Value of video-based education to enhance infant motor development.

BACKGROUND: Parents play a vital role in promoting infant motor development and physical activity; however, there is little information available to parents on how to support healthy movement. Therefore, the purpose of this study was to assess the feasibility of implementing video-based education to improve infant physical activity and motor development. METHODS: This multiple case study consisted of semi-structured interviews with mothers (n = 12) and early childhood experts (n = 5, e.g., pediatrician, home visitor). Participants watched pre-recorded videos and answered questions which were developed following Bowens and colleagues guide for designing feasibility studies. Data were analyzed using a directed content analysis approach. RESULTS: Most mothers (91.7 %) reported they were highly likely to recommend the videos to others and said the best way to share these videos would be through an app or social media (83.3 %) or health care entities (e.g., hospital, pediatrician, 75 %). Half of mothers (50 %) reported they would be interested in seeing videos once a month or once every couple of months. Further, all experts agreed parents would be somewhat or highly likely to use the videos and a majority (80 %) stated they were highly likely to recommend and share videos like these. Experts' top suggestions for sharing the videos was through an app/social media (40 %) and credible websites (40 %). DISCUSSION: Overall, the videos appear feasible for mothers. Both groups primarily suggested that videos be disseminated through social media, online, or through an app. Future research should engage parents and healthcare providers in developing videos.

Immuno-Oncology Medicines: Policy Implications and Economic Considerations.

Significant progress has taken place in the field of cancer immunotherapy in recent years. Cancer immunotherapy, particularly immune checkpoint inhibitors, have shown rather dramatic results and are believed to have completely transformed the field of oncology. However, these transformational therapies are more expensive than previous cancer therapies. As more cancer immunotherapy agents are being developed, with some already being marketed, it is important to consider how economic constraints will shape health policy and value assessment related to these agents. A number of strategies have been suggested to alleviate the price burden and the ensuing concerns about the sustainability of publicly funded healthcare systems. Among these strategies, value-based pricing (VBP) for innovative drugs dominates the headlines in the field of oncology. The specifics of how VBP may be implemented in the United States is still unclear. Nonetheless, policy reform and economic considerations will have to be incorporated into the planning of VBP. The objective of this paper is multifold: (i) to identify the factors affecting the impact of cancer immunotherapy on healthcare cost; (ii) to critically appraise current approaches used to assess the value of novel cancer therapies; (iii) to assess the methodological challenges associated with the economic evaluation of cancer immunotherapy. As the health care system in the U.S transitions toward a value-based model, the need for a formal value assessment framework is warranted in cancer immunotherapy.

Procalcitonin Monitoring as a Guide for Antimicrobial Therapy: A Review of Current Literature.

Effective antimicrobial stewardship practices are increasingly essential to best utilize the current arsenal of antimicrobials for the shortest necessary duration to minimize the development of antimicrobial resistance, secondary infections, and health care costs. Monitoring of serum procalcitonin (PCT) levels represents an effective antimicrobial stewardship strategy to differentiate bacterial infections from viral infections and noninfectious inflammatory conditions. Current literature illustrates the merits of PCT monitoring in reducing duration of antibiotic therapy without detrimental effects on mortality or infection relapses. However, the interpretation of PCT levels can be challenging, especially in light of comorbid disease states that can elevate PCT levels. This review sheds light on the utility of PCT monitoring, as well as providing insight into the practical interpretation of PCT levels. Much of the current literature surrounding PCT monitoring consists of use among patients with lower respiratory tract infections or in the critically ill. Overall, studies have demonstrated shorter antibiotic therapy durations when PCT monitoring is utilized. No studies to date have found increased rates of mortality or infection relapses, suggesting that PCT monitoring is not only effective, but also safe when used as a guide for antimicrobial therapy. Nonetheless, many conditions were shown to elevate PCT serum concentrations, even in the absence of bacterial infections, which can make interpretation of PCT concentrations challenging. Two common conditions that affect the accurate interpretation of PCT levels are renal dysfunction and congestive heart failure. Limited studies have been performed in these populations, but current available data propose the need for higher PCT thresholds in those with renal dysfunction or congestive heart failure and support utilizing PCT trends to monitor clinical improvement from bacterial infections. Evidence also suggests that PCT monitoring is cost-effective, as long as the test is ordered judiciously. In summary, PCT monitoring represents a promising antimicrobial stewardship strategy to limit exposure to unnecessary antimicrobial therapy.

A Systematic Review of the Effectiveness of Text Message Reminders on Asthma Medication Adherence.

OBJECTIVE: Cell phone text messaging reminders offers the promise of an efficient technology for the management of chronic diseases, such as asthma. This review aims to evaluate the effectiveness of text message reminders in improving medication adherence for asthma compared to usual care. METHODS: Randomized controlled trials assessing the effect of text message reminders on adherence to asthma medication were identified from PubMed, Medline, Web of Knowledge EBSCOhost, OvidSP, PsycINFO, and Cochrane Central Register of Controlled Trials and Cochran Health Technology Assessment databases. Literature searches were restricted to the English language, and no restrictions were imposed on the year and country of publication. RESULTS: Five studies that were deemed relevant to the systematic review were identified from the literature search. Findings on whether text message reminders improve medication adherence were mixed. However, the review indicates that text-messaging interventions were effective as a means of addressing forgetfulness by reminding patients to take their medications. CONCLUSION: This review adds to the body of literature reviewing the effectiveness of emerging technologies in the management of diseases. Despite the fact there is limited evidence across the population of studies to support the effectiveness of text message reminders, such technology represents an important tool to achieve optimal medication adherence among asthmatics.

Tetrahydroquinoline-based tricyclic amines as potent and selective agonists of the 5-HT2C receptor.

The syntheses, structure-activity relationships (SARs), and biological activities of tetrahydroquinoline-based tricyclic amines as 5-HT2C receptor agonists are reported. An early lead containing a highly unique 6,6,7-ring system was optimized for both in vitro potency and selectivity at the related 5-HT2B receptor. Orally bioactive, potent, and selective 6,6,6-tricyclic 5-HT2C agonists were identified.