scholarly journals Continuity in general practice as a predictor of mortality, acute hospitalization, and use of out-of-hours services: registry-based observational study in Norway

2021 ◽  
pp. BJGP.2021.0340 ◽  
Author(s):  
Hogne Sandvik ◽  
Øystein Hetlevik ◽  
Jesper Blinkenberg ◽  
Steinar Hunskaar
Keyword(s):  
Observational Study ◽  
Explanatory Variable ◽  
Patient Relationship ◽  
Regression Analyses ◽  
Out Of Hours ◽  
Acute Hospitalization ◽  
Quality Aspect ◽  
One Year ◽  
Relationship Of ◽  
Dose Dependent

Background: Continuity, usually considered a quality aspect of primary care, is under pressure. Aim: To analyse the association between longitudinal continuity with a named regular general practitioner (RGP) and use of out-of-hours (OOH) services, acute hospitalization, and mortality. Design and setting: Registry-based observational study in Norway covering 4 552 978 Norwegians listed with their RGPs. Method: Duration of RGP-patient relationship was used as explanatory variable for the use of OOH services, acute hospitalization, and mortality in 2018. Several patient-related and RGP-related covariates were included in the analyses by individual linking to high-quality national registries. Duration of RGP-patient relationship was categorized as 1, 2–3, 4–5, 6–10, 11–15, and > 15 years. Results are given as adjusted odds ratio (OR) with 95 % confidence interval resulting from multilevel logistic regression analyses. Results: Compared with a one-year RGP-patient relationship the OR for use of OOH services decreased gradually from 0.87 (0.86 – 0.88) after 2 – 3 years duration to 0.70 (0.69 – 0.71) after more than 15 years. OR for acute hospitalization decreased gradually from 0.88 (0.86 – 0.90) after 2 – 3 years duration to 0.72 (0.70 – 0.73) after more than 15 years. OR for dying decreased gradually from 0.92 (0.86 – 0.98) after 2 – 3 years duration to 0.75 (0.70 – 0.80) after an RGP-patient relationship of more than 15 years. Conclusion: Length of RGP-patient relationship is significantly associated with lower use of out-of-hours services, fewer acute hospitalizations, and lower mortality. The associations are dose-dependent and probably causative.

Perceived Effectiveness of Random Testing for Alcohol and Drugs in the Australian Aviation Community

2012 ◽  
Vol 2 (2) ◽  
pp. 72-81
Author(s):  
Christina M. Rudin-Brown ◽  
Eve Mitsopoulos-Rubens ◽  
Michael G. Lenné
Keyword(s):  
Logistic Regression ◽  
Online Survey ◽  
Random Testing ◽  
Regression Analyses ◽  
Perceived Effectiveness ◽  
Student Pilots ◽  
Alcohol And Drugs ◽  
Positive Attitudes ◽  
One Year ◽  
Alcohol And Other Drugs

Random testing for alcohol and other drugs (AODs) in individuals who perform safety-sensitive activities as part of their aviation role was introduced in Australia in April 2009. One year later, an online survey (N = 2,226) was conducted to investigate attitudes, behaviors, and knowledge regarding random testing and to gauge perceptions regarding its effectiveness. Private, recreational, and student pilots were less likely than industry personnel to report being aware of the requirement (86.5% versus 97.1%), to have undergone testing (76.5% versus 96.1%), and to know of others who had undergone testing (39.9% versus 84.3%), and they had more positive attitudes toward random testing than industry personnel. However, logistic regression analyses indicated that random testing is more effective at deterring AOD use among industry personnel.

scholarly journals Pharmacological and clinical evaluation of deferasirox formulations for treatment tailoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrea Piolatto ◽  
Paola Berchialla ◽  
Sarah Allegra ◽  
Silvia De Francia ◽  
Giovanni Battista Ferrero ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Renal Impairment ◽  
Observational Study ◽  
Iron Overload ◽  
Iron Loading ◽  
Comprehensive Comparison ◽  
Dispersible Tablets ◽  
One Year ◽  
Safety Features

AbstractDeferasirox (DFX) is the newest among three different chelators available to treat iron overload in iron-loading anaemias, firstly released as Dispersible Tablets (DT) and more recently replaced by Film-Coated Tablets (FCT). In this retrospective observational study, pharmacokinetics, pharmacodynamics, and safety features of DFX treatment were analyzed in 74 patients that took both formulations subsequently under clinical practice conditions. Bioavailability of DFX FCT compared to DT resulted higher than expected [Cmax: 99.5 (FCT) and 69.7 (DT) μMol/L; AUC: 1278 (FCT) and 846 (DT), P < 0.0001]. DFX FCT was also superior in scalability among doses. After one year of treatment for each formulation, no differences were observed between the treatments in the overall iron overload levels; however, DFX FCT but not DT showed a significant dose–response correlation [Spearman r (dose-serum ferritin variation): − 0.54, P < 0.0001]. Despite being administered at different dosages, the long-term safety profile was not different between formulations: a significant increase in renal impairment risk was observed for both treatments and it was reversible under strict monitoring (P < 0.002). Altogether, these data constitute a comprehensive comparison of DFX formulations in thalassaemia and other iron-loading anaemias, confirming the effectiveness and safety characteristics of DFX and its applicability for treatment tailoring.

Dresden commemorative meetings: Vladimir Scherbachev — Nikolay Medtner

2020 ◽  
pp. 25-39
Author(s):  
Р.Н. Слонимская
Keyword(s):  
Musical Culture ◽  
Russian Culture ◽  
Opera House ◽  
Boris Godunov ◽  
One Year ◽  
Relationship Of ◽  
The Relationship

В статье рассматриваются взаимоотношения выдающихся музыкальных деятелей русской культуры Владимира Владимировича Щербачёва и Николая Карловича Метнера. Фактический материал анализируется на основе писем Щербачёва к жене, Марии Илларионовне, написанных в период командировки 1922-1923 годов в Пильниц под Дрезденом. В письмах раскрывается атмосфера музыкальной культуры Германии этого периода (в том числе постановка в Дрезденской опере Бориса Годунова Модеста Петровича Мусоргского). Подробно описывается процесс работы Щербачёва над партитурой монументального симфонического полотна Второй симфонии на стихи Александра Блока и приводится мнение Метнера о ней. Раскрываются музыкально-эстетические позиции Щербачёва и Метнера в отношении разных сторон техники сочинения, педагогики, исполнительского искусства. Одна из ключевых проблем сохранение традиции и радикальное новаторство, вызывавшее у Метнера весьма сложную реакцию. В целом, письма музыкантов дают возможность воссоздать живой и органичный облик двух композиторов разных творческих ориентаций, но искренне переживающих за музыкальное искусство. В конце статьи представлена роль Щербачёва в становлении ленинградской школы композиции. The article considers the relationship of outstanding music figures of the Russian culture VladimirV.Scherbachev and NikolayK.Medtner. The analyzed factual material is based on Scherbachevs letters to his wife Maria Illarionovna, written during a one-year trip to Pilnitz on the Elbe near Dresden 19221923. The letters reveal the atmosphere of musical culture of Germany of this period (including the production of Boris Godunov by Mussorgsky in the Dresden opera house). The author gives a detailed description of the process of Scherbachevs work on the score of the monumental symphonic canvas the Second Symphony on the poems by A.Blok, and Medtners opinion about it. In general, the letters of the two musicians give us an opportunity to recreate living and organic image of the two composers possessing different creative bearings, but sincerely worried about the music art.

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