Faculty Opinions recommendation of Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system.

Author(s):  
John Heritage
2008 ◽  
Vol 61 (5) ◽  
pp. 1172-1179 ◽  
Author(s):  
L. Grigoryan ◽  
J. G. M. Burgerhof ◽  
J. E. Degener ◽  
R. Deschepper ◽  
C. S. Lundborg ◽  
...  

Author(s):  
Aaron J Tande ◽  
Benjamin D Pollock ◽  
Nilay D Shah ◽  
Gianrico Farrugia ◽  
Abinash Virk ◽  
...  

Abstract Background Several vaccines are now clinically available under emergency use authorization in the United States and have demonstrated efficacy against symptomatic COVID-19. The impact of vaccines on asymptomatic SARS-CoV-2 infection is largely unknown. Methods We conducted a retrospective cohort study of consecutive, asymptomatic adult patients (n = 39,156) within a large United States healthcare system who underwent 48,333 pre-procedural SARS-CoV-2 molecular screening tests between December 17, 2020 and February 8, 2021. The primary exposure of interest was vaccination with at least one dose of an mRNA COVID-19 vaccine. The primary outcome was relative risk of a positive SARS-CoV-2 molecular test among those asymptomatic persons who had received at least one dose of vaccine, as compared to persons who had not received vaccine during the same time period. Relative risk was adjusted for age, sex, race/ethnicity, patient residence relative to the hospital (local vs. non-local), healthcare system regions, and repeated screenings among patients using mixed effects log-binomial regression. Results Positive molecular tests in asymptomatic individuals were reported in 42 (1.4%) of 3,006 tests performed on vaccinated patients and 1,436 (3.2%) of 45,327 tests performed on unvaccinated patients (RR=0.44 95% CI: 0.33-0.60; p<.0001). Compared to unvaccinated patients, the risk of asymptomatic SARS-CoV-2 infection was lower among those >10 days after 1 st dose (RR=0.21; 95% CI: 0.12-0.37; p<.0001) and >0 days after 2 nd dose (RR=0.20; 95% CI: 0.09-0.44; p<.0001) in the adjusted analysis. Conclusions COVID-19 vaccination with an mRNA-based vaccine showed a significant association with a reduced risk of asymptomatic SARS-CoV-2 infection as measured during pre-procedural molecular screening. The results of this study demonstrate the impact of the vaccines on reduction in asymptomatic infections supplementing the randomized trial results on symptomatic patients.


2021 ◽  
pp. 31-52
Author(s):  
Grazia Dicuonzo ◽  
Francesca Donofrio ◽  
Antonio Fusco ◽  
Vittorio Dell’Atti

This paper investigates the digitalization challenges facing the Italian healthcare system. The aim of the paper is to support healthcare organizations as they take advantage of the potential of big data and artificial intelligence (AI) to promote sustainable healthcare systems. Both the development of innovative processes in the management of health care activities and the introduction of healthcare forecasting systems are valuable resources for clinical and care activities and enable a more efficient use of inputs in essential-level care delivery. By examining an innovative project developed by the Regional Social Health Agency (ARSS) of Veneto, this study analyses the impact of big data and AI on the sustainability of a healthcare system. In order to answer the research question, we used a case study methodology. We conducted semi-structured interviews with key members of the organizational group involved in the case. The results show that the implementation of AI algorithms based on big data in healthcare both improves the interpretation and processing of data, and reduces the time frame necessary for clinical processes, having a positive effect on sustainability.


2017 ◽  
Vol 11 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Edward F. Boumil ◽  
Rishel Brenna Vohnoutka ◽  
Yuguan Liu ◽  
Sangmook Lee ◽  
Thomas B Shea

Background: Amyotrophic lateral sclerosis (ALS) is a progressive disease of motor neurons that has no cure or effective treatment. Any approach that could sustain minor motor function during terminal stages would improve quality of life. Objective: We examined the impact of omega-3 (Ω-3) and Ω-6, on motor neuron function in mice expressing mutant human superoxide dismutase-1 (SOD-1), which dominantly confers familial ALS and induces a similar sequence of motor neuron decline and eventual death when expressed in mice. Method: Mice received standard diets supplemented with equivalent amounts of Ω-3 and Ω-6 or a 10x increase in Ω-6 with no change in Ω-3 commencing at 4 weeks of age. Motor function and biochemical/histological parameters were assayed by standard methodologies. Results: Supplementation with equivalent Ω-3 and Ω-6 hastened motor neuron pathology and death, while 10x Ω-6 with no change in Ω-3 significantly delayed motor neuron pathology, including preservation of minor motor neuron function during the terminal stage. Conclusion: In the absence of a cure or treatment, affected individuals may resort to popular nutritional supplements such as Ω-3 as a form of “self-medication”. However, our findings and those of other laboratories indicate that such an approach could be harmful. Our findings suggest that a critical balance of Ω-6 and Ω-3 may temporarily preserve motor neuron function during the terminal stages of ALS, which could provide a substantial improvement in quality of life for affected individuals and their caregivers.


Author(s):  
Gregory McInnes ◽  
Andrew G. Sharo ◽  
Megan L. Koleske ◽  
Julie E. H. Brown ◽  
Matthew Norstad ◽  
...  

Genome sequencing is enabling precision medicine—tailoring treatment to the unique constellation of variants in an individual’s genome. The impact of recurrent pathogenic variants is often understood, leaving a long tail of rare genetic variants that are uncharacterized. The problem of uncharacterized rare variation is especially acute when it occurs in genes of known clinical importance with functionally consequent frequent variants and associated mechanisms. Variants of unknown significance (VUS) in these genes are discovered at a rate that outpaces current ability to classify them using databases of previous cases, experimental evaluation, and computational predictors. Clinicians are thus left without guidance about the significance of variants that may have actionable consequences. Computational prediction of the impact of rare genetic variation is increasingly becoming an important capability. In this paper, we review the technical and ethical challenges of interpreting the function of rare variants in two settings: inborn errors of metabolism in newborns, and pharmacogenomics. We propose a framework for a genomic learning healthcare system with an initial focus on early-onset treatable disease in newborns and actionable pharmacogenomics. We argue that (1) a genomic learning healthcare system must allow for continuous collection and assessment of rare variants, (2) emerging machine learning methods will enable algorithms to predict the clinical impact of rare variants on protein function, and (3) ethical considerations must inform the construction and deployment of all rare-variation triage strategies, particularly with respect to health disparities arising from unbalanced ancestry representation.


2017 ◽  
Vol 20 (9) ◽  
pp. A690 ◽  
Author(s):  
K Krinke ◽  
K Borchert ◽  
S Braun ◽  
T Mittendorf

2018 ◽  
Vol 31 (3) ◽  
pp. 81-86
Author(s):  
Elizabeth Hartney

The current healthcare system is often as highly stressful environment for patients, their families, and for the employees of the system. Health leaders also experience stress, which can have profound repercussions if not well managed. This article describes the impact of stress on the brain and nervous system functioning of health leaders, then, drawing on evidence from the literature, presents a three-step model for managing stress at the individual, team/organizational, and system levels.


2021 ◽  
Vol 14 (2) ◽  
pp. 16-23
Author(s):  
Kinjouo Ghislain Kenguem ◽  
Victor François Nguetsop ◽  
Solefack Marie Caroline Momo

Les forêts d’Afrique centrale contiennent plusieurs produits d’origine animale et végétale. Les produits d’origine végétale peuvent se distinguer en produits forestiers ligneux et non ligneux. Le présent travail de recherche porte sur l’importance et la gestion durable de quelques Produits Forestiers Non Ligneux (PFNL), notamment l’écorce de trois arbres (Garcinia lucida, Scorodophloeus zenkeri, Alstonia boonei) dans la localité de Ngovayang I. À l’aide d’un questionnaire semi-structuré, les caractéristiques du secteur des PFNL, les stratégies de gestion, ainsi que l’impact de la valorisation des PFNL ont été déterminés. Il ressort des enquêtes que les écorces de ces trois espèces sont connues et utilisées à des fins diverses telles que la consommation, l’automédication et la vente. L’initiation à l’utilisation de l’écorce de ces espèces est liée au sexe et est également fonction de l’âge des enquêtés. Leurs écorces sont approvisionnées sur le marché et vendues en majorité par les hommes. G. lucida et S. zenkeri sont utilisées à des fins nutritionnelles, médicinales et lucratives, tandis qu’Alstonia boonei est utilisée exclusivement à des fins médicinales. Pour des personnes plus jeunes, d’une tranche d’âge comprise entre 15 et 35 ans, l’exploitation de l’écorce de ces trois espèces n’a aucun impact néfaste sur la disponibilité des ressources forestières. S’agissant des personnes âgées de 35 à 65 ans, l’exploitation non contrôlée et l’écorçage anarchique de G. lucida et de S. zenkeri peuvent entrainer leur pénurie et même leur disparition dans cette région. Toutefois, la récolte échelonnée de l’écorce de G. lucida, S. zenkeri et A. boonei est utilisée comme stratégie de gestion de l’écorce de ces arbres dans cette localité.   Central African forests are teemed with several goods of animal and plant origin. Goods of plant origin are forest products and non-timber forest products. This research work focused on the identification and importance of some non-timber forest products (NTFPs), especially the bark of tree species (Garcinia lucida, Scorodophloeus zenkeri and Alstonia boonei) in the locality of Ngovayang I. Using a semi-structured questionnaire, the characteristics of the NTFP sector, management strategies, and the impact of NTFP exploitation were determined in Ngovayang I. Surveys show that the bark of these three species is well known and used for various purposes such as consumption, self-medication and sale. The initiation of the use of the bark of these species is linked to sex and also depends on the age of the respondents. Their bark is supplied on the market and sold mostly by men. G. lucida and S. zenkeri are used for food, medicinal and profit-making purposes, while A. boonei is used exclusively for medicinal purposes. For younger people, aged between 15 and 35 years old, the exploitation of the bark of these three species has no negative impact on forest resources. For old people (35 to 65 years), the uncontrolled exploitation and uncontrolled debarking of G. lucida and S. zenkeri can lead to the shortage and even extinction of these two tree species in the region. However, the planned harvest of the bark of Garcinia lucida, Scorodophloeus zenkeri and Alstonia boonei is used as strategy of management of the bark of these trees in this locality.


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