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1.
Can J Aging ; : 1-8, 2024 Feb 19.
Article in English | MEDLINE | ID: mdl-38372162

ABSTRACT

BACKGROUND: The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults. OBJECTIVE/METHODS: This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used. FINDINGS: Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals. DISCUSSION: Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.

2.
Dis Mon ; 70(1S): 101672, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38143196

ABSTRACT

Inflammatory bowel disease (IBD) is a group of chronic relapsing disorders, including Crohn's disease (CD) and ulcerative colitis (UC), which affects an increasing number of people worldwide. In the last few decades, the scientific world has witnessed many developments in IBD management by controlling debilitating symptoms and remaining in remission for more protracted periods. Even so, we still have a large population suffering from active IBD. An individual's quality of life (QoL) can be severely affected by IBD, like any other chronic illness. In this article, we have reviewed factors influencing the QoL in IBD patients, including chronic pain, diet, physical activity, and psychological factors like depression, anxiety, and stress symptoms. We also discussed the mechanisms of diet-microbial-immune system interaction, currently available dietary therapies for active CD and UC, and early psycho-social interventions that can reduce the disease burden and improve QoL in IBD patients.


Subject(s)
Colitis, Ulcerative , Crohn Disease , Inflammatory Bowel Diseases , Humans , Quality of Life/psychology , Inflammatory Bowel Diseases/therapy , Inflammatory Bowel Diseases/psychology , Crohn Disease/diagnosis , Colitis, Ulcerative/therapy , Colitis, Ulcerative/diagnosis
3.
Healthc Q ; 26(2): 17-23, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37572067

ABSTRACT

Inequities in cancer screening were identified in Calgary, AB, by correlating low screening participation with higher material deprivation. This initiative sought to understand awareness of and barriers to breast, cervical and colorectal cancer screening to inform the co-design and implementation of an outreach strategy to increase screening awareness. Online focus groups with community members (n = 69) identified five themes, and interviews with community health workers (n = 21) identified four themes. The engagement phase led to a multi-component outreach strategy including a multilingual video series, a media campaign leveraging partner channels and a health worker information package with resources to assist with hosting community-based education sessions.


Subject(s)
Health Equity , Neoplasms , Humans , Early Detection of Cancer , Health Education , Focus Groups
4.
Cureus ; 15(5): e38373, 2023 May.
Article in English | MEDLINE | ID: mdl-37265897

ABSTRACT

During the early phase of the COVID-19 pandemic, reverse transcriptase-polymerase chain reaction (RT-PCR) testing faced limitations, prompting the exploration of machine learning (ML) alternatives for diagnosis and prognosis. Providing a comprehensive appraisal of such decision support systems and their use in COVID-19 management can aid the medical community in making informed decisions during the risk assessment of their patients, especially in low-resource settings. Therefore, the objective of this study was to systematically review the studies that predicted the diagnosis of COVID-19 or the severity of the disease using ML. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), we conducted a literature search of MEDLINE (OVID), Scopus, EMBASE, and IEEE Xplore from January 1 to June 31, 2020. The outcomes were COVID-19 diagnosis or prognostic measures such as death, need for mechanical ventilation, admission, and acute respiratory distress syndrome. We included peer-reviewed observational studies, clinical trials, research letters, case series, and reports. We extracted data about the study's country, setting, sample size, data source, dataset, diagnostic or prognostic outcomes, prediction measures, type of ML model, and measures of diagnostic accuracy. Bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with the number CRD42020197109. The final records included for data extraction were 66. Forty-three (64%) studies used secondary data. The majority of studies were from Chinese authors (30%). Most of the literature (79%) relied on chest imaging for prediction, while the remainder used various laboratory indicators, including hematological, biochemical, and immunological markers. Thirteen studies explored predicting COVID-19 severity, while the rest predicted diagnosis. Seventy percent of the articles used deep learning models, while 30% used traditional ML algorithms. Most studies reported high sensitivity, specificity, and accuracy for the ML models (exceeding 90%). The overall concern about the risk of bias was "unclear" in 56% of the studies. This was mainly due to concerns about selection bias. ML may help identify COVID-19 patients in the early phase of the pandemic, particularly in the context of chest imaging. Although these studies reflect that these ML models exhibit high accuracy, the novelty of these models and the biases in dataset selection make using them as a replacement for the clinicians' cognitive decision-making questionable. Continued research is needed to enhance the robustness and reliability of ML systems in COVID-19 diagnosis and prognosis.

5.
Soft comput ; : 1-13, 2023 Mar 20.
Article in English | MEDLINE | ID: mdl-37362268

ABSTRACT

The usage of social media is increasing by leaps and bounds in our day-to-day lives. It affects daily routines and brings a lot of change in different departments like health and education systems during the COVID-19 pandemic. Healthcare research and practice have been significantly impacted by the astounding growth of social media. Social media are changing health information management in several ways, from offering appropriate ways to enhance healthcare professional contact and share health-related knowledge and experience to facilitating the development of innovative medical research and wisdom. Social media analytics (SMAs) are efficient and effective interaction instruments that can be useful for both patients and clinicians in health interventions. Moreover, a significant portion of those involved in clinical practices (such as clinicians, professional colleges, and departments of health) are unaware of the importance of social media, its potential applications in their daily lives, as well as the possible consequences and how these will be handled. In the presented study, we proposed MCDM-based approaches known as "Criteria Importance Through Inter Correlation" (CRITIC) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) in order to identify the effective alternative among several options and make a better decision. After extracting features from the literature review, we choose six significant and relevant features and assign weights to them using CRITIC techniques while utilizing the TOPSIS technique to rank the alternatives based on their performance values. After the implementation of both methods and evaluation procedure, it is determined that the alternative with the highest score is placed at the top and called the "best alternative," while the alternative with the lowest score is placed at the bottom and called the worst alternative. Finally, we suggest a variety of research initiatives and new research areas where the aforementioned procedures become extremely useful in evaluating SMAs and their uses in online health interventions.

6.
Cureus ; 15(3): e36416, 2023 Mar.
Article in English | MEDLINE | ID: mdl-37090289

ABSTRACT

Chronic mesenteric ischemia is a rare but serious condition that can present with a variety of symptoms, including abdominal pain, diarrhea, and weight loss. Our case report presents a 63-year-old male with a past medical history of generalized anxiety disorder, Barrett's esophagus, hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD) with active smoking who initially presented with severe diffuse abdominal pain, nausea, vomiting, and chronic diarrhea resulting in malnutrition and 40-pound weight loss over a six-month span. The patient underwent extensive diagnostic evaluation and was diagnosed with Yersinia gastroenteritis via gastroenteritis panel (GI Panel), explaining all of the patient's symptoms. The patient underwent treatment for said gastroenteritis but did not experience remission of symptoms, leading to further diagnostic evaluations; a definitive diagnosis was not found, yet the patient's symptoms persisted. The patient then underwent extensive serologic and endoscopic evaluation, after extensive imaging and diagnostic work-up, the patient was finally diagnosed with chronic mesenteric ischemia (CMI) of the superior mesenteric artery (SMA) with severe celiac and inferior mesenteric artery (IMA) stenosis. The patient initially underwent stenting (7 mm by 26 mm Balloon Mounted LifestreamTM Covered Stent; Becton Dickson (BD); Franklin Lakes, NJ, USA), which provided temporary relief to his symptoms, however, the relief did not last long. Upon reimaging, the patient was found to have stenosis of the stent, leading to the eventual placement of a bare-metal stent (ExpressTM LD 7 x 27 mm balloon mounted bare-metal stent; Boston Scientific; Boston, MA, USA) across the celiac artery as well as the placement of an IMA stent (InnovaTM Self-expanding 5 x 20 mm bare-metal stent; Boston Scientific). This eventually resulted in the resolution of the patient's symptoms, eventual weight gain, and improvement in quality of life.

7.
Cureus ; 15(4): e37281, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37038381

ABSTRACT

ChatGPT, an artificial intelligence chatbot, has rapidly gained prominence in various domains, including medical education and healthcare literature. This hybrid narrative review, conducted collaboratively by human authors and ChatGPT, aims to summarize and synthesize the current knowledge of ChatGPT in the indexed medical literature during its initial four months. A search strategy was employed in PubMed and EuropePMC databases, yielding 65 and 110 papers, respectively. These papers focused on ChatGPT's impact on medical education, scientific research, medical writing, ethical considerations, diagnostic decision-making, automation potential, and criticisms. The findings indicate a growing body of literature on ChatGPT's applications and implications in healthcare, highlighting the need for further research to assess its effectiveness and ethical concerns.

8.
JRSM Cardiovasc Dis ; 11: 20480040221102741, 2022.
Article in English | MEDLINE | ID: mdl-35651591

ABSTRACT

Elderly patients with coronary artery disease have a high prevalence of frailty and malnutrition. Frailty syndrome is associated with poor outcomes in patients with myocardial infarction. There is a known overlap between frailty and malnutrition, yet these are two different entities. Fried Frailty Phenotype, Frail Scale, timed up and go test, and gait speed are rapid screening tests that may identify patients with frailty in everyday clinical setting. Short Form MNA is a sensitive tool to screen for malnutrition. Despite the availability of several tools for screening for both these conditions, the screening rates remain low. We aim to create awareness about the impacts of frailty and malnutrition, provide a brief overview of tools available and highlight the importance of screening in this high-risk population.

9.
Curr Probl Cardiol ; 47(9): 101267, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35636519

ABSTRACT

Infective endocarditis is a life-threatening disease of the endocardium of the heart and cardiac valves, caused by several infectious agents, ranging from Streptococci to rickettsia. It has continued to be a serious cause of cardiac infection, with a rise in the incidence globally over the last 5 years. Despite diagnostic and therapeutic advances, its prognosis remains poor, and a surge in morbidity and hospital mortality highlights the significance of the swift diagnosis of this disease. Given its complexity, patients with infective endocarditis need rapid response and prompt diagnosis from a multidisciplinary team with a timely diagnostic protocol and treatment in the critical phase. Still, there is a lack of evidence regarding the timing of surgery or the role of antibiotic prophylaxis in the management. In this review, we detail the epidemiological transition, challenges in the diagnosis, and the newer avenues in the medical and surgical management of infective endocarditis.


Subject(s)
Endocarditis, Bacterial , Endocarditis , Endocarditis/diagnosis , Endocarditis/epidemiology , Endocarditis/therapy , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Hospital Mortality , Humans , Incidence , Prognosis
10.
BMC Med Educ ; 21(1): 199, 2021 Apr 08.
Article in English | MEDLINE | ID: mdl-33832479

ABSTRACT

BACKGROUND & OBJECTIVE: Medical schools have evolved toward competency-based education and active learner-centered strategies. Medical informatics course was introduced in 2011 in the 3rd year at the College of Medicine (CoM), King Saud University (KSU), to enhance future medical graduates with technological and information competencies. Modified team-based learning and blended learning were emphasized using face-to-face lectures, various e-learning technologies, workshop and seminars. The current study's main objective was to assess students' perceptions towards blended and modified team-based learning at the CoM in KSU. METHODS: A survey was distributed to medical students in three consecutive years: 2017-2019. The survey contains items regarding student perception of various types of blended learning techniques applied in the course. The survey was administered using i-Clicker; an interactive device that enables students to answer survey questions. Descriptive statistics were used to examine the perception of students on these blended learning dimensions investigated. RESULTS: Seven-hundred and one student responded to the questionnaire (male; 69.5%, female 30.5%). Out of which, 59.1% of students found team interactions positively supported discussions and asked questions freely, and 48.1% expressed that working in groups facilitated their learning process. However, 56.0% of students chose face-to-face lectures as the most preferred class activities followed by discussion 23.8%. More than 78% of participants agree that online quizzes are good experience and enjoyable. Grade center where students can check for marks and attendance also received high perception (66.3%). CONCLUSION: Introducing modified team-based and blended-learning are considered challenging, and therefore, investigating their perceptions can provide useful insights into how these methods could be used more effectively. The blended-learning technique is highly essential in teaching medical informatics to overcome challenges faced due to a large number of students and the need for various exposures to reach the course's learning goals. Moreover, it is noticed that students were engaged in face-to-face and online activities, furthermore, modified team-based learning reported facilitating learning and asking questions without embarrassment.


Subject(s)
Students, Medical , Cohort Studies , Curriculum , Female , Humans , Male , Perception , Universities
11.
Pak J Med Sci ; 36(7): 1698-1702, 2020.
Article in English | MEDLINE | ID: mdl-33235600

ABSTRACT

OBJECTIVE: A paradigm shift towards a PBL bidirectional dialogic feedback can enhance learners' performance. This study aimed to investigate undergraduate medical students' perceptions of their PBL feedback. METHODS: We sent e-mail invitations to a web-based survey to year one and two students at College of Medicine, King Saud University. Items included the process, content, and benefits of PBL feedback. RESULTS: Of 209 respondents, 110 (53%) were first and 99 (47%) were second-year students. About 50% agreed that the feedback was regularly provided at scheduled timing and 72% perceived feedback environment as non-threatening. Agreement rates that the tutors asked students first to assess their performance, tell them what went well, what the areas for improvement are and develop with them an improvement plan were 59%, 61%, 61% and 52%, respectively. 61% agreed that tutors judged performance not personality. More year one students significantly agreed that the PBL feedback helped them to improve their knowledge acquisition and non-technical skills. CONCLUSION: Many of our PBL tutors have started the shift to a dialogic bi-directional feedback. We recommend continuing the faculty development efforts, peer-reviewing, and seeking student's feedback within the academic quality satisfaction surveys.

12.
J Pak Med Assoc ; 70(9): 1619-1624, 2020 Sep.
Article in English | MEDLINE | ID: mdl-33040121

ABSTRACT

Using WHO questionnaire known as TADDS(Tool for Assessment of Diabetic Retinopathy and Diabetes Management System), a country wide survey was conducted to assess the health care system for diabetes mellitus (DM) and diabetic retinopathy (DR). This would also provide any evidence of the presence and usefulness of links between the two. A total of 190 key informants for DR and DM services from 47 districts were interviewed. The answers were reviewed and any disagreement was resolved through discussion with stakeholders'. The final results were disseminated. The results showed that diabetes is listed as a priority; national plan exists but programme has not been implemented. Health professionals are unaware about Ministry of Health guidelines. There is infrequent networking between DM and DR care providers. Transport and cost are the main barriers for accessing these services. Out of pocket expenses provide 55% of health care financing.


Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Delivery of Health Care , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/epidemiology , Diabetic Retinopathy/therapy , Humans , Pakistan , Prevalence , Surveys and Questionnaires , World Health Organization
13.
Int J Health Policy Manag ; 7(9): 798-806, 2018 09 01.
Article in English | MEDLINE | ID: mdl-30316228

ABSTRACT

BACKGROUND: There is high reliance on out-of-pocket (OOP) health payments as a means of financing health system in Nigeria. OOP health payments can make households face catastrophe and become impoverished. The study aims to examine the financial burden of OOP health payments among households in Nigeria. METHODS: Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/2010 was utilized to assess the catastrophic and impoverishing effects of OOP health payments on households in Nigeria. Data analysis was carried out using ADePT 6.0 and STATA 12. RESULTS: We found that a total of 16.4% of households incurred catastrophic health payments at 10% threshold of total consumption expenditure while 13.7% of households incurred catastrophic health payments at 40% threshold of nonfood expenditure. Using the $1.25 a day poverty line, poverty headcount was 97.9% gross of health payments. OOP health payments led to a 0.8% rise in poverty headcount and this means that about 1.3 million Nigerians are being pushed below the poverty line. Better-off households were more likely to incur catastrophic health payments than poor households. CONCLUSION: Our study shows the urgency with which policy makers need to increase public healthcare funding and provide social health protection plan against informal OOP health payments in order to provide financial risk protection which is currently absent among high percentage of households in Nigeria.


Subject(s)
Catastrophic Illness/economics , Cost of Illness , Family Characteristics , Financing, Personal/economics , Health Expenditures/statistics & numerical data , Poverty/economics , Adolescent , Adult , Aged , Catastrophic Illness/epidemiology , Child , Child, Preschool , Female , Financing, Personal/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Nigeria , Poverty/statistics & numerical data , Socioeconomic Factors , Young Adult
14.
Int J Med Inform ; 118: 113-119, 2018 10.
Article in English | MEDLINE | ID: mdl-30153916

ABSTRACT

BACKGROUND: Implantable medical device registries are used as a medium to conduct post-marketing surveillance. Little information is available on the development and implementation of implantable biomedical device registries in general and specifically in Saudi Arabia and the Middle East. OBJECTIVES: This study presents the experiences of building an implantable medical device registry in the Kingdom of Saudi Arabia. The work specifically addresses the early experiences of the Saudi Food and Drug Authority in the planning and development of a data sharing model for the implementation of a medical device registry at different hospital sites within the country. METHODS: A two-year case study in which 60 health professionals from 5 hospitals in Saudi Arabia participated in a readiness assessment survey. The readiness assessment examined system-level capacity, hospital workflow and operations, clinical staff-level engagement, and technological assessment as they relate to the implementation of the Implantable Medical Device Registry (IMDR). Both subjective and objective data were collected as part of the readiness assessment survey at each hospital site. Data was collected from participants either individually or as part of a group at each hospital site. Using Microsoft Excel, Microsoft Word, flip charts, and back-and-forth discussion, the data was descriptively summarized and synthesized to provide an overview of hospital readiness for IMDR implementation. RESULTS: Results show that there are large differences among Saudi hospitals in terms of their readiness for IMDR implementation due to a variety of factors relating to differences in hospital-wide organizational systems, clinical practice, technological infrastructure, and data sharing capabilities. Each of the hospitals surveyed in this study had differences in how clinical biomedical implantation policies and procedures were utilized. Manual entry into the cloud-based IMDR was recommended as the most optimal data sharing model that would mitigate the differences between hospital readiness for IMDR implementation. CONCLUSION: Registries play a major role in monitoring the effectiveness of implantable biomedical devices. National standardized policies, enforced regulations, and information technology infrastructure are needed to achieve this goal. Furthermore, due to differences in hospital readiness, building a cloud-based registry system through manual data entry into the IMDR was found to be the most appropriate data sharing model that can be implemented at the national level.


Subject(s)
Cloud Computing , Hospital Administration/standards , Information Dissemination/methods , Medical Device Legislation/organization & administration , Prostheses and Implants , Registries/statistics & numerical data , Health Personnel , Humans , Patient Safety , Saudi Arabia , Surveys and Questionnaires
15.
J Pak Med Assoc ; 68(6): 841-847, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29887612

ABSTRACT

OBJECTIVE: To determine the factors influencing tooth loss and to assess the strength of association between the factors and the loss.s. METHODS: The unmatched case-control study was conducted at the Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, from March to April 2016, and comprised data of patients who visited the outpatient dental department. Face-to-face interviews and clinical examination were done. Data was analysed using SPSS 20. RESULTS: Of the 376 subjects, there were 188(50%) in each of the two groups. The mean age among the cases was 37.01±12.077 years and among the controls it was 28.06±9.591 years. Tobacco consumption and age >35 were significant predictors of tooth loss (p<0.05 each). Tobacco users with high duration and frequency had a significant value for increased chances of tooth loss (p<0.001). Both the smokers and smokeless tobacco users had more chances of tooth loss (p<0.001). CONCLUSIONS: There was negative implications of smoking on oral health which increased the chance of tooth loss.


Subject(s)
Oral Hygiene/statistics & numerical data , Smoking/epidemiology , Tobacco, Smokeless , Tooth Loss/epidemiology , Adult , Age Factors , Aged , Case-Control Studies , Dental Devices, Home Care , Educational Status , Female , Humans , Male , Middle Aged , Mouthwashes , Outpatient Clinics, Hospital , Pakistan/epidemiology , Tertiary Care Centers , Time Factors , Tobacco Use/epidemiology , Toothbrushing/statistics & numerical data , Young Adult
16.
Clin J Am Soc Nephrol ; 13(7): 1113-1123, 2018 07 06.
Article in English | MEDLINE | ID: mdl-29523680

ABSTRACT

AKI is a complex clinical condition associated with high mortality, morbidity, and health care costs. Despite improvements in methodology and design of clinical trials, and advances in understanding the underlying pathophysiology of rodent AKI, no pharmacologic agent exists for the prevention or treatment of AKI in humans. To address the barriers that affect successful clinical translation of drug targets identified and validated in preclinical animal models of AKI in this patient population, the National Institute of Diabetes and Digestive and Kidney Diseases convened the "AKI Outcomes: Overcoming Barriers in AKI" workshop on February 10-12, 2015. The workshop used a reverse translational medicine approach to identify steps necessary to achieve clinical success. During the workshop, breakout groups were charged first to design feasible, phase 2, proof-of-concept clinical trials for delayed transplant graft function, prevention of AKI (primary prevention), and treatment of AKI (secondary prevention and recovery). Breakout groups then were responsible for identification of preclinical animal models that would replicate the pathophysiology of the phase 2 proof-of-concept patient population, including primary and secondary end points. Breakout groups identified considerable gaps in knowledge regarding human AKI, our understanding of the pathophysiology of AKI in preclinical animal models, and the fidelity of cellular and molecular targets that have been evaluated preclinically to provide information regarding human AKI of various etiologies. The workshop concluded with attendees defining a new path forward to a better understanding of the etiology, pathology, and pathophysiology of human AKI.


Subject(s)
Acute Kidney Injury/therapy , Translational Research, Biomedical , Animals , Congresses as Topic , Disease Models, Animal , Humans , National Institute of Diabetes and Digestive and Kidney Diseases (U.S.) , United States
17.
Int J Health Policy Manag ; 7(11): 1015-1023, 2018 11 01.
Article in English | MEDLINE | ID: mdl-30624875

ABSTRACT

BACKGROUND: Despite the implementation of the National Health Insurance Scheme (NHIS) since 2005 in Nigeria, the level of health insurance coverage remains low. The study aims to examine the predictors of enrolment in the NHIS among women of reproductive age in Nigeria. METHODS: Secondary data from the 2013 Nigeria Demographic and Health Survey (NDHS) were utilized to examine factors influencing enrolment in the NHIS among women of reproductive age (n=38 948) in Nigeria. Demographic and socio-economic characteristics of women were determined using univariate, bivariate and multivariate analyses. Data analysis was performed using STATA version 12 software. RESULTS: We found that 97.9% of women were not covered by health insurance. Multivariate analysis indicated that factors such as age, education, geo-political zone, socio-economic status (SES), and employment status were significant predictors of enrolment in the NHIS among women of reproductive age. CONCLUSION: This study concludes that health insurance coverage among women of reproductive age in Nigeria is very low. Additionally, demographic and socio-economic factors were associated with enrolment in the NHIS among women. Therefore, policy-makers need to establish a tax-based health financing mechanism targeted at women who are young, uneducated, from poorest households, unemployed and working in the informal sector of the economy. Extending health insurance coverage to women from poor households and those who work in the informal sector through a tax-financed non-contributory health insurance scheme would accelerate progress towards universal health coverage (UHC).


Subject(s)
Health Services Accessibility , Healthcare Financing , Insurance, Health , Medically Uninsured , National Health Programs , Poverty , Universal Health Insurance , Adolescent , Adult , Age Factors , Family Characteristics , Female , Humans , Medically Uninsured/statistics & numerical data , Multivariate Analysis , Nigeria , Socioeconomic Factors , Taxes , Young Adult
18.
Eur J Health Econ ; 19(4): 521-532, 2018 May.
Article in English | MEDLINE | ID: mdl-28555372

ABSTRACT

BACKGROUND: Catastrophic health expenditure is a measure of financial risk protection and it is often incurred by households who have to pay out of pocket for health care services that are not affordable. The study assessed the determinants of catastrophic health expenditure among households in Nigeria. METHODS: Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors associated with catastrophic health expenditure in Nigeria. Household and individual characteristics associated with catastrophic health expenditure were determined using bivariate analysis and multivariate logistic regression. RESULTS: Results showed that irrespective of the threshold for the two concepts of total household expenditure and non-food expenditure, having household members aged between 6 and 14 years, having household members aged between 15 and 24 years, having household members aged between 25 and 54 years, having no education, having primary education, having secondary education, lack of health insurance coverage, visiting a private health facility, households living in north central zone, households living in north east zone and having household members with non-chronic illnesses were factors that increase the risk of incurring catastrophic health expenditure among households. CONCLUSIONS: Policy-makers and political actors need to design equitable health financing policies that will increase financial risk protection for people in both the formal and informal sectors of the economy.


Subject(s)
Catastrophic Illness/economics , Health Expenditures , Adult , Aged , Family Characteristics , Female , Financing, Personal , Health Services , Humans , Male , Middle Aged , Nigeria
19.
Kidney Int Rep ; 2(5): 836-843, 2017 Sep.
Article in English | MEDLINE | ID: mdl-29270490

ABSTRACT

INTRODUCTION: Patients undergoing on-pump cardiac surgery are at an increased risk of acute kidney injury. QPI-1002, a small interfering ribonucleic acid, is under clinical development for the prevention of acute kidney injury. The safety, tolerability, and pharmacokinetics of QPI-1002 was evaluated in this first-in-man, Phase 1 study of a small, interfering ribonucleic acid in patients at risk of acute kidney injury after on-pump cardiac surgery. METHODS: In this phase 1 randomized, placebo-controlled dose-escalation study, a single i.v. dose of QPI-1002 was administered in subjects undergoing on-pump cardiac surgery. Subjects received placebo (n = 4), or QPI-1002 in increasing doses of 0.5 mg/kg (n = 3), 1.5 mg/kg (n = 3), 5 mg/kg (n = 3), and 10 mg/kg (n = 3). RESULTS: A total of 16 subjects were enrolled in the study. The average maximum concentration and area under the curve from the time of dosing to the last measurable concentration of QPI-1002 were generally dose proportional, indicating that exposure increased with increasing dose. The average mean residence time (mean residence time to the last measurable concentration) was 10 to 13 minutes in all 4 drug-dosing cohorts. Adverse events occurred at a similar rate in all study groups. Of the total 109 reported adverse events, the events were distributed as 26 in the placebo group and 21, 19, 24, and 19 in the QPI-1002 0.5, 1.5, 5.0, and 10.0 mg/kg groups, respectively. Eight of the 16 subjects experienced at least 1 serious adverse event: 4 (100%) in the placebo group and 4 (33.3%) in the combined QPI-1002 cohorts. DISCUSSION: QPI-1002 was rapidly eliminated from plasma. QPI-1002 was safe and well tolerated across all dose groups. Overall, no dose-limiting toxicities or safety signals were observed in the study. Further development of QPI-1002 for prophylaxis of acute kidney injury is warranted.

20.
Pak J Med Sci ; 33(5): 1284-1287, 2017.
Article in English | MEDLINE | ID: mdl-29142580

ABSTRACT

OBJECTIVE: Medical Education Journal Club is an evidence-based approach to teach and learn critical appraisal techniques on available literature. This study evaluates the implementation and experience of two academic years of Journal club at Medical Education Department, King Saud University. METHODS: We started JC in 2015 at medical education department, KSU. An invitation with a published paper and event poster were sent 2 weeks prior of the session to participants. A traditional one-group posttest design with open item survey were conducted at the end of every session. RESULTS: A total of 12 sessions were conducted in total. The average attendance of 26 (Male: 42/79, 53.1%) and (Female: 31/79, 39.2%) with mix of professors, associate and assistant professors. The MEJC had a positive effect on participant's session expectations (45/79, 92.4%), and had increased their knowledge of the field (73/79, 92.4%). It was observed that the attendance of event depends on the speaker for the event. The sessions have also arisen the need of trainings and other scientific activities. CONCLUSIONS: MEJC is an educational activity that can play important aspect in providing high quality healthcare teachings. We conclude that the success and consistency of MEJC depends on speaker. It commensurate the audience interest to attend and learn. While proper advertisement of event, and regular attendance also plays a vital role in this regard.

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