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310038 records – page 1 of 31004.

Is it possible to distinguish homeopathic aggravation from adverse effects? A qualitative study.

https://arctichealth.org/en/permalink/ahliterature126331
Source
Forsch Komplementmed. 2012;19(1):13-9
Publication Type
Article
Date
2012
Author
Trine Stub
Anita Salamonsen
Terje Alraek
Author Affiliation
Department of Community Medicine, National Research Center in Complementary and Alternative Medicine (NAFKAM), University of Tromsø, Norway. trine.stub@uit.no
Source
Forsch Komplementmed. 2012;19(1):13-9
Date
2012
Language
English
Publication Type
Article
Keywords
Female
Homeopathy - adverse effects - standards
Humans
Male
Norway
Safety
Abstract
Homeopathic aggravation is a temporary worsening of existing symptoms following the administration of a correct homeopathic prescription. The aim of this study was to explore and compose criteria that may differentiate homeopathic aggravations from adverse effects.
A qualitative approach was employed using focus group interviews. 2 interviews, with 11 experienced homeopaths, were performed in Oslo, Norway. The practitioners have practiced classical homeopathy over a period of 10-32 years. Qualitative content analysis was used to analyze the text data. The codes were defined before and during the data analysis.
We found that aggravations were subtle and multifaceted events. Moreover, highly skilled homeopaths are required to identify and report aggravations. Adverse effect may be defined as an 'undesirable effect of a remedy'. This definition is pragmatic, flexible, and more in line with the holistic paradigm that the homeopaths represent. 8 criteria that distinguish aggravation from adverse effect were found. Highly sensitive persons hold a unique position regarding safety, as it is important to identify these patients in order to treat them correctly and avoid undesirable effects of the treatment.
This study rigorously explored homeopaths' views and experience on aggravation and adverse effects. The 8 criteria developed in this study may ensure patient safety and support therapists in identifying an 'undesirable effect of a remedy'.
PubMed ID
22398921 View in PubMed
Less detail

Vitamin K supplementation for the primary prevention of osteoporotic fractures: is it cost-effective and is future research warranted?

https://arctichealth.org/en/permalink/ahliterature126332
Source
Osteoporos Int. 2012 Nov;23(11):2681-92
Publication Type
Article
Date
Nov-2012
Author
O. Gajic-Veljanoski
A M Bayoumi
G. Tomlinson
K. Khan
A M Cheung
Author Affiliation
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Source
Osteoporos Int. 2012 Nov;23(11):2681-92
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Bone Density Conservation Agents - economics - therapeutic use
Calcium - economics - therapeutic use
Canada - epidemiology
Cholecalciferol - economics - therapeutic use
Cost-Benefit Analysis
Dietary Supplements
Drug Costs - statistics & numerical data
Drug Therapy, Combination
Female
Health Care Costs - statistics & numerical data
Humans
Middle Aged
Models, Econometric
Osteoporosis, Postmenopausal - complications - drug therapy - economics
Osteoporotic Fractures - economics - epidemiology - etiology - prevention & control
Quality of Life
Quality-Adjusted Life Years
Treatment Outcome
Vitamin K 1 - economics - therapeutic use
Vitamin K 2 - economics - therapeutic use
Abstract
Lifetime supplementation with vitamin K, vitamin D(3), and calcium is likely to reduce fractures and increase survival in postmenopausal women. It would be a cost-effective intervention at commonly used thresholds, but high uncertainty around the cost-effectiveness estimates persists. Further research on the effect of vitamin K on fractures is warranted.
Vitamin K might have a role in the primary prevention of fractures, but uncertainties about its effectiveness and cost-effectiveness persist.
We developed a state-transition probabilistic microsimulation model to quantify the cost-effectiveness of various interventions to prevent fractures in 50-year-old postmenopausal women without osteoporosis. We compared no supplementation, vitamin D(3) (800 IU/day) with calcium (1,200 mg/day), and vitamin K(2) (45 mg/day) with vitamin D(3) and calcium (at the same doses). An additional analysis explored replacing vitamin K(2) with vitamin K(1) (5 mg/day).
Adding vitamin K(2) to vitamin D(3) with calcium reduced the lifetime probability of at least one fracture by 25%, increased discounted survival by 0.7 quality-adjusted life-years (QALYs) (95% credible interval (CrI) 0.2; 1.3) and discounted costs by $8,956, yielding an incremental cost-effectiveness ratio (ICER) of $12,268/QALY. At a $50,000/QALY threshold, the probability of cost-effectiveness was 95% and the population expected value of perfect information (EVPI) was $28.9 billion. Adding vitamin K(1) to vitamin D and calcium reduced the lifetime probability of at least one fracture by 20%, increased discounted survival by 0.4 QALYs (95% CrI -1.9; 1.4) and discounted costs by $4,014, yielding an ICER of $9,557/QALY. At a $50,000/QALY threshold, the probability of cost-effectiveness was 80% while the EVPI was $414.9 billion. The efficacy of vitamin K was the most important parameter in sensitivity analyses.
Lifetime supplementation with vitamin K, vitamin D(3), and calcium is likely to reduce fractures and increase survival in postmenopausal women. Given high uncertainty around the cost-effectiveness estimates, further research on the efficacy of vitamin K on fractures is warranted.
PubMed ID
22398856 View in PubMed
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The burden of illness of osteoporosis in Canada.

https://arctichealth.org/en/permalink/ahliterature126333
Source
Osteoporos Int. 2012 Nov;23(11):2591-600
Publication Type
Article
Date
Nov-2012
Author
J-E Tarride
R B Hopkins
W D Leslie
S. Morin
J D Adachi
A. Papaioannou
L. Bessette
J P Brown
R. Goeree
Author Affiliation
Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, ON, L8P 1H1, Canada. tarride@mcmaster.ca
Source
Osteoporos Int. 2012 Nov;23(11):2591-600
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Bone Density Conservation Agents - economics - therapeutic use
Canada - epidemiology
Cost of Illness
Drug Costs - statistics & numerical data
Emergency Service, Hospital - economics - statistics & numerical data
Female
Health Care Costs - statistics & numerical data
Home Care Services - economics - statistics & numerical data
Hospitalization - economics - statistics & numerical data
Humans
Long-Term Care - economics
Male
Middle Aged
Osteoporosis - economics - epidemiology - therapy
Osteoporotic Fractures - economics - epidemiology - therapy
Prevalence
Sensitivity and specificity
Abstract
To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis.
Since the 1996 publication of the burden of osteoporosis in 1993 in Canada, the population has aged and the management of osteoporosis has changed. The study purpose was to estimate the current burden of illness due to osteoporosis in Canadians aged 50 and over.
Analyses were conducted using five national administrative databases from the Canadian Institute for Health Information for the fiscal-year ending March 31 2008 (FY 2007/2008). Gaps in national data were supplemented by provincial and community data extrapolated to national levels. Osteoporosis-related fractures were identified using a combination of most responsible diagnosis at discharge and intervention codes. Fractures associated with severe trauma codes were excluded. Costs, expressed in 2010 dollars, were calculated for osteoporosis-related hospitalizations, emergency care, same day surgeries, rehabilitation, continuing care, homecare, long-term care, prescription drugs, physician visits, and productivity losses. Sensitivity analyses were conducted to measure the impact on the results of key assumptions.
Osteoporosis-related fractures were responsible for 57,413 acute care admissions and 832,594 hospitalized days in FY 2007/2008. Acute care costs were estimated at $1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over $2.3 billion for the base case analysis and as much as $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis.
Osteoporosis is a chronic disease that affects a large segment of the adult population and results in a substantial economic burden to the Canadian society.
Notes
Cites: Osteoporos Int. 2008 Mar;19(3):269-7618060586
Cites: Osteoporos Int. 2008 Jan;19(1):79-8617641811
Cites: Osteoporos Int. 2009 May;20(5):703-1418802659
Cites: CMAJ. 2009 Sep 1;181(5):265-7119654194
Cites: Osteoporos Int. 2010 Aug;21(8):1317-2219802507
Cites: CMAJ. 2010 Nov 23;182(17):1864-7320940232
Cites: Appl Health Econ Health Policy. 2011 Mar 1;9(2):111-2321271750
Cites: Osteoporos Int. 2011 Jun;22(6):1835-4421165602
Cites: Age Ageing. 2011 Sep;40(5):602-721775335
Cites: J Bone Miner Res. 2011 Oct;26(10):2411-821710615
Cites: Osteoporos Int. 2012 Jun;23(6):1757-6821927921
Cites: CMAJ. 2002 Nov 12;167(10 Suppl):S1-3412427685
Cites: J Bone Miner Res. 1997 Jan;12(1):24-359240722
Cites: Osteoporos Int. 2005 Feb;16(2):222-815232678
Cites: Osteoporos Int. 2005 Mar;16 Suppl 2:S8-S1715378232
Cites: Osteoporos Int. 2005 Dec;16(12):1475-8016217587
Cites: Osteoporos Int. 2007 Jan;18(1):77-8417048064
Cites: JAMA. 2007 Nov 28;298(20):2381-818042915
Cites: Contemp Clin Trials. 2008 Mar;29(2):194-21017766187
PubMed ID
22398854 View in PubMed
Less detail
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):526-30
Publication Type
Article
Date
Mar-6-2012
Author
Marte Handal
Svetlana Skurtveit
Jørg G Mørland
Author Affiliation
Avdeling for legemiddelepidemiologi, Divisjon for epidemiologi, Nasjonalt folkehelseinstitutt, Norway. marte.handal@fhi.no
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):526-30
Date
Mar-6-2012
Language
Norwegian
Publication Type
Article
Keywords
Adolescent
Adult
Anti-Anxiety Agents - administration & dosage - pharmacokinetics
Anticonvulsants - administration & dosage - pharmacokinetics
Benzodiazepines - administration & dosage - pharmacokinetics
Drug Interactions
Drug Prescriptions - statistics & numerical data
Drug Therapy, Combination - statistics & numerical data
Female
Humans
Hypnotics and Sedatives - administration & dosage - pharmacokinetics
Male
Middle Aged
Norway
Physician's Practice Patterns
Registries
Young Adult
Abstract
The various benzodiazepines have essentially the same mechanism of action and differ from one another primarily through differences in pharmacokinetics. There is no pharmacological basis for using more than one benzodiazepine for the same patient. The purpose of the study was to examine the occurence of co-medication with different types of benzodiazepines in Norway.
Data were obtained from the Norwegian Prescription Database. Patients who received at least one benzodiazepine in 2008 were included (n = 299,185). The percentage of users who were co-medicated with at least two different benzodiazepines and the amounts prescribed were calculated and stratified by gender and age.
It is highly probably that 27,861 (14,6%) of patients who received at least two benzodiazepines in the course of 2008 used two different benzodiazepines simultaneously. 13,267 (6.9%) of the patients were prescribed at least two different benzodiazepines on the same prescription. A larger number of women were co-medicated with different benzodiazepines, but the proportion of comedication was higher in men than in women, and most frequent in the age group 18-49 years.
There is an extensive and unfortunate prescription practice whereby the same patient is prescribed different benzodiazepines that are used concurrently. Patients who use different benzodiazepines concurrently are mainly prescribed these by one and the same doctor.
PubMed ID
22398769 View in PubMed
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Patient satisfaction in rehabilitation of patients with multiple sclerosis.

https://arctichealth.org/en/permalink/ahliterature126336
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):523-6
Publication Type
Article
Date
Mar-6-2012
Author
Trygve Holmøy
Kjersti Træland Hanssen
Antonie G Beiske
Author Affiliation
The Neurological Clinic, Akershus University Hospital, Norway. trygve.holmoy@medisin.uio.no
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):523-6
Date
Mar-6-2012
Language
English
Norwegian
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multiple Sclerosis - psychology - rehabilitation
Norway
Patient satisfaction
Program Evaluation
Quality of Life
Questionnaires
Rehabilitation Centers
Abstract
The motor and non-motor symptoms of multiple sclerosis often result in a substantially reduced health-related quality of life. We surveyed patient satisfaction and own evaluation of the benefit of a period spent at a specialised rehabilitation centre.
All patients who spent a period at the Hakadal MS rehabilitation centre in 2010 were asked to complete a validated questionnaire designed to determine patient satisfaction with rehabilitation institutions.
Of a total of 339 patients, 277 (82%) returned the questionnaire. The great majority of respondents were satisfied with the knowledge, cooperation, care and engagement of those providing treatment, as well as with the advance information provided and the premises. They also found that they were consulted concerning their rehabilitation programme and that they were prepared for the period following their stay. More than 85% of the respondents stated that the stay would have major or very great importance for their general qualify of life and physical health. A similar score for mental health was given by 83%, mastery of day-to-day tasks by 77% and participation in social activities by 71%.
Patients who have had stays at the Hakadal MS rehabilitation centre are satisfied and feel that the stay will be of great importance to their level of functioning and mastery.
Notes
Comment In: Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):50622398758
PubMed ID
22398768 View in PubMed
Less detail

What did they know, and when did they know it?

https://arctichealth.org/en/permalink/ahliterature126337
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):505-6
Publication Type
Article
Date
Mar-6-2012
Author
Charlotte Haug
Source
Tidsskr Nor Laegeforen. 2012 Mar 6;132(5):505-6
Date
Mar-6-2012
Language
English
Norwegian
Publication Type
Article
Keywords
Child
Drug Approval
Humans
Influenza A Virus, H1N1 Subtype
Influenza Vaccines - adverse effects
Mass Vaccination
Narcolepsy - chemically induced
Norway
World Health Organization
Notes
Comment In: Tidsskr Nor Laegeforen. 2012 Apr 17;132(7):786-722511081
PubMed ID
22398757 View in PubMed
Less detail

Carbapenem-resistant Gram-negative bacilli in Canada 2009-10: results from the Canadian Nosocomial Infection Surveillance Program (CNISP).

https://arctichealth.org/en/permalink/ahliterature126338
Source
J Antimicrob Chemother. 2012 Jun;67(6):1359-67
Publication Type
Article
Date
Jun-2012
Author
L F Mataseje
E. Bryce
D. Roscoe
D A Boyd
J. Embree
D. Gravel
K. Katz
P. Kibsey
M. Kuhn
A. Mounchili
A. Simor
G. Taylor
E. Thomas
N. Turgeon
M R Mulvey
Author Affiliation
Public Health Agency of Canada, Winnipeg, MB, Canada.
Source
J Antimicrob Chemother. 2012 Jun;67(6):1359-67
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Bacterial Proteins - genetics
Canada - epidemiology
Carbapenems - pharmacology
Cross Infection - epidemiology - microbiology
DNA, Bacterial - chemistry - genetics
Electrophoresis, Gel, Pulsed-Field
Female
Gram-Negative Bacteria - drug effects - isolation & purification
Gram-Negative Bacterial Infections - epidemiology - microbiology
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Molecular Sequence Data
Molecular Typing
Plasmids - analysis
Polymerase Chain Reaction
Prevalence
Sequence Analysis, DNA
beta-Lactam Resistance
beta-Lactamases - genetics
Abstract
To investigate the occurrence and molecular mechanisms associated with carbapenemases in carbapenem-resistant Gram-negative isolates from Canadian cases.
Twenty hospital sites across Canada submitted isolates for a 1 year period starting 1 September 2009. All Enterobacteriaceae with MICs = 2 mg/L and Acinetobacter baumannii and Pseudomonas aeruginosa with MICs = 16 mg/L of carbapenems were submitted to the National Microbiology Laboratory (NML) where carbapenem MICs were confirmed by Etest and isolates were characterized by PCR for carbapenemase genes, antimicrobial susceptibilities, PFGE and plasmid isolation.
A total of 444 isolates (298 P. aeruginosa, 134 Enterobacteriaceae and 12 A. baumannii) were submitted to the NML of which 274 (61.7%; 206 P. aeruginosa, 59 Enterobacteriaceae and 9 A. baumannii) met the inclusion criteria as determined by Etest. Carbapenemase genes were identified in 30 isolates: bla(GES-5) (n = 3; P. aeruginosa), bla(KPC-3) (n = 7; Enterobacteriaceae), bla(NDM-1) (n = 2; Enterobacteriaceae), bla(VIM-2) and bla(VIM-4) (n = 8; P. aeruginosa) bla(SME-2) (n = 1; Enterobacteriaceae) and bla(OXA-23) (n = m9; A. baumannii). PFGE identified a cluster in each of Enterobacteriaceae, P. aeruginosa and A. baumannii corresponding to isolates harbouring carbapenemase genes. Three KPC plasmid patterns (IncN and FllA) were identified where indistinguishable plasmid patterns were identified in unrelated clinical isolates.
Carbapenemases were rare at the time of this study. Dissemination of carbapenemases was due to both dominant clones and common plasmid backbones.
PubMed ID
22398651 View in PubMed
Less detail

RareICT: a web-based resource to augment self-care and independence with a rare medical condition.

https://arctichealth.org/en/permalink/ahliterature126339
Source
Work. 2012;41(3):329-37
Publication Type
Article
Date
2012
Author
Anne Moen
Ole Smørdal
Author Affiliation
Institute of Health and Society, University of Oslo, Oslo, Norway. anne.moen@intermedia.uio.no
Source
Work. 2012;41(3):329-37
Date
2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Adult
Anal Canal - abnormalities
Child
Female
Health Services Accessibility
Home Nursing
Humans
Internet
Male
Norway
Rare Diseases - congenital - nursing
Rectal Diseases - congenital - nursing
Self Care
Software
Abstract
Everyday challenges to "live well" with a rare disorder, anorectal anomaly, was the starting point to design a social-software environment, called RareICT, to help patients and family members in their everyday, additional un-paid work.
Persons with the rare disorder, family members and health providers were recruited to elaborate challenges to daily living given this condition.
An exploratory study was designed, and we set up a series of participatory design workshops to explore challenges to everyday living with a rare medical condition.
Anorectal anomaly has few visible outward signs, and is often surrounded with secrecies. Findings shed light on efforts to maintain physical functioning, psychosocial and emotional wellbeing. For an affected person to "live well" modifications to everyday routines, along with management work, support work and planning work are required. Accumulating practical strategies, everyday experiences and knowledge, along with virtual access to peers may augment such health maintenance work if integrity, accountability and trust, confidentiality and privacy are maintained.
A social-software environment was set up to offer co-evolving content and augment health-related decision-making at home. To evaluate the project will focus on interest in maintaining participation determined and how users benefit from services such as RareICT.
PubMed ID
22398502 View in PubMed
Less detail

Models in interprofessional education: the IP enhancement approach as effective alternative.

https://arctichealth.org/en/permalink/ahliterature126340
Source
Work. 2012;41(3):253-60
Publication Type
Article
Date
2012
Author
Siegrid Deutschlander
Esther Suter
Jana Lait
Author Affiliation
Health Systems and Workforce Research Unit, Alberta Health Services, Calgary, Alberta, Canada. siegrid.deutschlander@albertahealthservices.ca
Source
Work. 2012;41(3):253-60
Date
2012
Language
English
Publication Type
Article
Keywords
Alberta
Cooperative Behavior
Curriculum
Education, Professional - methods
Educational Measurement
Health Personnel - education
Humans
Interprofessional Relations
Intervention Studies
Licensure
Mentors
Models, Educational
Patient Care Team - organization & administration
Pilot Projects
Professional Competence
Students, Health Occupations
Abstract
This article discusses the strategies and challenges of implementing interprofessional education interventions with students from different disciplines. It reviews two models of interprofessional education in academic prelicensure curricula including the extra-curricular and the crossbar models by considering ease of implementation, program reach and sustainability. It also introduces the interprofessional enhancement approach as an additional curriculum development strategy.
The Alberta Interprofessional Education for Collaborative Patient-Centred Practice project used the Interprofessional Enhancement Approach by integrating course content into existing placement courses for nursing, respiratory therapy, pharmacy, and physiotherapy students. The students conducted their regular discipline-specific placements at various clinical sites in southern Alberta, Canada that were supplemented by three interprofessional strategies: mentoring, workshops and online discussions. The intervention reached over sixty individuals including students, preceptors and faculty.
As compared to other approaches (extra-curricular and crossbar models), this approach shows that IP course content can be added to placement courses without restructuring complete curricula. This article intends to initiate further discussions about different IP education models in prelicensure education.
PubMed ID
22398493 View in PubMed
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310038 records – page 1 of 31004.