scholarly journals The Impact of Prescribed Dosage Assumptions on the Evaluation of Adherence and Persistence to Medication in Patients After Acute Myocardial Infarction

Author(s):  
Artis Luguzis ◽  
Juris Barzdins

Medication adherence is a significant problem in public health. Prescription-level pharmacy databases have great potential for monitoring actual drug adherence patterns at the healthcare system level. Many research papers have reported adherence estimates in different settings and populations. However, comparison between studies is not always straightforward due to different approaches taken when computing adherence. A crucial component to accurately estimate adherence is the availability of days’ supply information for each dispensing event. Reasonable assumptions regarding medication dosage have to be made, when this information is not available. In this study, we evaluate adherence and persistence to medication in patients after myocardial infarction and show that corresponding estimates differ significantly, when using different dosage assumptions, namely, when using defined daily dose or tablet per day dosage regimens. Moreover, we demonstrate that observed differences between medications might be a result of inaccurate dosage assumptions. We propose a comparison of distribution of days between dispensing events to that of days’ supplied as a relatively simple visual inspection to validate dosage assumptions.

2014 ◽  
Vol 32 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Karen A. Monsen ◽  
Ingrid S. Attleson ◽  
Kristin J. Erickson ◽  
Claire Neely ◽  
Gary Oftedahl ◽  
...  

2009 ◽  
Vol 3 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Elena Savoia ◽  
Paul D. Biddinger ◽  
Priscilla Fox ◽  
Donna E. Levin ◽  
Lisa Stone ◽  
...  

ABSTRACTObjective: Legal preparedness is a critical component of comprehensive public health preparedness for public health emergencies. The scope of this study was to assess the usefulness of combining didactic sessions with a tabletop exercise as educational tools in legal preparedness, to assess the impact of the exercise on the participants’ level of confidence about the legal preparedness of a public health system, and to identify legal issue areas in need of further improvement.Methods: The exercise scenario and the pre- and postexercise evaluation were designed to assess knowledge gained and level of confidence in declaration of emergencies, isolation and quarantine, restrictions (including curfew) on the movement of people, closure of public places, and mass prophylaxis, and to identify legal preparedness areas most in need of further improvement at the system level. Fisher exact test and paired t test were performed to compare pre- and postexercise results.Results: Our analysis shows that a combination of didactic teaching and experiential learning through a tabletop exercise regarding legal preparedness for infectious disease emergencies can be effective in both imparting perceived knowledge to participants and gathering information about sufficiency of authorities and existence of gaps.Conclusions: The exercise provided a valuable forum to judge the adequacy of legal authorities, policies, and procedures for dealing with pandemic influenza at the state and local levels in Massachusetts. In general, participants were more confident about the availability and sufficiency of legal authorities than they were about policies and procedures for implementing them. Participants were also more likely to report the need for improvement in authorities, policies, and procedures in the private sector and at the local level than at the state level. (Disaster Med Public Health Preparedness. 2009;3:104–110)


Author(s):  
Emilda Emilda

The limitations of waste management in the Cipayung Landfill (TPA) causing a buildup of garbage up to more than 30 meters. This condition has a health impact on people in Cipayung Village. This study aims to analyze the impact of waste management at Cipayung Landfill on public health in Cipayung Village, Depok City. The research is descriptive qualitative. Data obtained by purposive sampling. Data was collected by interviews, observation and documentation. Based on interviews with 30 respondents, it was found that the most common diseases were diarrhea, then other types of stomach ailments, subsequent itching on the skin and coughing. This is presumably because the environmental conditions in the form of unhealthy air and water and clean and healthy living behaviors (PHBS) have not become the habit of the people. The results indicated that there were no respondents who had implemented all of these criteria. In general respondents have implemented  3 criteria, namely maintaining hair hygiene, maintaining skin cleanliness, and maintaining hand hygiene. While maintaining clean water storage is the most often overlooked behavior. To minimize this health impact, improvements in waste management in Cipayung landfill are needed along with continuous socialization and education to develop PHBS habits and the importance of maintaining a clean environment.


2017 ◽  
Vol 25 (1) ◽  
pp. 47-65
Author(s):  
Tapiwa V. Warikandwa ◽  
Patrick C. Osode

The incorporation of a trade-labour (standards) linkage into the multilateral trade regime of the World Trade Organisation (WTO) has been persistently opposed by developing countries, including those in Africa, on the grounds that it has the potential to weaken their competitive advantage. For that reason, low levels of compliance with core labour standards have been viewed as acceptable by African countries. However, with the impact of WTO agreements growing increasingly broader and deeper for the weaker and vulnerable economies of developing countries, the jurisprudence developed by the WTO Panels and Appellate Body regarding a trade-environment/public health linkage has the potential to address the concerns of developing countries regarding the potential negative effects of a trade-labour linkage. This article argues that the pertinent WTO Panel and Appellate Body decisions could advance the prospects of establishing a linkage of global trade participation to labour standards without any harm befalling developing countries.


Author(s):  
M. S. Bugaeva ◽  
O. I. Bondarev ◽  
N. N. Mikhailova ◽  
L. G. Gorokhova

Introduction. The impact on the body of such factors of the production environment as coal-rock dust and fluorine compounds leads to certain shift s in strict indicators of homeostasis at the system level. Maintaining the relative constancy of the internal environment of the body is provided by the functional consistency of all organs and systems, the leading of which is the liver. Organ repair plays a crucial role in restoring the structure of genetic material and maintaining normal cell viability. When this mechanism is damaged, the compensatory capabilities of the organ are disrupted, homeostasis is disrupted at the cellular and organizational levels, and the development of the main pathological processes is noted.The aim of the study is to compare the morphological mechanisms of maintaining structural homeostasis of the liver in the dynamics of the impact on the body of coal-rock dust and sodium fluoride.Materials and methods. Experimental studies were conducted on adult white male laboratory rats. Features of morphological mechanisms for maintaining structural homeostasis of the liver in the dynamics of exposure to coal-rock dust and sodium fluoride were studied on experimental models of pneumoconiosis and fluoride intoxication. For histological examination in experimental animals, liver sampling was performed after 1, 3, 6, 9, 12 weeks of the experiment.Results. The specificity of morphological changes in the liver depending on the harmful production factor was revealed. It is shown that chronic exposure to coal-rock dust and sodium fluoride is characterized by the development of similar morphological changes in the liver and its vessels from the predominance of the initial compensatory-adaptive to pronounced violations of the stromal and parenchymal components. Long-term inhalation of coal-rock dust at 1–3 weeks of seeding triggers adaptive mechanisms in the liver in the form of increased functional activity of cells, formation of double-core hepatocytes, activation of immunocompetent cells and endotheliocytes, ensuring the preservation of the parenchyma and the general morphostructure of the organ until the 12th week of the experiment. Exposure to sodium fluoride leads to early disruption of liver compensatory mechanisms and the development of dystrophic changes in the parenchyma with the formation of necrosis foci as early as the 6th week of the experiment.Conclusions. The study of mechanisms for compensating the liver structure in conditions of long-term exposure to coal-rock dust and sodium fluoride, as well as processes that indicate their failure, and the timing of their occurrence, is of theoretical and practical importance for developing recommendations for the timely prevention and correction of pathological conditions developing in employees of the aluminum and coal industry.The authors declare no conflict of interests.


2020 ◽  
Vol 13 (2) ◽  
pp. 109
Author(s):  
Yuyun Sarinengsih

ABSTRAKStunting yaitu keadaan gagal tumbuh akibat dari kekurangan gizi kronis. Prevalensi stunting di Kabupaten Tasikmalaya menempati urutan keempat, dimana kecamatan Sukahening menempati urutan pertama tertinggi dengan jumlah 155 balita mengalami stunting. Faktor yang dapat mempengaruhi kejadian stunting yaitu pengasuhan anak yang kurang baik dimana tidak diberikannya ASI secara Ekslusif. Pencegahan stunting yaitu pada 1000 hari kehidupan dimana salah satunya pemberian ASI secara Ekslusif.Penelitian ini bertujuan untuk mengetahui hubungan antara pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Jenis Penelitian yang digunakan adalah deskriptif korelasional dengan pendekatan cross-sectional. Populasi total sampling sebanyak 95 responden menggunakan teknik purposive sampling.Hasil Penelitian diperoleh lebih dari setengah responden 51,6% tidak diberikan ASI secara Ekslusif, dan sebagian besar 65,3% balita mengalami stunting. Hasil perhitungan chi-square diperoleh ρ.value (0,000<0,05) maka H0 ditolak sehingga terdapat hubungan antara Pemberian ASI Ekslusif dengan kejadian stunting pada balita 1-5 tahun di Puskesmas Sukahening Kecamatan Sukahening Kabupaten Tasikmalaya.Hasil penelitian ini diharapkan dapat memberi informasi yang bermanfaat dan perlu dilakukan pendidikan kesehatan ulang yang terjadwal terkait nutrisi yang terjangkau dan sehat sehingga dapat meningkatkan cakupan ASI Ekslusif dan dapat menurunkan angka stunting.Kata Kunci : ASI Ekslusif, StuntingDaftar Pustaka : 25 buku (2010-2018)9 jurnal (2013-2019)2 Website (2010-2017) ABSTRACTStunting is a condition of growth failure due to chronic malnutrition. The stunting prevalence in Tasikmalaya Regency was at the fourth place where Sukahening sub-district was at the highest with 155 stunting. Factor that can influence the occurrence of stunting is a poor parenting where exclusive breastfeeding is not given. The best prevention of stunting is on 1000 days of life where exclusive breastfeeding is given. The impact, if the baby is not given exclusive breastfeeding, they will lack of nutrition and also will have an impact on the growth or inappropriate height. This aims of the research is to determine the relationship between exclusive breastfeeding and the incidence of stunting on toddler under 5 years of at Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. The type of research used is descriptive correlation with a cross-sectional approach. The total samplings were 95 respondents which used purposive sampling technique. The results of the research were obtained more than half of the respondents 51.6% were given exclusive breastfeeding, and most 65.3% of children under five had stunting. The chi-square calculation results obtained that ρ.value (0,000 <0,05) then H0 is rejected so that there is a relationship between exclusive breastfeeding and the incidence of stunting on toddlers under 5 years in Sukahening Public Health Center, Sukahening Sub district, Tasikmalaya Regency. Performed the health education related to affordable and healthy nutrition so that it can increase the coverage of exclusive breastfeeding and can reduce stunting rates. Keywords : Exclusive breastfeeding, Stunting Bibliography : 25 books (2010-2018) 9 journals (2013-2019) 2 Websites (2010-2017) 


2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.


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