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Pollock Paaske posted an update 6 months ago
19, 95% CI=1.44-3.33] were significantly associated with ARI among children under five years in Indonesia.
This study revealed that the determinants of ARI among children under five years in Indonesia remain related to the socio-demographic aspect. This research highlighted that the family’s and the living area’s wealth index remains essential in improving children’s health outcomes.
Our findings support increasing awareness of the low-income family through adequate information and health promotion. Advancing the feasibility, accessibility, and affordability of health information and health services across all Indonesian regions should be strengthened.
Our findings support increasing awareness of the low-income family through adequate information and health promotion. Advancing the feasibility, accessibility, and affordability of health information and health services across all Indonesian regions should be strengthened.
To develop ‘incorpoRATE’, a brief and broadly applicable measure of physicians’ willingness to incorporate shared decision making (SDM) into practice.
incorpoRATE was developed across three phases 1) A review of relevant literature to inform candidate domain and item development, 2) Cognitive interviews with US physicians to iteratively refine the measure, and 3) Pilot testing of the measure across a larger sample of US physicians to explore item and measure performance.
The final measure consists of seven items that assess physician perspectives on various components of SDM use that may present as barriers in practice. During pilot testing, the majority of physicians expressed positive opinions about the overall concept of SDM, yet were less comfortable acting on informed patient choices when there was known incongruence with their own recommendations.
incorpoRATE is a novel physician-reported measure that assesses physicians’ willingness to incorporate SDM in practice.
incorpoRATE has the potential to help us further understand the limited adoption of SDM and areas of focus for improving the use of SDM in the future. We recommend that incorpoRATE be subject to further psychometric, real-world testing, in order to explore its performance across different samples of physicians and organizations.
incorpoRATE has the potential to help us further understand the limited adoption of SDM and areas of focus for improving the use of SDM in the future. We recommend that incorpoRATE be subject to further psychometric, real-world testing, in order to explore its performance across different samples of physicians and organizations.
Providing a second opinion (SO) in oncology is complex, and communication during SOs remains poorly understood. This study aimed to systematically observe how patients and oncologists communicate about SO-specific topics (i.e., patient motivation, the referring oncologist, treatment transfer/back-referral), and how such communication affects patient satisfaction.
A prospective mixed-methods study of cancer patients seeking a SO (N=69) and consulting oncologists was conducted. Before the SO, patients reported their expected place of future treatment. Ki16198 in vitro Following the SO, patients’ and oncologists’ satisfaction was assessed. All SOs were audio-recorded. Absolute and relative duration of SO-specific talk were calculated and specific events (e.g., questions/utterances) were coded (incl. valence, explicitness).
SOs lasted 19-73min, of which 3.7% was spent discussing motivations. Oncologists rarely explored patients’ motivations. Talk about referring oncologists (12.5% of consultation) was mostly critical by patients (M=43.0%), but positive/confirming by consulting oncologists (M=73.5%). Although 22.2% of patients expected a treatment transfer, this topic (3.3% of consultation time) was rarely explicitly discussed. Patients who were referred back were significantly less satisfied (d=0.85).
Patient-provider communication in oncological SOs appears insufficiently aligned.
Patients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided.
Patients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided.Cardiac cephalalgia is an uncommon symptom occurring in coronary artery disease. It is difficult to identify cardiac cephalalgia and link it to coronary artery disease because these patients present with only a headache and no typical symptoms of angina, such as chest pain, radiating pain, or chest tightness. Currently, the diagnostic value of cardiac cephalalgia in acute myocardial infarction is still under debate. We here report a case of cardiac cephalalgia. An 83-year-old woman with a severe headache lasting 6 h was diagnosed with acute myocardial infarction. ST elevation and severe stenosis of the right coronary artery were observed. Passage of the guide wire and radiocontrast agent increased the intensity of the headache, which disappeared once the right coronary artery was opened. As of one month into follow-up, the headache had not recurred. These observations strongly indicate a close association between cardiac cephalalgia and acute myocardial infarction, and they could help diagnose acute myocardial infarction related to headaches.
Meningococcal serogroup B (MenB) has emerged as the leading cause of invasive meningococcal disease (IMD) in several countries following the release of effective vaccines against serogroups A, C, W, and Y. In 2013, however, the first multicomponent MenB vaccine (Bexsero®) was licensed in Europe.
To review the evidence on the cost-effectiveness of vaccination against MenB.
Searches were performed in MEDLINE, EMBASE, Web of Science, NHS EED, Econlit, Tufts CEA registry, and HTA. Three reviewers independently screened and selected studies. Using a narrative synthesis, studies were categorized by vaccination strategies. The quality of included studies was assessed using the Comparative Health Economics Evaluation Reporting Standards (CHEERS) checklist.
13 studies were included. Ten studies were conducted in the European region and three in the Americas. None of the vaccination strategies were considered cost-effective. Including herd effects improved value for money for MenB vaccines. Routine infant vaccination was the most effective short-term strategy, however, adolescent strategies offered the best value for money.
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