scholarly journals Evaluating Cost and Performance for Improved Meningitis Disease Surveillance in Chad

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Ngozi Erondu ◽  
Ulla K. Griffiths
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Cost Model ◽  
Phase 1 ◽  
Evaluation Study ◽  
Phase 2 ◽  
Meningitis Belt ◽  
And Performance ◽  
System Phase

An evaluation study was conducted in Chad to improve meningitis surveillance after the introduction of the serogroup A meningococcal conjugate vaccine. This project was carried out in four phases. Phase 1: Determine the actual costs of the current meningitis surveillance system; phase 2: Evaluate the performance and quality of the system; phase three: Determine the potential costs of scaling up the surveillance system to a feasible operational standard; and phase four: Use the results from Chad to develop a surveillance cost model that can be used for predicting the costs of surveillance strategies in other African meningitis belt countries.

scholarly journals Longitudinal Impact of APRNs on Nursing Home Quality Measures in the Missouri Quality Initiative

2021 ◽  
Author(s):  
Marilyn Rantz ◽  
G. F. Petroski ◽  
L. L. Popejoy ◽  
A. A. Vogelsmeier ◽  
K. E. Canada ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Phase 1 ◽  
Quality Measures ◽  
The State ◽  
Full Time ◽  
Improve Quality ◽  
Phase 2 ◽  
Intervention Phase ◽  
Tract Infections

Abstract Objectives To measure the impact of advanced practice nurses (APRNs) on quality measures (QM) scores of nursing homes (NHs) in the CMS funded Missouri Quality Initiative (MOQI) that was designed to reduce avoidable hospitalizations of NH residents, improve quality of care, and reduce overall healthcare spending. Design A four group comparative analysis of longitudinal data from September 2013 thru December 2019. Setting NHs in the interventions of both Phases 1 (2012–2016) and 2 (2016–2020) of MOQI (n=16) in the St. Louis area; matched comparations in the same counties as MOQI NHs (n=27); selected Phase 2 payment intervention NHs in Missouri (n=24); NHs in the remainder of the state (n=406). Participants NHs in Missouri Intervention: Phase 1 of The Missouri Quality Initiative (MOQI), a Centers for Medicare and Medicaid (CMS) Innovations Center funded research initiative, was a multifaceted intervention in NHs in the Midwest, which embedded full-time APRNs in participating NHs to reduce hospitalizations and improve care of NH residents. Phase 2 extended the MOQI intervention in the original intervention NHs and added a CMS designed Payment Intervention; Phase 2 added a second group of NHs to receive the Payment. Intervention Only. Measurements Eight QMs selected by CMS for the Initiative were falls, pressure ulcers, urinary tract infections, indwelling catheters, restraint use, activities of daily living, weight loss, and antipsychotic medication use. For each of the monthly QMs (2013 thru 2019) an unobserved components model (UCM) was fitted for comparison of groups. Results The analysis of QMs reveals that that the MOQI Intervention + Payment group (group with the embedded APRNs) outperformed all comparison groups: matched comparison with neither intervention, Payment Intervention only, and remainder of the state. Conclusion These results confirm the QM analyses of Phase 1, that MOQI NHs with full-time APRNs are effective to improve quality of care.

scholarly journals Fitusiran Treatment Impacts on Health-Related Quality of Life in Subjects with Hemophilia A and B with Inhibitors Assessed with the Haemophilia Quality of Life Questionnaire for Adults (Haem-A-QoL)

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 23-24
Author(s):  
Sylvia Von Mackensen ◽  
Pratima Chowdary ◽  
Sarah Mangles ◽  
Qifeng Yu ◽  
Baisong Mei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hemophilia A ◽  
Phase 1 ◽  
Phase 2 ◽  
Publicly Traded ◽  
Advisory Committees ◽  
Related Quality ◽  
Health Related ◽  
Dose Dependent

Background: Fitusiran, an investigational RNA interference treatment for people with hemophilia A or B (PwH), with or without inhibitors, has shown dose-dependent lowering of antithrombin, increase in thrombin generation, and decrease in bleeding frequency in clinical trials. The novel mechanism of action and long pharmacodynamic effect enables once-monthly subcutaneous administration. This sustained hemostatic protection and less burdensome administration may improve patient-reported outcomes (PRO). Objective: To evaluate changes in PRO in terms of patient-relevant improvements in health-related quality of life (HRQoL) in PwH with inhibitors (PwHI) on prophylactic fitusiran treatment. Methods: Fitusiran was evaluated in a phase 1 dose-escalation study (NCT02035605) followed by a phase 2 open-label extension (OLE) study (NCT02554773) with monthly subcutaneous fixed doses of 50 mg or 80 mg. HRQoL was assessed using the Haem-A-QoL and the EuroQol 5 Dimensions (EQ-5D) questionnaires at baseline and at end of study in a cohort of 17 PwHI (Hemophilia A, n=15; Hemophilia B, n=2) from the phase 1 study. Results: Subjects previously treated on-demand or prophylactically had a mean (standard deviation [SD]) age of 34.6 (10.3) years and a mean (SD) number of bleeding episodes in the 6 months before baseline of 16.6 (10.7). Mean (SD) changes from baseline to end of study (day 84 or later) in Haem-A-QoL total (-9.2 [11.2]) and physical health (−12.3 [15.1]) domain scores suggest clinically meaningful improvement (lower scores indicate better HRQoL). Numeric reduction (i.e., improvement) in all other domains appeared to be dose-dependent (greater improvement in the 80 mg group) (Table 1). Changes in EQ-5D utility and EQ-VAS scores were not clinically meaningful. Further analyses in PwH with and without inhibitors from the phase 2 OLE will be presented. Conclusions: Fitusiran prophylaxis may improve HRQoL - particularly the Haem-A-QoL 'Physical health' domain (painful swelling, joint pain, pain with movement, difficulty walking, and time to get ready) as shown in a cohort of 17 PwHI . Additional analyses from ongoing OLE and phase 3 studies are planned to quantify the patient-relevant changes with fitusiran treatment in all hemophilia patients over time. Disclosures Von Mackensen: Sanofi, Bayer, Sobi, Chugai, Kedrion, Spark: Consultancy; Biotest, Sobi, CSL Behring: Honoraria; Novo Nordisk, Sobi: Research Funding. Chowdary:BioMarin: Honoraria; Bayer, CSL Behring, Freeline, Novo Nordisk, Pfizer and Sobi: Research Funding; Chugai, CSL Behring, Novo Nordisk, Pfizer, Roche, Sobi: Speakers Bureau; Bayer, Chugai, CSL Behring, Freeline, Novo Nordisk, Pfizer, Roche, Sanofi, Shire (Baxalta), Sobi, Spark: Membership on an entity's Board of Directors or advisory committees. Mangles:Roche, Takeda, Novo Nordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees; Sobi, Octapharma, Novo Nordisk, Shire and Roche/Chugai: Other: travel funding. Yu:Sanofi: Other: was an employee and stockholder of Sanofi, at the time of study; Albireo Pharmaceuticals, Inc: Current Employment. Mei:Sanofi: Current Employment, Current equity holder in publicly-traded company. Andersson:Sanofi: Current Employment, Current equity holder in publicly-traded company. Dasmahapatra:Sanofi: Current Employment, Current equity holder in publicly-traded company.

scholarly journals Oxytocin and Naltrexone Successfully Treat Hypothalamic Obesity in a Boy Post-Craniopharyngioma Resection

2017 ◽  
Vol 103 (2) ◽  
pp. 370-375 ◽  
Author(s):  
Eugenie A Hsu ◽  
Jennifer L Miller ◽  
Francisco A Perez ◽  
Christian L Roth
Keyword(s):  
Parental Monitoring ◽  
Animal Studies ◽  
Phase 1 ◽  
Poor Quality ◽  
Free Access ◽  
Phase 2 ◽  
Z Score ◽  
Hypothalamic Obesity ◽  
Food Seeking

Abstract Context Hypothalamic obesity, a treatment-resistant condition common to survivors of craniopharyngioma (CP), is strongly associated with a poor quality of life in this population. Oxytocin (OT), a hypothalamic neuropeptide, has been shown to play a role in the regulation of energy balance and to have anorexigenic effects in animal studies. Naltrexone (NAL), an opiate antagonist, has been shown to deter hedonic eating and to potentiate OT’s effects. Design In this parent-observed study, we tested the administration of intranasal OT for 10 weeks (phase 1), followed by a combination of intranasal OT and NAL for 38 weeks (phase 2) in a 13-year-old male with confirmed hypothalamic obesity and hyperphagia post-CP resection. Treatment resulted in 1) reduction in body mass index (BMI) z score from 1.77 to 1.49 over 10 weeks during phase 1; 2) reduction in BMI z score from 1.49 to 0.82 over 38 weeks during phase 2; 3) reduced hyperphagia during phases 1 and 2; 4) continued hedonic high-carbohydrate food-seeking in the absence of hunger during phases 1 and 2; and 5) sustained weight reduction during decreased parental monitoring and free access to unlocked food in the home during the last 10 weeks of phase 2. Conclusion This successful intervention of CP-related hypothalamic obesity and hyperphagia by OT alone and in combination with NAL is promising for conducting future studies of this treatment-recalcitrant form of obesity.

scholarly journals An evaluation of foundation doctor training: a mixed-methods study of the impact on workforce well-being and patient care [the Evaluating the Impact of Doctors in Training (EDiT) study]

2013 ◽  
Vol 1 (15) ◽  
pp. 1-208 ◽  
Author(s):  
S Mason ◽  
C O’Keeffe ◽  
A Carter ◽  
R O’Hara ◽  
C Stride
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Longitudinal Study ◽  
Phase 1 ◽  
Well Being ◽  
Junior Doctors ◽  
Phase 2 ◽  
Adequate Quality ◽  
The Impact

BackgroundA major reform of junior doctor training was undertaken in 2004–5, with the introduction of foundation training (FT) to address perceived problems with work structure, conditions and training opportunities for postgraduate doctors. The well-being and motivation of junior doctors within the context of this change to training (and other changes such as restrictions in working hours of junior doctors and increasing demand for health care) and the consequent impact upon the quality of care provided is not well understood.ObjectivesThis study aimed to evaluate the well-being of foundation year 2 (F2) doctors in training. Phase 1 describes the aims of delivering foundation training with a focus on the role of training in supporting the well-being of F2 doctors and assesses how FT is implemented on a regional basis, particularly in emergency medicine (EM). Phase 2 identifies how F2 doctor well-being and motivation are influenced over F2 and specifically in relation to EM placements and quality of care provided to patients.MethodsPhase 1 used semistructured interviews and focus groups with postgraduate deanery leads, training leads (TLs) and F2 doctors to explore the strategic aims and implementation of FT, focusing on the specialty of EM. Phase 2 was a 12-month online longitudinal study of F2 doctors measuring levels of and changes in well-being and motivation. In a range of specialties, one of which was EM, data from measures of well-being, motivation, intention to quit, confidence and competence and job-related characteristics (e.g. work demands, task feedback, role clarity) were collected at four time points. In addition, we examined F2 doctor well-being in relation to quality of care by reviewing clinical records (criterion-based and holistic reviews) during the emergency department (ED) placement relating to head injury and chronic obstructive pulmonary disease (COPD).ResultsPhase 1 of the study found that variation exists in how successfully FT is implemented locally; F2 lacks a clearly defined end point; there is a minimal focus on the well-being of F2 doctors (only on the few already shown to be ‘in difficulty’); the ED presented a challenging but worthwhile learning environment requiring a significant amount of support from senior ED staff; and disagreement existed about the performance and confidence levels of F2 doctors. A total of 30 EDs in nine postgraduate medical deaneries participated in phase 2 with 217 foundation doctors completing the longitudinal study. F2 doctors reported significantly increased confidence in managing common acute conditions and undertaking practical procedures over their second foundation year, with the biggest increase in confidence and competence associated with their ED placement. F2 doctors had levels of job satisfaction and anxiety/depression that were comparable to or better than those of other NHS workers, and adequate quality and safety of care are being provided for head injury and COPD.ConclusionsThere are ongoing challenges in delivering high-quality FT at the local level, especially in time-pressured specialties such as EM. There are also challenges in how FT detects and manages doctors who are struggling with their work. The survey was the first to document the well-being of foundation doctors over the course of their second year, and average scores compared well with those of other doctors and health-care workers. F2 doctors are benefiting from the training provided as we found improvements in perceived confidence and competence over the year, with the ED placement being of most value to F2 doctors in this respect. Although adequate quality of care was demonstrated, we found no significant relationships between well-being of foundation doctors and the quality of care they provided to patients, suggesting the need for further work in this area.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals A systematic review protocol of medical and clinical research landscapes and quality in Malaysia and Indonesia [REALQUAMI]

2020 ◽  
Author(s):  
Boon How Chew ◽  
Shaun Wen Huey Lee ◽  
Poh Ying Lim ◽  
Soo Huat Teoh ◽  
Aneesa Abdul Rashid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Biomedical Research ◽  
Phase 1 ◽  
Research Performance ◽  
Health Conditions ◽  
Research Quality ◽  
Independent Effect ◽  
Responsible Conduct Of Research ◽  
And Performance

Abstract Background Research landscapes and quality may change in many ways. Much research waste has been increasingly reported. Poorly conducted clinical and biomedical researches are detrimental to the health of the people and healthcare performance with misleading clinical evidence. Efforts to improve research performance will need good data on the profiles and performance of past research. This systematic review aims to describe the characteristics and examine the quality of clinical and biomedical research in Malaysia and Indonesia. Methods A search will be conducted in PubMed, EMBASE, CINAHL and PsycINFO to identify for published clinical and biomedical research from 1962 to 2019 from Malaysia and/or Indonesia. Additional search will also be conducted in MyMedR (Malaysian only). Studies found will be independently screened by a team of reviewers, relevant information will be extracted and the quality of articles will be assessed. In Phase 1, the characteristics of the research including the profiles of the researchers and the journals in which they are published will be reported descriptively. In Phase 2, a research quality screening tool will be validated to assess the research quality based on three domains of relevance, the credibility of the methods and usefulness of the results. Associations between the research characteristics and quality will be analysed. The independent effect of each of the determinant will be quantified in multivariable regression analysis. Longitudinal trends of the research characteristics, health conditions studied and settings, among others will be explored. Discussion Results of this study will serve as the 'baseline' data for future evaluation and within the country and between countries comparison. This review may also provide informative results to stakeholders of the evolution of research conduct and performance from the past until now. The longitudinal and prospective trends of the research characteristics and quality could provide suggestions on improvement initiatives. Additionally, information on health conditions, research settings, and whether they are over- or under-studied may help future prioritization of research initiatives and resources. Registration: CRD42020152907 (PROSPERO) and https://osf.io/w85ce (Open Science Framework’s registry for Research on the Responsible Conduct of Research).

scholarly journals A systematic review of medical and clinical research landscapes and quality in Malaysia and Indonesia [REALQUAMI]: the review protocol

2019 ◽  
Author(s):  
Boon-How Chew ◽  
Lim Poh Ying ◽  
Shaun Wen Huey Lee ◽  
Navin Kumar Devaraj ◽  
Adibah Hanim Ismail @ Daud ◽  
...  
Keyword(s):  
Biomedical Research ◽  
Phase 1 ◽  
Research Performance ◽  
Past Research ◽  
Relevant Information ◽  
Health Conditions ◽  
Research Quality ◽  
Independent Effect ◽  
And Performance

AbstractBackgroundResearch landscapes and quality may change in many ways. Much research waste has been increasingly reported. Efforts to improve research performance will need good data on the profiles and performance of past research.PurposeTo describe the characteristics and quality of clinical and biomedical research in Malaysia and Indonesia.MethodsA search will be conducted in PubMed, EMBASE, CINAHL and PsycINFO to identify for published clinical and biomedical research from 1962 to 2017 from Malaysia and/or Indonesia.Additional search will also be conducted in MyMedR (for Malaysian team only). Studies found will be independently screened by a team of reviewers, relevant information will be extracted and quality of articles will be assessed. As part of quality control, another reviewer will independently assess 10-20% of the articles extracted. In Phase 1, the profiles of the published research will be reported descriptively. In Phase 2, a research quality screening tool will be validated to assess research quality based on three major domains of relevance, credibility of the methods and usefulness of the results. Associations between the research characteristics and quality will be analysed. The independent effect of each of the determinant will be quantified in multivariable regression analysis. Longitudinal trends of the research profiles, health conditions in different settings will be explored. Depending on the availability of resources, this review project may proceed according to the different clinical and biomedical disciplines in sequence.DiscussionResults of this study will serve as the ‘baseline’ data for future evaluation and within country and between countries comparison. This review may also provide informative results to stakeholders of the evolution of research conduct and performance from the past till now. The longitudinal and prospective trends of the research profiles and quality could provide suggestions on improvement initiatives. Additionally, health conditions or areas in different settings, and whether they are over- or under-studied may help future prioritization of research initiatives and resources.

scholarly journals Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress

2020 ◽  
Author(s):  
Cinzia Cecchetto ◽  
Marilena Aiello ◽  
Silvio Ionta ◽  
Claudio Gentili ◽  
Sofia Adelaide Osimo
Keyword(s):  
Binge Eating ◽  
Emotional Eating ◽  
Online Survey ◽  
Phase 1 ◽  
Eating Behaviour ◽  
Phase 2 ◽  
Emotional Wellbeing ◽  
Negative Effects ◽  
The Impact

Due to the spread of COVID 2019, the Italian government imposed a lockdown on the national territory. Initially, citizens were required to stay at home and not to mix with others outside of their household (Phase 1); eventually, some of these restrictions were lifted (Phase 2). To investigate the impact of lockdown on emotional and binge eating, an online survey was conducted to compare measures of self-reported physical (BMI), psychological (Alexithymia), affective (anxiety, stress, and depression) and social (income, workload) state during Phase 1 and Phase 2. Data from 365 Italian residents showed that increased emotional eating was predicted by higher depression, anxiety, quality of personal relationships, and quality of life, while the increase of bingeing was predicted by higher stress. Moreover, we showed that higher alexithymia scores were associated by increased emotional eating and higher BMI scores were associated with both increased emotional eating and binge eating. Finally, we found that from Phase 1 to Phase 2 binge and emotional eating decreased. These data provide evidence of the negative effects of isolation and lockdown on emotional wellbeing, and, relatedly, on eating behaviour.

scholarly journals A Cross-Sectional Examination of the Mental Wellbeing, Coping and Quality of Working Life in Health and Social Care Workers in the UK at Two Time Points of the COVID-19 Pandemic

Epidemiologia ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 227-242
Author(s):  
Paula McFadden ◽  
Ruth D. Neill ◽  
John Moriarty ◽  
Patricia Gillen ◽  
John Mallett ◽  
...  
Keyword(s):  
Social Care ◽  
Phase 1 ◽  
Working Life ◽  
Phase 2 ◽  
Cross Sectional ◽  
Quality Of Working Life ◽  
Care Workers ◽  
Health And Social Care ◽  
The Uk

As the COVID-19 pandemic continues to evolve around the world, it is important to examine its effect on societies and individuals, including health and social care (HSC) professionals. The aim of this study was to compare cross-sectional data collected from HSC staff in the UK at two time points during the COVID-19 pandemic: Phase 1 (May–July 2020) and Phase 2 (November 2020–January 2021). The HSC staff surveyed consisted of nurses, midwives, allied health professionals, social care workers and social workers from across the UK (England, Wales, Scotland, Northern Ireland). Multiple regressions were used to examine the effects of different coping strategies and demographic and work-related variables on participants’ wellbeing and quality of working life to see how and if the predictors changed over time. An additional multiple regression was used to directly examine the effects of time (Phase 1 vs. Phase 2) on the outcome variables. Findings suggested that both wellbeing and quality of working life deteriorated from Phase 1 to Phase 2. The results have the potential to inform interventions for HSC staff during future waves of the COVID-19 pandemic, other infectious outbreaks or even other circumstances putting long-term pressures on HSC systems.

Influence of crude protein content and flint maize processing methods on the performance of early-weaning Nellore calves

2022 ◽  
pp. 1-10
Author(s):  
L. A. Godoi ◽  
B. C. Silva ◽  
G. A. P. Souza ◽  
B. C. Lage ◽  
D. Zanetti ◽  
...  
Keyword(s):  
Crude Protein ◽  
Phase 1 ◽  
Protein Supplement ◽  
Phase 2 ◽  
Animal Performance ◽  
Processing Methods ◽  
Finishing Cattle ◽  
Whole Plant ◽  
Dietary Components ◽  
And Performance

Abstract This study aims to determine the effects of dietary crude protein (CP) content of early-weaned calves; and the influence of flint maize processing methods on intake, total tract nutrient digestibilities and performance of Nellore heifer calves. Fifteen early-weaned Nellore female calves (4 ± 0.5 months; 108 ± 13.1 kg) were used. In phase 1, animals were fed one of the following diets for 112 days: 130, 145 or 160 g CP/kg dry matter (DM). In phase 2, animals received one of the two diets for 84 days: 0.60 dry ground maize grain, 0.30 whole-plant maize silage plus 0.10 mineral-protein supplement or 0.90 snaplage plus 0.10 mineral-protein supplement. In phase 1, intake and digestibility of dietary components were not affected (P > 0.05) by increasing dietary CP content. Daily total urinary nitrogen (N) and urinary urea N increased (P < 0.05) in response to increasing dietary CP content. Animal performance was not affected (P > 0.05) by dietary CP content. In phase 2, maize processing methods did not affect (P > 0.05) intake and digestibility of dietary components as well as animal performance, carcase characteristics and carcase composition. Therefore, based on the current experimental condition, we conclude that dietary CP concentrations of 130 g/kg DM can be indicated for early-weaned Nellore calves. However, more studies are recommended to validate this result and to evaluate concentrations below 130 g CP/kg DM for early-weaned Nellore calves. Moreover, snaplage could be used as an exclusive fibre and energy source for finishing cattle in feedlot.

Sign in / Sign up

Export Citation Format

Share Document