Stokesgray8126

As compared with participants who did not consider driving cessation at baseline, those who did were more likely to expect a better quality of life in the event of driving cessation and to use public transportation at baseline and follow-up despite their older age and poorer health. CONCLUSION Some factors associated with reduced social participation and driving cessation are inevitable, such as health status. However, other factors may facilitate maintenance of social participation, including anticipation of driving cessation and mobility habits. Our findings highlight the need for appropriate interventions that are widely available to older drivers before driving cessation occurs and for public policy actions facilitating alternative transport systems. BACKGROUND Omalizumab shows greater clinical benefit with 300mg dose than 150mg. OBJECTIVE To determine outcomes post-withdrawal, relapse, and retreatment in omalizumab responders, and, from stepping up to 300 mg after insufficient symptom control with 150mg. METHODS This was a prospective, randomized (34), open-label, non-comparator study (clinicaltrials.govNCT02161562). 314 adult patients with chronic spontaneous/idiopathic urticaria (CSU) and symptomatic on H1-antihistamines were enrolled between August 1, 2014 and November 6, 2015. Patients received 150mg/300mg omalizumab, every 4 weeks for 24 weeks. Omalizumab 150 mg dose could be stepped-up to 300 mg between week 8 and week 24 if UAS7 was >6. If patients relapsed after treatment withdrawal at week 24, they could be retreated with the same dose on which omalizumab was started. Patients on 300mg could extend treatment by 12 weeks if they didn't achieve symptom control on 300mg in the initial dosing phase. Primary endpoint was the proportion of well-controlled patients who relapsed post-withdrawal, and achieved symptom control at the end of retreatment. Symptom control was assessed using the 7-day sum of daily Urticaria Activity Score (UAS7; UAS7 ≤6 = well-controlled). RESULTS Overall, 115/314 patients had adequate symptom control at week 24 (end of initial dosing period), 56 were retreated after relapse post-withdrawal; 87.8% (95% confidence interval [CI] 78.6% to 96.9%) regained symptomatic control (UAS7 ≤ 6). Most (141/178) patients initially treated with 150mg required step-up to 300mg, which resulted in a 9.5 point (95% CI 7.6 to 11.3) improvement in UAS7 scores over the mean change observed initially on 150mg. CONCLUSION Step-up to 300mg helps a greater proportion of patients achieve symptom control, and retreatment with omalizumab is as effective as initial therapy. BACKGROUND Falls often cause unexpected injuries that older adults find difficult to recover from (e.g., hip and other major fractures, intracranial bleeding); therefore, fall prevention and interventions are of particular significance. OBJECTIVES This study aimed to examine the effectiveness of multifactorial fall prevention interventions among community-dwelling older adults and compare subgroups that differed in terms of their degree of fall risk and the intensity and components of interventions. METHODS An exhaustive systematic literature search was undertaken using the following databases Ovid-Medline, Ovid-Embase, and the Cochrane Central Register of Controlled Trials (Central). Two investigators independently extracted data and assessed the quality of the studies by examining the risk of bias. We conducted a meta-analysis of randomized controlled trials that had been published up to March 31st, 2019, using Review Manager. RESULTS Of 1,328 studies, 45 articles were relevant to this study. In total, 29 sof people who experienced falls during the study period compared to usual care in the healthy group (risk ratio 0.77; 95% confidence interval 0.62-0.95). Active multifactorial interventions (risk ratio 0.73; 95% confidence interval 0.60-0.89) and those featuring exercise (risk ratio 0.79; 95% confidence interval 0.66-0.95) and environmental modification (risk ratio 0.80; 95% confidence interval 0.68-0.95) had a significantly lower number of people who experienced falls compared to those receiving usual care. CONCLUSIONS Active multifactorial interventions had positive effects on fall rates and the number of people experiencing falls. Thus, healthcare workers, including nurses, should be involved in planning fall prevention programs so that older adults can be provided with optimal care; multifactorial interventions that include exercise and environmental modification are particularly effective in reducing falls. BACKGROUND Primary treatments for early-stage breast cancer can cause adverse effects, such as pain, fatigue, and sleep disturbance, that can markedly affect the patients' health-related quality of life. OBJECTIVE This study aimed to evaluate the benefits of a WeChat-based multimodal nursing program on early rehabilitation in postoperative women with breast cancer. DESIGN Clinical randomized controlled trial. SETTING Surgical breast cancer department of a general hospital in Shaanxi Province, China. learn more PARTICIPANTS Women with breast cancer were recruited via convenience sampling. The inclusion criteria were (1) age ≥18 years, (2) newly diagnosed with breast cancer, (3) stage I-III disease, and (4) indicated for surgery with adjuvant therapy. Exclusion criteria were (1) comorbidity with other malignant tumors and infections and (2) cognitive or psychiatric disorders. METHODS We recruited patients with breast cancer and randomly allocated them to the intervention (n = 56) and control (n = 55) groups. The former was' was affected by group (F = 21.55, P  less then  0.001) and time (F = 28.96, P  less then  0.001), whereas physical well-being was only affected by time (F = 35.39, P  less then  0.001). Pain, fatigue, and sleep were not significantly influenced by group effects. CONCLUSIONS We found a significant improvement in the health-related quality of life of postoperative women with breast cancer who used the WeChat-based multimodal nursing program during early rehabilitation. This demonstrated that the program is an effective intervention for postoperative rehabilitation in such patients. Findings of the study will provide evidence for eHealth services in clinical and transitional nursing care.