Search results for "DMI"
showing 10 items of 7539 documents
Public Health Policy to Tackle Social Health Inequalities: A Balancing Act Between Competing Institutional Logics
2020
Kvale and colleagues examine the logics of Norwegian government initiatives to respond to social inequalities in health. Whereas the individualist logic favors bounded and specialized measures and organization, the collectivist logic favors broad approaches and organizational coordination. A content analysis of Norwegian health policy documents between 2003 and 2017 shows how such specialized and integrative measures and structures are alternately introduced and hence create a pattern of priorities to tackle public health challenges alternating between a collectivist and an individualist logic. They argue that reform of service coordination to tackle social inequalities in health requires a…
Aplicación de The Community Assessment Risk Screen en centros de atención primaria del Sistema Sanitario Valenciano
2014
ResumenObjetivoAplicar la herramienta The Community Assessment Risk Screen (CARS) para detectar pacientes mayores con riesgo de reingreso hospitalario y estudiar la viabilidad de su inclusión en los sistemas de información sanitaria.DiseñoEstudio de cohortes retrospectivo.EmplazamientoDepartamentos de salud 6, 10 y 11 de la Comunidad Valenciana.ParticipantesPacientes de 65años o más atendidos en diciembre de 2008 en 6 centros de salud. La muestra fue de 500 pacientes (error muestral=±4,37%, fracción de muestreo=1/307).MedicionesInstrumento CARS formado por 3ítems: diagnósticos (enfermedades cardiacas, diabetes, infarto de miocardio, ictus, EPOC, cáncer), número de fármacos prescritos e ingr…
Effects of Morning Versus Evening Statin Administration on Lipid Profile: A Systematic Review and Meta-Analysis
2017
Background Evidence about the optimal time of day at which to administer statins is lacking. Objective The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile. Methods We searched PubMed, SCOPUS, Web of Science, and Embase databases (from inception up to July 24, 2016) to identify the relevant studies. Mean differences (MDs) between the change scores in lipid parameters were pooled using a fixed-effect model. Results Eleven articles with 1034 participants were eligible for the analysis. The pooled analysis comparing effects of morning vs evening administration of statins on plasma total cholesterol (TC; P = .10), high…
Reducing the initial number of rituximab maintenance-therapy infusions for ANCA-associated vasculitides: randomized-trial post-hoc analysis
2020
AbstractObjectiveThe randomized, controlled MAINRITSAN2 trial was designed to compare the capacity of an individually tailored therapy [randomization day 0 (D0)], with reinfusion only when CD19+ lymphocytes or ANCA had reappeared, or if the latter’s titre rose markedly, with that of five fixed-schedule 500-mg rituximab infusions [D0 + D14, then months (M) 6, 12 and 18] to maintain ANCA-associated vasculitis (AAV) remissions. Relapse rates did not differ at M28. This ancillary study was undertaken to evaluate the effect of omitting the D14 rituximab infusion on AAV relapse rates at M12.MethodsMAINRITSAN2 trial data were subjected to post-hoc analyses of M3, M6, M9 and M12 relapse-free surviv…
Single Preoperative Oral Application of Ascorbic Acid Does Not Affect Postoperative Plasma Levels of Ascorbic Acid
2002
<i>Background and Aims:</i> A decrease in ascorbic acid (AA) plasma concentration is well known during the postoperative period and postulated to be caused by increased radical scavenging activity in response to surgical trauma. This often affects postoperative patients and is associated with multiple organ failure. Therefore, substitution of AA could potentially decrease the risk of postoperative complications. This study examines the effect of preoperative oral administration of 1,000 mg AA on the postoperative AA plasma concentration. <i>Methods:</i> 54 patients were randomly split into two groups; patients in group 1 received no AA preoperatively while group 2 re…
Patterns of care and cost profiles of women with breast cancer in Italy: EPICOST study based on real world data
2020
Objectives To estimate total direct health care costs associated to diagnosis and treatment of women with breast cancer in Italy, and to investigate their distribution by service type according to the disease pathway and patient characteristics. Methods Data on patients provided by population-based Cancer Registries are linked at individual level with data on health-care services and corresponding claims from administrative databases. A combination of cross-sectional approach and a threephase of care decomposition model with initial, continuing and final phases-of-care defined according to time occurred since diagnosis and disease outcome is adopted. Direct estimation of cancer-related cost…
Incidence and factors associated with burnout in anesthesiology: A systematic review
2017
Background. Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods. We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). Al…
Adherence, compliance and persistence to oral antineoplastic therapy: a review focused on chemotherapeutic and biologic agents
2011
Introduction: To date, orally administered chemotherapy and biologic agents represent a significant percentage of all antineoplastic treatments in several types of cancer, which are most likely to increase in the near future. In this scenario, the issue of adherence and persistence to oral therapy is a key issue since poor compliance to oral antineoplastic treatments may negatively influence patients' clinical outcomes and, in turn, cause an increase in costs, number of hospitalizations and time spent in the hospital. Areas covered: The issue of adherence to new oral chemotherapeutic and/or biologic agents has not been deeply evaluated and data published in medical literature are quite scar…
ENTERAL NUTRITION SUPPORT TO TREAT MALNUTRITION IN INFLAMMATORY BOWEL DISEASE
2015
Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aethiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal tract disease. Often oral nutrition alone is not sufficient in the pathogenesis of gastrointestinal tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or elederly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral …
Water and Sodium in Heart Failure: A Spotlight on Congestion.
2014
Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is …