty and one toward students. The rationale for the survey and the results are presented. Comparisons between faculty and student responses are made for similar questions. Results Overall, the results demonstrate that the majority of both students and faculty believe that postgraduation specialization fellowships are needed for either 1 year or a flexible length. There was a consensus of opinion that the fellowship should be paid, as these would be designed for licensed audiologists. Most believed that the fellowships should be "governed by a professional organization (e.g., higher salary" as benefits most important to them, with lower ratings for "recognition as a subject matter expert" or "potential pathway to Ph.D. program." Conclusions As a result of the survey, further exploration of a postgraduate specialization fellowship is warranted, especially to determine funding opportunities to offset cost for the sites and to ensure that fellows are paid adequately.OBJECTIVE TNIIIA2 is a peptide of the extracellular matrix glycoprotein tenascin-C. We evaluated whether intra-articular injection of TNIIIA2 could prevent articular cartilage degeneration without inducing synovitis in an osteoarthritis mice model. DESIGN Ten micrograms per milliliter of TNIIIA2 were injected into the knee joint of mice (group II) to evaluate the induction of synovitis. The control group received an injection of phosphate buffered saline (group I). Synovitis was evaluated using synovitis score 2 and 4 weeks after injection. The ligaments of knee joints of mice were transected to make the osteoarthritis model. After transection, 10 µg/mL of TNIIIA2 was injected into the knee joint (group IV). The control group received an injection of phosphate buffered saline after transection (group III). Histologic examinations were made using hematoxylin and eosin and safranin-O staining at 2, 4, 8, and 12 weeks postoperatively. An in vitro study was also performed to determine the mechanism by which TNIIIA2 prevents cartilage degeneration. Human chondrocytes were isolated, cultured, and treated with TNIIIA2. The expressions of various mRNAs, including inflammatory cytokines, and anabolic and catabolic factors for cartilage were compared using real-time polymerase chain reaction. RESULTS There were no differences between groups in the study of intra-articular injection of mice (group I vs. group II). In the osteoarthritis model, we found development of osteoarthritis was suppressed in group IV at 4 and 8 weeks. TNIIIA2 upregulated the expressions of tumor necrosis factor-α, matrix metalloproteinase 3, and basic fibroblast growth factor. CONCLUSION We demonstrated that TNIIIA2 could prevent cartilage degeneration without synovitis.OBJECTIVE The aim of this study was to evaluate a staff behaviour change intervention to increase the use of ward-based practice books and active practice by stroke inpatients. DESIGN This is a pre-post observational study. SETTING This study was conducted in a inpatient rehabilitation unit in Australia. SUBJECTS Stroke inpatients participated in the study. INTERVENTION A staff behaviour change intervention was designed to support staff to implement practice books. The intervention included staff training on motivation and coaching, and weekly audit and feedback for six months. The environment was restructured to bring staff together weekly at the bedside to review audit data and share skills. MAIN MEASURES Medical record audit and behavioural mapping were used to compare the number of stroke participants with/using a practice book pre- and post-intervention. Pre- and post-intervention, the percentage of observations where a stroke participant was actively practising, repetitions of practice recorded and type of supervision were compared. RESULTS A total of 24 participants were observed (n = 12 pre, n = 12 post). Post-intervention, the number of participants with practice books increased from one to six (OR = 11, 95% CI = (0.9, 550.7)), but this change was not statistically significant (P = 0.069). Five participants recorded repetitions in their practice books post-intervention, three were observed using practice books. There was no change in median repetitions recorded (rpbs = 0.00, 95% CI = (-0.4, 0.4), P = 1.000) or observed active practice (rpbs = -0.02, 95% CI = (-0.4, 0.4), P = 0.933). Active practice was often fully supervised by a therapist. CONCLUSION A staff behaviour change intervention has the potential to increase the number of stroke survivors receiving ward-based practice books but did not increase active practice.Closed-loop communication (CLC) promotes a shared understanding of information. The authors hypothesized that simulation-based CLC training would improve staff perceptions of CLC ability and decrease medical errors. Participants experienced 2 hands-on CLC simulations one month apart. A retrospective chart review of Emergency Severity Index (ESI) 1 patients was conducted 4 months pre and post CLC simulation-based training. Seventy simulations were held over 13 weeks. Staff perceptions of CLC ability improved and were sustained after one month. Nine ESI 1 patients were seen pre CLC, and 9 post; 8/9 pre-CLC ESI 1 patients had medical errors, with 19 total errors noted; 5/9 post-CLC ESI 1 patients had medical errors, with 5 total errors noted (rate ratio [99% CI] = 3.8 [1.4, 10.2]; P = .008). This simulation-based CLC training curriculum improved staff perceptions of their CLC ability and was associated with a significant decrease in the number of medical errors in ESI 1 patients.INTRODUCTION Self-assessment of health status can be considered a good predictor of population morbidity and mortality. Sociodemographic, environmental and health conditions can influence health self-perception. However, in rural areas, the identification of morbidities that affect workers' health and their general health condition is unknown. This study aims to evaluate the relationship between health self-perception and the occurrence of morbidities according to type of work. METHODS This was a cross-sectional, population-based study of a rural area of Brazil. Health self-perception outcomes were classified as good (very good or good) or not good (fair, poor or very poor). Rural work, classified as yes or no, was considered to be the exposure. Crude and adjusted Poisson regression analyses were performed, obtaining prevalence ratio (PR) estimates and the respective confidence intervals (95%CI). All analyses were stratified by sex and adjusted for confounding factors. RESULTS The sample comprised 893 individuals.