Enevoldsenpape7394
ctly compared clinically meaningful PROMIS domains across eight orthopaedic subspecialties, which would not have been possible with legacy measures alone. These results support PROMIS's utility as a common metric to assess and compare patient health status across multiple orthopaedic subspecialties.
For over more than a decade, low-dose amitriptyline and mirtazapine are prescribed off-label for insomnia. However, placebo-controlled evidence on these antidepressants for insomnia is still lacking. Therefore, the present trial aims to assess the effectiveness of low-dose amitriptyline (10-20 mg/day) and mirtazapine (7.5-15 mg/day) in patients with insomnia disorder with difficulty maintaining sleep or early-morning awakening problems in general practice.
The Drug REdiscovery low-dose Amitriptyline and Mirtazapine for INsomnia disorder in General practice (DREAMING) study is a randomised, double-blind, placebo-controlled trial in about 50 general practices. Adults (18-85 years) with insomnia disorder (Diagnostic and Statistical Manual of Mental Disorders-5) who ask their general practitioner (GP) for sleep medication when non-pharmacological treatment is deemed not effective, are eligible.
isolated sleep initiation problem, contraindications for or drug-drug interactions with either amitriptyline or mind to key stakeholders.
NTR7449.
NTR7449.
Experimental and clinical data demonstrate that skin diseases like psoriasis are affected by psychological factors and can be modulated by interventions other than conventional drug therapy. Phorbol 12-myristate 13-acetate price The expectation of patients towards the benefit of a forthcoming treatment as well as treatment pre-experiences have been demonstrated as crucial factors mediating placebo responses in inflammatory skin diseases. However, it is unknown whether and to what extent treatment outcomes of psoriasis patients under therapy with monoclonal antibodies like secukinumab can be experimentally modulated at subjective and physiological levels by modifying the expectation of patients via verbal instruction or prior experience.
Treatment expectations will be modulated in patients with moderate-to-severe psoriasis undergoing treatment with the anti-interleukin-17A monoclonal antibody secukinumab. Patients with a Psoriasis Area and Severity Index (PASI) >12 will be randomly allocated to one of three groups (N=40 each). As a standard.
Early detection of cognitive impairments is crucial for the successful implementation of preventive strategies. However, in rural isolated areas or so-called 'medical deserts', access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, remote solutions such as telemedicine platforms represent great potential and can help to overcome this barrier. Moreover, current advances made in voice and image analysis can help overcome the barrier of physical distance by providing additional information on a patients' emotional and cognitive state. Therefore, the aim of this study is to evaluate the feasibility and reliability of a videoconference system for remote cognitive testing empowered by automatic speech and video analysis.
60 participants (aged 55 and older) with and without cognitive impairment will be recruited. A complete neuropsychological assessment including a short clinical interview will be administered in two conditions, once by telemedicine and once by f from this study will be published in peer-reviewed journals.
The procedures are not invasive and there are no expected risks or burdens to participants. All participants will be informed that this is an observational study and their consent taken prior to the experiment. link2 Demonstration of the effectiveness of such technology makes it possible to diffuse its use across all rural areas ('medical deserts') and thus, to improve the early diagnosis of neurodegenerative pathologies, while providing data crucial for basic research. Results from this study will be published in peer-reviewed journals.
To review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs).
The literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar.
Six observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients' experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition.
Limited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions.
CRD42019139365.
CRD42019139365.
The main aim of this study was to assess prelacteal feeding practice and its determinant factors among mothers having children less than 6 months of age in Bure district, Northwest Ethiopia.
Community-based cross-sectional study design.
Northern Ethiopia.
The present study was conducted among 621 mothers who had children less than 6 months of age in Bure district, Northwest Ethiopia, from 1 March 2019 to 30 March 2019.
Mothers prelacteal feeding practice, modelled using multivariable logistic regression.
Determinant factors of prelacteal feeding practice.
This study found that the prevalence of prelacteal feeding practice was 11.6% ((95% CI 9.0% to 14.2%)). Delayed initiation of breast feeding (adjusted OR, AOR=5.4, 95% CI 2.2 to 13.5), mothers who did not get counselling of breast feeding (AOR=2.9, 95% CI 1.2 to 7.2), home delivery (AOR=6.9, 95% CI 2.2 to 21.5), primiparous mothers (AOR=4.1, 95% CI 1.4 to 12.2), a newborn with history of neonatal illness (AOR=3.3, 95% CI 1.3 to 8.5) and lack ofts of early initiation of breast feeding, promote institutional delivery, enhance maternal health-seeking behaviour and encourage mothers to have postnatal care visits is recommended.
The association between hypertensive disorders in pregnancy (HDP) and an increased risk of asthma in offspring remains controversial. No systematic review of this topic has been performed. The aim of this systematic review was to summarise the available evidence regarding the association between HDP and the risk of asthma in offspring.
Systematic review and meta-analysis.
On the basis of a prepared protocol, a systematic search of PubMed, EMBASE, the Cochrane Library and Web of Science was performed using a detailed search strategy from the database inception to 17 January 2020. Cohort, case-control and cross-sectional studies published in English reporting the diagnoses of maternal HDP and asthma in offspring were included. The Meta-analysis of Observational Studies in Epidemiology guidelines were followed throughout the study. The estimated pooled ORs of HDP and asthma in offspring were calculated from the studies, and the meta-analysis was performed using random-effects models.
Ten cohort studies involving a total of 6 270 430 participants were included. According to the Newcastle-Ottawa Scale, the overall methodological quality was good since 8 studies were of high quality and 2 studies were of moderate quality. After controlling for potential confounders, HDP was associated with a possible increased risk of asthma in offspring, with a pooled adjusted OR (aOR) of 1.19 (95% CI 1.12 to 1.26). The subgroup analyses according to HDP subgroups, sibling design, study quality, study location, offspring ages, singleton status, exposure assessment, outcome assessment and adjusted factors showed similar results.
Exposure to HDP may be associated with an increased risk of asthma in offspring. Further research is needed to verify the results and determine whether the observed relationship is causal.
CRD42020148250.
CRD42020148250.
Communication failures between clinicians lead to poor patient outcomes. Critically injured patients have multiple injured organ systems and require complex multidisciplinary care from a wide range of healthcare professionals and communication failures are abundantly common. This study sought to determine barriers and facilitators to interdisciplinary communication between the consulting trauma, intensive care unit (ICU) team and specialty consultants for critically injured patients at an urban, safety-net, level 1 trauma centre.
An observational qualitative study of barriers and facilitators to interdisciplinary communication.
We conducted observations of daily rounds in two trauma surgical ICUs and recorded the most frequently consulted teams.
Key informant interviews after presenting clinical vignettes as discussion prompts were conducted with a broad range of clinicians from the ICUs and physicians and nurse practitioners from the consultant teams who were identified during the observations. Interitators and barriers to accessibility, and therefore, interdisciplinary communication.
Accessibility impacted interdisciplinary communication between the consulting and the consultant team.
Elucidates barriers and facilitators to interdisciplinary communication between consulting and consultant teams.
Elucidates barriers and facilitators to interdisciplinary communication between consulting and consultant teams.
Shift work and night shifts are very common in healthcare organisations worldwide. However, healthcare professionals doing shift work and night shifts are exposed to several stressors with psychological, social, physical and sleeping consequences. This study aimed to evaluate the effect of night shifts on the psychosocial, physical well-being and sleeping patterns of healthcare professionals in Saudi Arabia.
We conducted an observational cross-sectional study from July to September 2019 at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Convenience sampling technique was used to recruit healthcare providers to participate in the study. link3 The outcomes measured included the effect of working hours of healthcare workers on psychosocial and physical health, substance use, and sleep quality and patterns. Pearson's χ
test was used to compare proportions, and Student's t-test/Analysis of variance (ANOVA) was used to examine the mean differences among different demographic groups.
A total of 352 healthcare providers were involved in the study, of whom only 272 were night shift workers.
