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1.
Anticancer Res ; 41(11): 5377-5391, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732407

RESUMO

BACKGROUND/AIM: To assess the quantity and quality of systematic reviews of in vitro cancer studies. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, Web of Knowledge and PROSPERO databases were searched. Articles described as systematic reviews of in vitro studies, focused on or relevant to cancer and published in English were selected and appraised using an adapted version of AMSTAR 2 'critical domains'. RESULTS: From 4,021 records, 41 reviews described as systematic and cancer-related were identified. Publication dates indicate increasing frequency of systematic review conduct. Mean number of databases searched was three (range=1-8). Thirty-six reviews (88%) reported search methods, 35 (85%) specified inclusion criteria, 26 (63%) reported study selection methods, and 21 (51%) used reporting guidelines. Only 13 reviews (32%) involved formal quality assessment. CONCLUSION: Detailed investigation of reviews of cancer-relevant in vitro studies indicates need for further development and use of robust search strategies, appropriate quality assessment tools, and researchers with relevant skills.


Assuntos
Pesquisa Biomédica/normas , Confiabilidade dos Dados , Oncologia/normas , Publicações Periódicas como Assunto/normas , Projetos de Pesquisa/normas , Revisões Sistemáticas como Assunto/normas , Animais , Guias como Assunto/normas , Humanos , Controle de Qualidade
4.
Pan Afr Med J ; 39: 279, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34754356

RESUMO

Introduction: cross-border mobility of persons with Tuberculosis (TB) is a global public health concern. We aimed at documenting health systems´ potential bottlenecks and opportunities in pulmonary TB continuum of care in cross-border expanses of East and Horn of Africa. Methods: a cross-sectional program assessment with descriptive analysis of TB services, health staff capacities, diagnostic capacities, data management and reporting, and treatment outcomes. Data were extracted from health facility TB registers and semi-structured key informant interviews conducted in selected 26 cross-border sites within the 7 member states of the Intergovernmental Authority on Development (IGAD) region. Results: the overall cross-border TB cure rate in the year preceding the study (37%) was way beneath the global target with considerable variations amongst the study countries. The restricted support to the cross-border health facilities was mediated and even exacerbated by expansive distances from the respective capital cities. Restricted geographical access to the facilities by cross-border populations was a longstanding challenge. Substantial staffing gaps, TB service delivery capacity needs and inadequate diagnostics were noticeable. The TB control guidelines were not harmonized between the countries and the inter-country referral systems were either absent or inappreciable, contributing to ineffective cross-border referrals and transfers. The frail linkages between stakeholders were contemptible, but increasing governments´ commitments in tackling infectious diseases were encouraging. Conclusion: cross-border TB interventions should drive regional TB policies, strategies and programs that sustain countries´ coordination, harmonization of management guidelines, advocacy for increased human resources support, enhanced capacity building of cross-border TB staff, adequate diagnostics equipping of the cross-border health facilities and seamless transfer and referral of patients traversing boundaries.


Assuntos
Atenção à Saúde/organização & administração , Emigração e Imigração , Saúde Pública , Tuberculose/terapia , África , Fortalecimento Institucional , Continuidade da Assistência ao Paciente/organização & administração , Estudos Transversais , Guias como Assunto , Política de Saúde , Humanos , Internacionalidade , Tuberculose/diagnóstico , Tuberculose/prevenção & controle
5.
Pan Afr Med J ; 39: 287, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34754364

RESUMO

In Tunisia, Hospital sterilization guidelines recommend the establishment of a quality assurance system. The purpose of this study is to give an overview of the situation in a sterilization unit in order to assess the adherence to good practice criteria and to identify opportunities for improvement. We conducted a prospective study in the sterilization unit of the Hospital Tahar Sfar, Mahdia in 2019. Two internal audits were conducted under the same conditions and were carried out one year apart. The first audit identified failures and malfunctions and the outlining of an action plan. The impact of the measures undertaken was tested using a second audit. Data collection was carried out by direct observation of the existing resources and practices. Compliance rate was calculated taking into account compliant criteria and applicable criteria. The results of the first audit revealed a compliance rate of around 28.1%. The analysis used to observe deviations made it possible to identify 5 axes of improvement, in particular the implementation of a system of documentation and a quality management system. In total, we prepared 14 documents related to the managerial processes, 26 to the operational processes and 41 to the support processes. The actions put in place enabled to achieve a compliance rate of 60.4%. The approach taken to upgrade sterilization processes made it possible to standardize them while ensuring traceability.


Assuntos
Hospitais/normas , Garantia da Qualidade dos Cuidados de Saúde , Esterilização/normas , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Auditoria Administrativa , Estudos Prospectivos , Melhoria de Qualidade , Tunísia
7.
Pan Afr Med J ; 40: 63, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34804331

RESUMO

The objectives of this study were to explore the content of web-based communication on COVID-19 by religious authorities (RAs) in Uganda and to assess the level of integration of the Uganda Ministry of Health (MoH) and World Health Organisation (WHO) COVID-19 risk communication guidelines into the statements released by these RAs. A grey literature review was conducted by searching the websites of intra- and inter-religious bodies for the terms "COVID-19" and "coronavirus". Thematic analysis was used to assess the content of RA statements which were also mapped to the items of the MoH and WHO statements. Results indicate that RA communications were centred on COVID-19 description and management; the need to adhere to established guidelines; and the adoption of health-protective behaviours, notably, social distancing and avoidance of misinformation. RAs also discussed the effects of COVID-19 and its control measures on the population and spoke against pandemic-aggravated injustices (gender-based violence and embezzlement). The RA messages incorporated the WHO statement to a greater extent than the MoH statement. In conclusion, RAs played a critical role in delivering public health messages in Uganda during the COVID-19 pandemic, a position we believe should be maximized by public health authorities for effective communication during emergencies.


Assuntos
COVID-19/prevenção & controle , Comunicação , Saúde Pública , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Internet , Religião , Uganda
8.
Heart Surg Forum ; 24(5): E906-E908, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34730492

RESUMO

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that threatens global health. During the pandemic period of COVID-19, the task for prevention in the general ward of cardiovascular surgery is fairly arduous. The present study intends to summarize our experience with infection control, including ward setting, admission procedures, personnel management, health education, and so on, to provide references for clinical management.


Assuntos
COVID-19/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/normas , Doenças Cardiovasculares/epidemiologia , Guias como Assunto , Pandemias/prevenção & controle , Quartos de Pacientes/normas , Centros de Atenção Terciária , COVID-19/epidemiologia , Doenças Cardiovasculares/cirurgia , China/epidemiologia , Comorbidade , Humanos , Estudos Retrospectivos , SARS-CoV-2
9.
Am J Nurs ; 121(11): 70, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34673703

RESUMO

According to this study: Targeted interventions improved the treatment of infants with bronchiolitis by reducing the use of non-evidence-based therapies without any identified negative consequences.


Assuntos
Bronquiolite/terapia , Guias como Assunto , Hospitalização , Albuterol/uso terapêutico , Austrália , Humanos , Lactente , Nova Zelândia , Estudos Retrospectivos
10.
Nurs Womens Health ; 25(5): 329-336, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34602165

RESUMO

OBJECTIVE: To solicit advice from members of the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) on what to include in an update of nurse staffing standards. DESIGN: Online, single-question survey with thematic analysis of responses. SETTING: Electronic survey link sent via e-mail. PARTICIPANTS: AWHONN members who shared their e-mail with the association and who responded to the survey (n = 1,813). MEASURES: Participants were asked to answer this single question: "The AWHONN (2010) Guidelines for Professional Registered Nurse Staffing for Perinatal Units are being updated. During their initial development, feedback from nearly 900 AWHONN members was extremely helpful in providing specific details for the nurse staffing guidelines. We'd really like to hear from you again. Please give the writing team your input. What should AWHONN consider when updating the AWHONN nurse staffing guidelines?" RESULTS: The e-mail was successfully delivered to 20,463 members; 8,050 opened the e-mail, and 3,050 opened the link to the survey. There were 1,892 responses. After removing duplicate and blank responses, 1,813 responses were available for analysis. They represented all hospital practice settings for maternity and newborn care and included nurses from small-volume and rural hospitals. Primary concerns of respondents centered on two aspects of patient acuity-the increasing complexity of clinical cases and the need to link nurse staffing standards to patient acuity. Other themes included maintaining current nurse-to-patient ratios, needing help with implementation in the context of economic challenges, and changing wording from "guidelines" to "standards" to promote widespread adoption. CONCLUSION: In a single-question survey, AWHONN members offered rich, detailed recommendations that were used in the updating of the AWHONN nurse staffing standards.


Assuntos
Guias como Assunto , Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem no Hospital/normas , Recursos Humanos/normas , Feminino , Humanos , Recém-Nascido , Enfermagem Neonatal , Relações Enfermeiro-Paciente , Parto , Admissão e Escalonamento de Pessoal , Gravidez , Sociedades de Enfermagem
11.
Int Marit Health ; 72(3): 223-227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604993

RESUMO

Since the global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of a coronavirus disease 2019 (COVID-19) infection started, millions of people globally have become infected. It must not be forgotten that thousands of those affected are commercial or recreational divers. A severe COVID-19 seriously affects the respiratory system and the pulmonary parenchyma but it may also involve the cardiovascular and the blood coagulation system. For this reason, many divers and hyperbaric medicine specialists are becoming increasingly concerned about a diver's ability to safely return to diving after a SARS-CoV-2 infection. The article presents current guidelines for diving fitness health assessment after a COVID-19 both for active and prospective divers, with particular emphasis on the types of diagnostic procedures and tests to be performed in cases of asymptomatic infection with SARS-CoV-2 as well as in patients who have recovered from a symptomatic COVID-19.


Assuntos
COVID-19/complicações , Mergulho/normas , Retorno ao Trabalho , Guias como Assunto , Humanos , SARS-CoV-2
12.
JAMA ; 326(16): 1614-1621, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34698778

RESUMO

Importance: Mendelian randomization (MR) studies use genetic variation associated with modifiable exposures to assess their possible causal relationship with outcomes and aim to reduce potential bias from confounding and reverse causation. Objective: To develop the STROBE-MR Statement as a stand-alone extension to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guideline for the reporting of MR studies. Design, Setting, and Participants: The development of the STROBE-MR Statement followed the Enhancing the Quality and Transparency of Health Research (EQUATOR) framework guidance and used the STROBE Statement as a starting point to draft a checklist tailored to MR studies. The project was initiated in 2018 by reviewing the literature on the reporting of instrumental variable and MR studies. A group of 17 experts, including MR methodologists, MR study design users, developers of previous reporting guidelines, and journal editors, participated in a workshop in May 2019 to define the scope of the Statement and draft the checklist. The draft checklist was published as a preprint in July 2019 and discussed on the preprint platform, in social media, and at the 4th Mendelian Randomization Conference. The checklist was then revised based on comments, further refined through 2020, and finalized in July 2021. Findings: The STROBE-MR checklist is organized into 6 sections (Title and Abstract, Introduction, Methods, Results, Discussion, and Other Information) and includes 20 main items and 30 subitems. It covers both 1-sample and 2-sample MR studies that assess 1 or multiple exposures and outcomes, and addresses MR studies that follow a genome-wide association study and are reported in the same article. The checklist asks authors to justify why MR is a helpful method to address the study question and state prespecified causal hypotheses. The measurement, quality, and selection of genetic variants must be described and attempts to assess validity of MR-specific assumptions should be well reported. An item on data sharing includes reporting when the data and statistical code required to replicate the analyses can be accessed. Conclusions and Relevance: STROBE-MR provides guidelines for reporting MR studies. Improved reporting of these studies could facilitate their evaluation by editors, peer reviewers, researchers, clinicians, and other readers, and enhance the interpretation of their results.


Assuntos
Lista de Checagem , Epidemiologia , Guias como Assunto , Análise da Randomização Mendeliana/métodos , Estudos Observacionais como Assunto , Viés , Estudo de Associação Genômica Ampla , Humanos , Disseminação de Informação , Projetos Piloto , Mídias Sociais
14.
J Manag Care Spec Pharm ; 27(10): 1352-1364, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34595944

RESUMO

BACKGROUND: Due to the US opioid epidemic, in March of 2016, the Centers for Disease Control and Prevention (CDC) published new guidelines for primary care providers on opioid prescribing for chronic pain. Payer coverage changes were also implemented to help modify opioid prescribing behavior. Whether these initiatives were associated with changes in opioid initiation patterns is unknown. OBJECTIVE: To assess the association between 3 of the 2016 CDC guidelines and 2 subsequent payer pharmacy coverage changes with changes in opioid initiation behavior across different provider specialties. METHODS: We conducted a real-world evidence study using claims data from OptumLabs Data Warehouse between January of 2014 and December of 2018. Subjects were continuously enrolled opioid naive patients, aged at least 18 years, who had at least 1 chronic pain diagnosis within 2 weeks before their first (first-time) opioid prescription. The study used multiple treatment period segmented regression analysis to evaluate the association, across different provider specialties, between the CDC guideline release and the payer pharmacy coverage changes with immediate change in level and overall change in the rate of first-time extended-release opioid prescriptions, firsttime opioid prescriptions at doses of at least 50 MME (morphine milligram equivalent) per day, and first-time opioid prescriptions with overlapping benzodiazepine prescription. RESULTS: The CDC guidelines were not associated with any change in the rate of first-time prescriptions of extended-release opioids. However, a January 2017 payer pharmacy coverage change was associated with a reduction over time in first-time extended-release opioid prescription rates by 22.15 in every 100,000 prescriptions (CI = -40.04 to -2.92, P = 0.013). The CDC guidelines were associated with an immediate decline in level of first-time opioid prescription at doses of at least 50 MME per day by 74.00 in every 10,000 prescriptions (CI = -124.86 to -23.13, P = 0.004) and an increased rate of decline over time by 13.64 in every 10,000 prescriptions (CI = -17.07 to -10.21, P < 0.001). These associations varied across provider types and specialties. The March 2018, payer coverage change was associated with an immediate reduction in level of first-time opioid prescriptions at doses of at least 50 MME per day across all specialties and an increased reduction over time among surgeons. The CDC guidelines were associated, respectively, with a reduction in the rate of overlapping first-time opioid prescriptions with benzodiazepines among family medicine, internal medicine, surgeons, emergency medicine providers, and providers with unknown specialty by 6.11, 5.10, 2.89, 11.43, and 9.11 in every 10,000 prescriptions monthly (CI = -9.48 to -2.73, -9.86 to -0.35, -5.40 to -0.38, -17.26 to -5.61 and -11.96 to -6.25, respectively, P < 0.001, P = 0.035, P = 0.024, P < 0.001 and P < 0.001). CONCLUSIONS: Some specialist providers also adopted the CDC guidelines, and the response to the guidelines differed across various provider specialties. Some CDC guidelines were associated with a reduction in high-risk first-time opioid prescriptions. Payer pharmacy coverage changes reinforced the guidelines both in situations where the CDC guidelines did and did not show any association. DISCLOSURE: This research was funded by Agency for Healthcare Research and Quality (R01 HS025164; PI: Karaca-Mandic). Karaca-Mandic reports grants from the American Cancer Society and Sempre Health, along with fees from Tactile Medical and Precision Health Economics, unrelated to this study. The other authors have nothing to disclose.


Assuntos
Analgésicos Opioides/uso terapêutico , Centers for Disease Control and Prevention, U.S. , Dor Crônica/tratamento farmacológico , Guias como Assunto , Cobertura do Seguro , Seguro de Serviços Farmacêuticos , Padrões de Prática Médica , Idoso , Bases de Dados Factuais , Feminino , Humanos , Revisão da Utilização de Seguros , Masculino , Pessoa de Meia-Idade , Estados Unidos
15.
J Prev Med Hyg ; 62(2): E415-E420, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34604582

RESUMO

Introduction: Osteoporosis is a chronic and progressive disease associated with gradual bone loss and elevated risk of fracture. Role of health care professional especially nurses in lowering burden of osteoporosis via patients and public education is critical. Current study conducted to evaluate knowledge and attitude regarding osteoporosis among the nurses in orthopedic wards and their experience with national clinical osteoporosis guideline. Methods: A cross-sectional study was conducted from August to December 2016 among all nurses in orthopedic ward of hospitals affiliated to Shiraz University of Medical Sciences. The 23- item self-administered scale consisted of knowledge and attitude questions were used. Moreover, data regarding participation in osteoporosis training courses and awareness of the national osteoporosis clinical guideline were collected as a measure of nurses' experience with guideline. The gathered data were analyzed using SPSS (V. 16), student t-test was used to compare total knowledge and attitude scores between categorical demographic and professional data. Pearson test was used to calculate the correlation between total knowledge and attitude scores and years of practice. A p-value < 0.05 was considered statistically significant. Results: From total of 160 nurses, 143 of them completed the questionnaire (response rate: 89.3%). The total mean ± SD knowledge and attitude scores were 11.60 ± 3.10 and 3.47 ± 0.92 respectively. Six nurses (4.2%) had participated in osteoporosis training courses after graduation, and 39 (27.3%) had been aware of the national osteoporosis clinical guideline. Knowledge and attitude scores among nurses who practice in private hospitals was higher than those practices in the teaching hospitals. These differences were statistically significant based on student t-test. According to Pearson correlation coefficient, there was positive and significant correlation between nurses' knowledge and attitude score (Correlation coefficient: 0.199, p-value = 0.037). Conclusion: Our findings reveal that nurses' knowledge and attitude regarding osteoporosis was not satisfactory. Most of them were not aware of national osteoporosis clinical guideline and had not participated in osteoporosis training courses after their graduation. We need more empowered nurses to lowering burden of osteoporosis and its consequences in the future.


Assuntos
Competência Clínica , Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros/psicologia , Osteoporose/psicologia , Idoso , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Inquéritos e Questionários
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