- Incidence and economic burden of community-acquired gastroenteritis in the Netherlands: Does having children in the household make a difference? [Journal Article]
- PlosPLoS One 2019; 14(5):e0217347
- This study aimed at estimating gastroenteritis (GE) incidence in all age groups of the Netherlands' general population, with special emphasis on the role of children in GE burden, and the associated …
This study aimed at estimating gastroenteritis (GE) incidence in all age groups of the Netherlands' general population, with special emphasis on the role of children in GE burden, and the associated costs. Monthly from November 2014 to November 2016, a random sample of 2000 residents in the Netherlands was invited to complete a questionnaire on household characteristics and health complaints. We calculated GE incidence rates standardized to the Dutch population and used multivariable logistic regression models to identify potential risk factors. We calculated the costs related to resources used within the healthcare sector, the resources used by patients and their families, and productivity losses (paid worktime) due to GE. The overall standardized incidence rate was 0.81 GE episodes/person-year, with the highest rate in children ≤4 years (1.96 episodes/person-year). GE was observed more often in households with children (≤17 years), especially if children attended out-of-home childcare services, and among individuals with non-native Dutch ethnic background. Less GE was observed among employed persons aged 25-64 years, compared with those unemployed, but the opposite was observed in persons ≥65 years. The average costs per GE episode was €191, resulting in €945 million annual total costs for GE in the Netherlands (€55 per inhabitant). The majority of costs (55%) were attributable to productivity losses of the ill or their caregivers. In conclusion, GE still poses a significant burden, particularly in preschool children and adults living in households with children. Similar to other industrialized countries, the major factor driving the costs due to GE was the loss of productivity. This study also provides up-to-date baseline GE incidence rates and associated societal costs to better contextualize the burden of the disease in support of policy making.
- Using the theoretical domains framework to identify barriers and enabling factors to implementation of guidance for the diagnosis and management of nonalcoholic fatty liver disease: a qualitative study. [Journal Article]
- TBTransl Behav Med 2019 May 23
- Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition worldwide and is steadily on the increase. In response, national and international guidance have been developed to standard…
Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition worldwide and is steadily on the increase. In response, national and international guidance have been developed to standardize diagnosis and guide management of the condition. However, research has highlighted a discordance between published guidance and clinical practice. The purpose of this study is to identify barriers and enabling factors to implementation of guidance to inform the development of an intervention. We interviewed 21 health care professionals and 12 patients with NAFLD. Topic guides were developed with reference to national and international guidance. Data were content analyzed using the Theoretical Domains Framework. Beliefs about consequences and professional role and identity were the most prominent domains identified from health care professionals in the context of diagnosis and management of NAFLD. Environmental context and resources, memory, attention and decision processes, goals, behavioral regulation, knowledge, and skills emerged as important barriers/facilitators to implementation of guidance targeting management of NAFLD. Knowledge and beliefs about consequences were the most prominent domains from the perspective of patients. Social influences, environmental context and resources and behavioral regulation were most prominent in the context of NAFLD management. Guideline implementation can be improved by use of interventions that target standardized use of diagnostic criteria by health care professionals. Training of health care professionals was identified as important to improve care delivered to patients in order to effectively manage NAFLD. Interventions that target knowledge of patients, in particular, raising awareness that NAFLD can be progressive when not actively managed would facilitate implementation of guidance.
- Investigating the Smoking Cessation Informational Needs of Cancer Patients and Informal Caregivers. [Journal Article]
- JCJ Cancer Educ 2019 May 22
- Continued smoking at the time of a cancer diagnosis can severely impact the efficacy of cancer patient treatment and survival. The time of diagnosis can serve as a "teachable moment" for smoking cess…
Continued smoking at the time of a cancer diagnosis can severely impact the efficacy of cancer patient treatment and survival. The time of diagnosis can serve as a "teachable moment" for smoking cessation education, since patients may be receptive to discussions about quitting. Caregivers may have a pivotal role in supporting patients with their cessation efforts. The purpose of this study was to identify the smoking cessation informational needs of cancer patients and their caregivers. A needs assessment survey was administered to both patients and caregivers that assessed information needs across five domains: (1) General Information and Support; (2) Smoking, Health and Disease; (3) Relationships; (4) Testimonials; (5) Interventions. Mean importance scores were determined based on the proportion of respondents who ranked how important individual items were within the broader domains. Forty patients and twenty-two caregivers completed the survey. Among patients, the mean age was 61 years, with 35% diagnosed with a head and neck malignancy and 62% reporting as current smokers. Among caregivers, the mean age was 58 years, with 81% reporting to be the patient's immediate family member and 50% as current smokers. The General Information and Support domain was rated as the most important domain for both cancer patients and caregivers. The top preferred modality for receiving smoking cessation education across all domains was pamphlets for both groups. This study identifies the key informational elements that should be considered in the development of smoking cessation resources to meet the informational needs of cancer patients and caregivers.
- Semantic integration of clinical laboratory tests from electronic health records for deep phenotyping and biomarker discovery. [Journal Article]
- NDNPJ Digit Med 2019; 2
- Electronic Health Record (EHR) systems typically define laboratory test results using the Laboratory Observation Identifier Names and Codes (LOINC) and can transmit them using Fast Healthcare Interop…
Electronic Health Record (EHR) systems typically define laboratory test results using the Laboratory Observation Identifier Names and Codes (LOINC) and can transmit them using Fast Healthcare Interoperability Resource (FHIR) standards. LOINC has not yet been semantically integrated with computational resources for phenotype analysis. Here, we provide a method for mapping LOINC-encoded laboratory test results transmitted in FHIR standards to Human Phenotype Ontology (HPO) terms. We annotated the medical implications of 2923 commonly used laboratory tests with HPO terms. Using these annotations, our software assesses laboratory test results and converts each result into an HPO term. We validated our approach with EHR data from 15,681 patients with respiratory complaints and identified known biomarkers for asthma. Finally, we provide a freely available SMART on FHIR application that can be used within EHR systems. Our approach allows readily available laboratory tests in EHR to be reused for deep phenotyping and exploits the hierarchical structure of HPO to integrate distinct tests that have comparable medical interpretations for association studies.
- The importance of chronic pain education and awareness amongst occupational safety and health professionals. [Journal Article]
- JPJ Pain Res 2019; 12:1385-1392
- CONCLUSIONS: Our study demonstrates a need for pain education within OSH training programs and through continuing education.
- Improving the Prediction of Emergency Department Crowding: A Time Series Analysis Including Road Traffic Flow. [Journal Article]
- SHStud Health Technol Inform 2019; 260:57-64
- CONCLUSIONS: The results provide evidence that circadian patterns of medical emergencies are connected to human activity levels in the region and could be captured by public monitoring of traffic flow. In order to corroborate this model, data from further years and additional regions need to be considered. It would also be interesting to study public activity by additional variables.
- [Number of nephrologists, hemodialysis services, and prevalence trend of chronic kidney disease in the ministry of health of Peru]. [Journal Article]
- RPRev Peru Med Exp Salud Publica 2019 Jan-Mar; 36(1):62-67
- We conducted a descriptive and ecological study that evaluated the relationship between the prevalence trend of patients with chronic kidney disease (CKD), the number of nephrologists, and the number…
We conducted a descriptive and ecological study that evaluated the relationship between the prevalence trend of patients with chronic kidney disease (CKD), the number of nephrologists, and the number of hemodialysis services of the Ministry of Health (MINSA). The study was based on a secondary analysis of the care provided by MINSA, the Observatory of Human Resources in Health, and the hemodialysis services registered as Health Service Providers of the Intangible Health Solidarity Fund (FISSAL, in Spanish). The adjusted prevalence of CKD was found to have increased from 0.5 to 1.5 per 1,000 patients between 2010 and 2017. The regions with the greatest increase were Tumbes, Ucayali, and Piura. The number of nephrologists per 1,000 CKD patients decreased from 4.4 in 2010 to 1.9 in 2016; and the hemodialysis services contracted by FISSAL increased from 16 in 2012 to 74 in 2019.
- Economic burden of inpatients infected with Klebsiella pneumoniae carbapenemase. [Journal Article]
- EEinstein (Sao Paulo) 2019 May 16; 17(4):eGS4444
- CONCLUSIONS: The findings of our study indicate a thoughtful economic hazard posed by KPC that all healthcare sectors have to face. The increasing worldwide incidence of these bacteria represents a growing burden that most health systems are unable to deal with. There is an imperative need to develop protocols and new antimicrobials to treatment of KPC, aiming to rearrange resources to increase the effectiveness of healthcare services.
- One hundred years after the 1918 pandemic: new concepts for preparing for influenza pandemics. [Journal Article]
- COCurr Opin Infect Dis 2019 May 20
- CONCLUSIONS: Despite the progress in pandemic preparedness, gaps remain including important scientific questions, adequate resources and most importantly, the ability to rapidly deliver highly effective vaccines.
New Search Next
- Community Health Workers in the Emergency Department-Can they Help with Chronic Hypertension Care. [Review]
- CHCurr Hypertens Rep 2019 May 21; 21(7):49
- To review community health worker (CHW) interventions tailored for hypertension management and to determine if the emergency department (ED) population would benefit from such interventions.
To review community health worker (CHW) interventions tailored for hypertension management and to determine if the emergency department (ED) population would benefit from such interventions.