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Littérature scientifique sur le sujet « Clinical observational study »

Auteur : Grafiati
Publié le 9 mars 2023
Mis à jour le 10 mars 2023

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Articles de revues sur le sujet "Clinical observational study"

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Joseph, Shiji, Lulu Mathews et Vijayakumar M. Vijayakumar M. « An Observational Study of the Clinical Profile of Congenital Hypothyroidism in Children. » Asian Journal of Medical Research 8, no 1 (mars 2019) : PE01—PE05. http://dx.doi.org/10.21276/ajmr.2019.8.1.pe1.

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Shilpa, D. Saxena et Shabina. « THE CYSTIC ARTERY : AN OBSERVATIONAL STUDY AND CLINICAL SIGNIFICANCE OF ITS VARIANTS ». International Journal of Anatomy and Research 8, no 4.1 (10 novembre 2020) : 7788–93. http://dx.doi.org/10.16965/ijar.2020.223.

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Background: Cystic artery variations are frequent and important for invasive as well as invasive procedure around the hepatibiliary area. Variation can be in term of origin, course and termination of CA. Aim: Aim was to identify new type of Cystic arterial variation in term of origin, no. of CA, and termination and surgical implications of these variations. Materials and methods: Study was carried out at department of anatomy, S.M.S Medical college and hospitals Jaipur (Raj). Total 60 cadaver were included in the study. Ethical clearance was taken for the same. Subjects with history of abdominal surgery around Hepatobiliary area were excluded. Result: Source of origin of SCA was RHA (majority of cases), Aberrant RHA, SMA, HAP. DCA was observed in 13.34% cases. Accessory CA arose from RHA, ARHA, HAP, PSPD. Compound DCA was observed in 5% cases. Longer CA was observed in the study. Conclusion: Variation related to CA are essential to keep in mind while dealing with Hepatobiliary area during invasive and non invasive procedures as well. KEY WORDS: Cystic, Hepatobiliary, Cystic arterial variation.
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Zehra, Amreen. « A Demographic Study of Chronic Bronchitis : An Observational Study ». Journal of Integrated Community Health 10, no 02 (30 décembre 2021) : 3–7. http://dx.doi.org/10.24321/2319.9113.202105.

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Background: Chronic bronchitis is a global public health problem affecting those over the age of 40, and it will continue to be a challenge in the future. It is a leading cause of chronic morbidity and mortality around the world.Objective: The purpose of this study is to determine the demographic status of chronic bronchitis patients.Materials and Methods: It is an open-label clinical study conducted on 50 diagnosed patients who visited the Moalejat, Ajmal Khan Tibbiya College and Hospital, Aligarh Muslim University, selected for further inquiry regarding age, sex, occupation, temperament, seasonal variations, etiological factors. Results: In the present study, among the patients selected for chronic bronchitis,it was observed that maximum participants 17(34.0%) belonged to the age group of 60-65 years and patients were also evaluated based on the history of risk factors. Among various risk factors, cigarette smoking is a vital risk factor, accounting for 94% of patients in our study.Conclusion: In conclusion, every tool should be leveraged to raise CB awareness and implement an effective COPD/CB early detection programme in our community.
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Turner, Dana P., et Timothy T. Houle. « Observational Study Designs ». Headache : The Journal of Head and Face Pain 59, no 7 (juillet 2019) : 981–87. http://dx.doi.org/10.1111/head.13572.

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Wang, Li, Hui Ge, Guohong Wei, Longyun Pong, Liqiu Wu et Huijuan Ye. « Berberine and Prediabetes : A Clinical Observational Study ». Journal of Diabetes Mellitus 10, no 04 (2020) : 209–21. http://dx.doi.org/10.4236/jdm.2020.104017.

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H.N, Dr Ravindra. « Patency of Peripheral Venous Catheter : An Observational Study ». International Journal of Psychosocial Rehabilitation 24, no 5 (25 mai 2020) : 7057–61. http://dx.doi.org/10.37200/ijpr/v24i5/pr2020712.

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Kim, Min Ju, Hyeon Kyu Choi, Hyun Ji Cha, Young Rok Lee, Hyun jin Jang, So jeong Kim, Ju Hyun Jeon et Young Il Kim. « Clinical study on recurrent Bell’s palsy : A retrospective observational study ». Journal of Korean Medicine 43, no 2 (1 juin 2022) : 8–26. http://dx.doi.org/10.13048/jkm.22016.

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Objectives: This study is designed to statistically analyze characteristics, treatment effect and prognosis of patients who were treated for the recurrent Bell’s palsyMethods: This study retrospectively analyzed the medical records and telephone questionnaire of 82 patients treated with the recurrent Bell’s palsy at the OO Korean Medicine hospital from August 01, 2018 to July 31, 2021.Results: The lower the EQ-VAS® and HB scale before and after treatment, the higher the satisfaction with the treatment. The average of the number of days and duration of outpatient treatment for male was longer than that for female. The average number of days and duration of outpatient treatment in the group that received combined treatment was longer than that of patients who received Korean Medicine only. The higher the satisfaction of treatment, the higher the willingness to receive treatment in the event of recurrent facial palsy. HB scale after treatment was the lowest in their 40s, and the average value of HB scale after treatment tended to increase as age increased except for those in their 40s.Conclusion: This study showed that the lower the HB scale after treatment, the lower the EQ-VAS®, the higher the treatment satisfaction, and the higher the probability receiving treatment if the facial paralysis recurs. Those in their 10s to 40s showed excellent results after treatment. Comparatively, those in their 50s and above showed a little effect after treatment. Gender, affected side, history of facial palsy, season of onset, age, hypertension and diabetes had no statistically significance with recurrent Bell’s palsy prognosis.
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Kanani, Bipin, et Nirav J. Garala. « A clinical observational study in cases of eclampsia ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no 9 (26 août 2019) : 3524. http://dx.doi.org/10.18203/2320-1770.ijrcog20193770.

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Background: Eclampsia is a life threatening condition and one of the leading causes of maternal deaths worldwide. It is also associated with complications like acute renal failure, DIC, postpartum hemorrhage, etc. and adverse fetal outcomes. Hence we aimed to study fetomaternal outcomes in cases of Eclampsia.Methods: A total of 75 cases of eclampsia out of 13524 deliveries were evaluated, from 1st January 2016 to 30th June 2017 at RZ Hospital, a government tertiary referral centre. Maternal outcomes were studied for its complications, effectiveness of magnesium sulphate treatment, fetal outcome and mode of delivery.Results: Incidence rate of eclampsia was 0.55%, 62.66% of all cases were primigravida, 76% of cases were in age group of 21-26 years, 84% cases were from lower socio economic status, maternal mortality occurred in 2 of 75 cases. 66.67% of patients were of term pregnancy (37 to 42 weeks). 71%(53) patients delivered vaginally out of which 9 deliveries were spontaneous and 44 deliveries were induced vaginal delivery. 22 patients required caesarean section.Conclusions: Early detection and prevention of pregnancy induced hypertension and pre-eclampsia and other associated risk factors for eclampsia might help to reduce the incidence of eclampsia. Maternal adverse outcomes in this study were magnesium toxicity, acute renal failure (ARF), disseminated intravascular coagulation (DIC) and post partum hemorrhage (PPH) while 92% patients had no complications.
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R., Geetha Lakshmi, Bommireddy Pranavi, Neethu George et K. Saraswathi. « A clinical observational study on second-trimester abortion ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no 4 (25 mars 2020) : 1339. http://dx.doi.org/10.18203/2320-1770.ijrcog20201008.

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Background: Second-trimester abortion is an important component of the comprehensive women’s health care. Data’s regarding second-trimester abortion is still under-reporting. Though the percentage of induced second-trimester abortion is low, its morbidity is higher than the first-trimester induced abortion. The abortion related mortality usually increases with the age of gestation.Methods: A retrospective observational study was conducted in the department of obstetrics and gynecology at Sree Balaji Medical College and Hospital, Chennai, over a period of one year. The data were collected from the medical case records and we have analyzed on the epidemiology, etiologies, complications and the methods of second- trimester abortion using statistical analysis.Results: In this study, there was no standard regimen of mifepristone and misoprostol were used for second-trimester abortion. The dosages were varied based on the gestational age of pregnancy. As the gestational age progresses, the amount of misoprostol required for the induction of second trimester abortion decreases and the difference is statistically significant. There was no reported case of rupture uterus, but varied complications such as post-abortal hemorrhage, retained placenta, need for blood transfusion, uterine perforation and one maternal death were reported during the study period.Conclusions: In order to reduce the morbidity and mortality of second trimester abortion, more policies and monitored services have to be rendered by the health system. Data regarding the second trimester abortion have to be improved.
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Krishna, Dr Kajal, et Dr Neeta Natu. « Gestational diabetes : A clinical observational non randomized study ». International Journal of Clinical Obstetrics and Gynaecology 4, no 2 (1 mars 2020) : 130–33. http://dx.doi.org/10.33545/gynae.2020.v4.i2c.514.

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Thèses sur le sujet "Clinical observational study"

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Paulo, António Augusto dos Santos. « Psychosocial and clinical characteristics predicting women’s acceptance of office hysteroscopy : an observational study ». Doctoral thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/17072.

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Doutoramento em Ciências e Tecnologias da Saúde - Decisão Clínica
A histeroscopia é hoje uma técnica imprescindível em ginecologia quer no diagnóstico de alterações genitais superiores, quer no tratamento minimamente invasivo, sendo segura, fiável e com poucos efeitos secundários e complicações. A miniaturização dos aparelhos juntamente com aperfeiçoamento técnico (nomeadamente com a abordagem vaginoscópica, sem recurso a espéculo, nem a tração do colo) vieram permitir o seu uso em consultório. Usado sem anestesia reduz os riscos do internamento e tornam o exame acessível; tem contudo a limitação da dor provocada pela instrumentação. Apesar de muitas tentativas analgésicas e anestésicas, o controlo da dor não é satisfatória em algumas doentes nas quais a histeroscopia é difícil de suportar. Este trabalho pretende estabelecer se a dor é menor com os mini histeroscópios do que com os instrumentos convencionais, avaliar quão grave é o problema da dor (quantificando a proporção de mulheres que se queixam) mesmo com este aparelhos mais delgados e tentar saber se existem fatores de risco que favoreçam a dor, ou que pelo contrário protejam a doente. Também se pretende estabelecer se os inquéritos de satisfação às doentes se correlacionam com a pontuação de dor e se a ansiedade interfere com as queixas álgicas. Finalmente também tentámos investigar se uma técnica nova de anestesia local, administrada através do histeroscópio com recurso a uma agulha cistoscópica, reduz a dor e torna o exame mais tolerável. Os resultados mostraram haver redução estatisticamente significativa da perceção da dor com mini histeroscópios em relação a aparelhos convencionais. Mostraram ainda que mesmo com calibres finos há uma proporção de doentes entre 13 e 30% que ainda refere dor moderada a severa e que reduzir o calibre abaixo dos 3,5mm pode não resultar numa redução maior da dor. Quanto a fatores de risco para a dor os nossos resultados não encontraram relação, exceto uma proteção na dor para as doentes obesas, que relacionamos com uma maior impregnação hormonal (androgénica e por via da aromatase, estrogénica). A ansiedade não parece ser importante na dor sentida, ainda que exista uma pouco significativa relação entre traço ansioso e intensidade da dor relatada. No que se refere aos questionários de satisfação, correlacionam-se muito bem com a dor reportada, tendo uma boa sensibilidade e especificidade; sendo simples de administrar e fáceis de interpretar poderiam provavelmente substituir as escalas da dor e ser úteis para eventual seleção das doentes a quem administrar a anestesia local histeroscópica. Finamente a técnica histeroscópica de injeção local de anestésico reduz significativamente a dor e poderá ser uma solução para tornar a intervenção suportável em ambulatório.
Hysteroscopy today is an essential tool in gynaecology both for diagnosis of female upper genital tract abnormalities and for minimally invasive surgery procedures. It is safe, reliable and has few side effects and complications. Diminishment of instrument diameter together with technical improvements (such as the vaginal “no touch” approach without use of speculum or cervical traction) has allowed procedures in office environment. Used without analgesia or aneasthesia it has reduced hospitalization risks and made the examination affordable; it has a drawback which is the level of pain some women refer with instrumentation. Although many attempts with the use of analgesics and anaesthetics have been made, pain control is not satisfactory in some patients for whom hysteroscopy is hard to endure. In this work we aim to establish if pain reporting is lower with mini-hysteroscopes compared to conventional scopes, how big is the problem “pain” (quantifying the proportion of women still complaining) even when using the slender mini-scopes and try to establish if there are risk factors which might influence pain reporting, or on the contrary protect, women from agony. We also explored if satisfaction questionnaires correlate well with pain scores and if patient anxiety interferes with pain. Finally we have investigated if a new local anaesthetic administration technique, with the use of a cystoscopic needle through the hysteroscope, can reduce pain and make the procedure more tolerable. Our results show there is a statistically significant reduction of pain scores when using mini-hysteroscope compared to conventional instruments. They also show that even using smaller caliber scopes there is a proportion of women varying from 13 to 30% who will still complain of moderate to severe pain and that reduction of scopes below 3.5mm diameter may not reduce pain scores any further. As to risk factors for pain, our results have not found relation to pain with risk factors except for some protection for pain in women with high body mass index, and we relate this finding with elevated circulating hormones (androgens which are peripherally converted to estrogens via aromatase in adipose tissue). Anxiety does not seem important in pain reporting, even if a slight statistical significance was found between anxiety trait and pain reporting. As to satisfaction questionnaires, they seem to correlate well with the pain experience and show and excellent sensitivity and specificity: simple to administer and easy to interpret, they could probably replace more complicated pain rating scales and be useful in selecting women who would benefit from local anaesthesia. Finally as to the new technique of applying local anaesthetics “hysteroscopic anaesthesia”, results show a statistical reduction of pain after injection and it could become a practical solution in making hysteroscopy bearable in an office setting.
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Silva, Pedro Miguel Couto Moreira e. « Curricular trainig report as study coordinator in Blueclinical Ltd ». Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/15798.

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Mestrado em Biomedicina Farmacêutica
The present report describes in detail the activities and knowledge aquired during my internship as study coordinator in Blueclinical – Investigação e Desenvolvimento em Saúde, Ltd., in order to obtain the master degree in Pharmaceutical Biomedicine. According to the type of services provided, Blueclinical is formed by three business units: Blueclinical Clinical Research Partnership, Blueclinical Phase I and Blueclinical Research and Development. The fact of belonging to such a company gave me the opportunity to be in touch with different areas of pharmaceutical development and to contact with different research teams, which for me was an added advantage to the integration and consolidation of knowledge, as well as in the development and improvement of soft and hard skills. The main activity developed was the coordination of clinical studies, in Unidade Local de Saúde de Matosinhos, E.P.E., which was one of the institutions that established a partnership with Blueclinical, Ltd. During my internship I was able to contact with various stages of development and coordination of clinical trials, which will be reported in this report.
O presente relatório descreve com detalhe as atividades e aprendizagens adquiridas no âmbito do meu estágio curricular como coordenador de estudos na Blueclinical, Lda., para obtenção do grau de mestre de Biomedicina Farmacêutica. De acordo com o tipo de serviços prestados, a Blueclinical pode ser dividida em três unidades de negócio: Blueclinical Clinical Research Partnership, Blueclinical Phase I e Blueclinical Research and Development. O facto de pertencer a esta companhia deu-me a oportunidade de estar em contacto com diferentes áreas do desenvolvimento farmacêutico e de contactar com diferentes equipas de investigação, o que para mim foi uma vantagem para a integração e consolidação de conhecimento, bem como para o desenvolvimento de hard e soft skills. A principal atividade desenvolvida foi a coordenação de estudos clínicos, na Unidade Local de Saúde de Matosinhos, E.P.E., que se insere na rede de hospitais que estabeleceram parceria com a Blueclinical, Lda. Durante o meu estágio pode contactar com diversas fases de coordenação e desenvolvimento de ensaios clínicos, que serão relatadas nesta dissertação.
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McBride, Ali. « Evaluating Fast Track Time Analysis of Clinical Drug Trial Phases Utilizing a Quasi-Experimental Observational Study ». The University of Arizona, 2007. http://hdl.handle.net/10150/624440.

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Class of 2007 Abstract
Objectives: In this paper we analyzed the time frame for oncology drugs that were designated as a fast track drug and the time transition from a phase II to phase III clinical trial completion. Methods In our study we utilized oncology drugs that were approved between the years of 2000-2006 (FDA.gov). We then analyzed the CDER data base that provided information to Fast Track drugs that have been approved within the time period as determined by the FDA selection criteria (21 CFR 312.81(a)). Under certain circumstances, the FCA may consider reviewing portions of a marketing application in advance of the complete New Drug Application (NDA) or Biologic License Application (BLA). We will evaluate fast track designated products which may also be eligible to participate in FDA’s Continuous Marketing Applications Pilot 1 or Pilot 2 programs. For our analysis, we specifically selected oncology drugs. In particular, we analyzed 32 drugs from the stated time period. Each fast track drug was then selected and analyzed for its clinical phase development time period based on news announcements during clinical trails. For each announcement we conducted an event study analysis through lexis Nexus with respect to the announcement of a clinical trial enrollment, clinical trials news (Phase I, II, III). Results: The results of our preliminary study show that there was a shorter time to development transition for the fast track oncology drugs. The oncology clinical phase transition from II to three on average lasted 12 months with a range of 2 - 29 months The average length of the phase development had to excludes 4 drugs due to the lack of information provided from the LexisNexis database. The current timeline for fats track drugs has shown a decrease in transition from clinical trials to the market. In the example of Spyrcel, the data from our study had to be excluded, there was a definitive difference in the time to approval process for the drug as compared to other standard review entities. The approvals for dasatinib, or Sprycel, for refractory CML was shown to move through the development to approval in one of the fastest timeframes in modern development. Since its first clinical study on in Gleevec-resistant patients, the medication was decided on entering an accelerated timeline. It took us just 25 months to bring Sprycel from first-in-human dosing to a regulatory submission. In contrast, the industry average for this cycle time is 6.4 years which is three times greater than the cycle time for Sprycel. Conclusions: The new Subpart H regulations state that post-marketing studies to confirm clinical benefit that would consist usually by "studies underway” at the time of accelerated approval, this has not always been the case and is not a requirement (Dagher R, Johnson J, Williams G et al). In conclusion, the accelerated approval program in oncology has been successful in making 18 different products available to patients for 22 different cancer treatment indications since the inception of the fast track program. From the current data and transition information, there is a comparative difference between the clinical phase transitions from phase II to Phase III clinical trials. However, this preliminary data needs to be further evaluated against the standard FDA review process from oncology drugs. Moreover, further studies will be needed to interpret whether the average length of oncology studies biases the value of our study.
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Gilman, Lynn. « Supervisory interventions and treatment adherence an observational study of supervisor interventions and their impact on therapist model adherence / ». [Bloomington, Ind.] : Indiana University, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3352938.

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Thesis (Ph.D.)--Indiana University, Dept. of Counseling and Educational Instruction, School of Education, 2009.
Title from PDF t.p. (viewed on Feb. 4, 2010). Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2572. Adviser: Thomas L. Sexton.
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Herman, Patricia, Sally Dodds, Melanie Logue, Ivo Abraham, Rick Rehfeld, Amy Grizzle, Terry Urbine, Randy Horwitz, Robert Crocker et Victoria Maizes. « IMPACT - Integrative Medicine PrimAry Care Trial : protocol for a comparative effectiveness study of the clinical and cost outcomes of an integrative primary care clinic model ». BioMed Central, 2014. http://hdl.handle.net/10150/610366.

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BACKGROUND:Integrative medicine (IM) is a patient-centered, healing-oriented clinical paradigm that explicitly includes all appropriate therapeutic approaches whether they originate in conventional or complementary medicine (CM). While there is some evidence for the clinical and cost-effectiveness of IM practice models, the existing evidence base for IM depends largely on studies of individual CM therapies. This may in part be due to the methodological challenges inherent in evaluating a complex intervention (i.e., many interacting components applied flexibly and with tailoring) such as IM.METHODS/DESIGN:This study will use a combination of observational quantitative and qualitative methods to rigorously measure the health and healthcare utilization outcomes of the University of Arizona Integrative Health Center (UAIHC), an IM adult primary care clinic in Phoenix, Arizona. There are four groups of study participants. The primary group consists of clinic patients for whom clinical and cost outcomes will be tracked indicating the impact of the UAIHC clinic (n=500). In addition to comparing outcomes pre/post clinic enrollment, where possible, these outcomes will be compared to those of two matched control groups, and for some self-report measures, to regional and national data. The second and third study groups consist of clinic patients (n=180) and clinic personnel (n=15-20) from whom fidelity data (i.e., data indicating the extent to which the IM practice model was implemented as planned) will be collected. These data will be analyzed to determine the exact nature of the intervention as implemented and to provide covariates to the outcomes analyses as the clinic evolves. The fourth group is made up of patients (n=8) whose path through the clinic will be studied in detail using qualitative (periodic semi-structured interviews) methods. These data will be used to develop hypotheses regarding how the clinic works.DISCUSSION:The US health care system needs new models of care that are more patient-centered and empower patients to make positive lifestyle changes. These models have the potential to reduce the burden of chronic disease, lower the cost of healthcare, and offer a sustainable financial paradigm for our nation. This protocol has been designed to test whether the UAIHC can achieve this potential.TRIAL REGISTRATION:Clinical Trials.gov NCT01785485.
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Clarson, Lorna Elise. « Risk of incident vascular disease in patients with gout : an observational study in the Clinical Practice Research Datalink ». Thesis, Keele University, 2015. http://eprints.keele.ac.uk/2309/.

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Gout is the most prevalent inflammatory arthritis, predominantly managed in primary care. Both hyperuricaemia (the biochemical precursor to gout) and other inflammatory arthritides, e.g. rheumatoid arthritis, have been shown to increase risk of vascular disease. This thesis aims to investigate the risk of incident cardiovascular, cerebrovascular and peripheral vascular disease in primary care gout patients. A systematic review identified 17 studies investigating gout and vascular diseases. Meta-analysis showed increased mortality from all cardiovascular and coronary heart disease. Increased incidence of, but not mortality from myocardial infarction was found. Few studies investigated the association between gout and cerebrovascular or peripheral vascular disease. A retrospective cohort study used data from the Clinical Practice Research Datalink to examine the risk of incident cardiovascular, cerebrovascular and peripheral vascular disease in 8386 gout patients and 39766 age-, gender- and practice-matched controls, in the ten years following diagnosis of gout (or matched date) using Cox proportional hazards and multilevel discrete-time event history analysis. Risk was also investigated by gender and with follow-up limited to one, two and five years. The effect of exposure to drugs used to treat both gout and vascular risk factors on the magnitude of risk was examined using a cohort and nested case-control study design. The strongest association identified was between gout and peripheral vascular disease. Women with gout had the greatest excess vascular risk and experienced a wider range of vascular events. Exposure to drugs used to manage vascular risk factors was associated with increased likelihood of a vascular event, but use of gout treatments such as allopurinol did not influence incident vascular risk. This suggests that gout patients, particularly women, should have screening for and aggressive management of vascular risk factors, although as conventional approaches may be insufficient, further research is required to establish the optimum risk reduction strategy.
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Brink, Filip. « Safe handling of antineoplastic drugs at a public hospital in Guangzhou, China : an observational study in clinical practice ». Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2471.

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Background Antineoplastic drugs constitute an important cornerstone in treating malignant cancer diseases. The nurses administering these drugs risk developing short- and long-term side effects from exposure if not properly protected by personal protective equipment. The National Institute for Occupational Safety & Health produces guidelines and recommendations for healthcare personnel handling antineoplastic drugs in order to minimise exposure. Aim The aim of this study was to observe and describe registered nurses’ compliance to National Institute for Occupational Safety & Health guidelines and recommendations concerning the use of personal protective equipment during drug administration at a public hospital in Guangzhou, China. Method Data was collected at three different departments using structured direct observations, totalling 211 administrations encompassing day and evening shifts. Results Total compliance to National Institute for Occupational Safety & Health guidelines and recommendations was 0 percent as a result of non-existent gown use. The overall compliance for the use of double gloves was 76,3 percent. The Department of Medical Oncology had the highest department-specific compliance rate for double gloves at 80,7 percent, whereas the evening shift at Chemotherapy Outpatient Department boasted the highest shift-specific compliance rate for the same item at 83,3 percent. Conclusion Interventions are needed concerning the use of personal protective equipment, in particular the use of gowns. Obtained hospital-specific guidelines did not include the procedure of drug administration, warranting the implementation of hospital-specific standard operating procedure guidelines encompassing this aspect.
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Sham, Mohamed Ehtaih. « Shape modified radial artery adipo-facio cutaneous perforator flap- An observational anatomical vascular analysis & ; prospective randomized control clinical study ». Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/667764.

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Resumen y antecedentes del estudio: Se describen varias modificaciones en la recolección de un colgajo radial del antebrazo. Para lograr una cosecha y un diseño de aletas fiables y seguros, se debe tener una comprensión muy clara de los perforadores de la arteria radial, en relación con su distribución, territorio y flujo. El propósito de este estudio es determinar la ubicación, el tamaño y el territorio vascular de los perforadores cutáneos de la arteria radial y demostrar la aplicación de la modificación de la forma del colgajo libre de antebrazo radial basado en sus perforadores distales y proximales en varios defectos de cabeza y cuello. Materiales y Métodos: Estudio anatómico: Se disecaron 12 cadáveres humanos frescos y 24 antebrazos de cadáver para determinar el número, ubicación, tamaño y territorio vascular del perforador de la arteria radial. El territorio cutáneo de los perforadores distalmente dominantes se analizó mediante inyecciones de azul de metileno y un angiograma tomográfico computarizado tridimensional para determinar la red vascular. Estudio clínico: 15 pacientes con diversos defectos del cuello de la cabeza después de las resecciones oncológicas se reconstruyeron con un colgajo de antebrazo libre adipo-fascio cutáneo de forma modificada. A todos estos pacientes se les realizó un seguimiento prospectivo de la curación del sitio del donante, el déficit del nervio sensorial y motor, la función y la calidad de vida para la evaluación del sitio del donante. Resultados: Se disecaron 24 antebrazos de cadáver, se diseccionaron un total de 222 perforadores para un promedio de 18,5 perforadores por antebrazo.127 perforadores (57.20%) se distribuyeron radialmente y 95 perforadores (42.79%) tuvieron una distribución cubital. Se identificaron 90 perforadores (40,54%) en el lado distal (estilo radial) y 132 perforadores (59,45%) se identificaron en el lado proximal (epicóndilo lateral). El número medio de perforadores, en el lado radial fue 10.6 y 7.9 en el lado cubital, la comparación de ambos usando la prueba de t de Student da un valor de P de 0.006, que es significativo. La comparación del número medio de perforadores en el lado distal fue de 7.5 y el lado proximal fue de 11.0; la prueba t de Student Paired da un valor de P de 0.003, que fue estadísticamente significativo. Comparando el diámetro medio de los perforadores en el lado distal (1.11) y el lado proximal (0.86), el lado que usa la prueba t de Student Paired da un valor de P de 0.01 que fue estadísticamente significativo. Se realizó una prueba de ji cuadrado para comparar el diámetro medio de los perforadores en el lado distal, que eran más de 1 mm (80%) y menos de 1 mm (20%) y en el lado proximal más de 1 mm (35,6%) y menos de 1 mm (64,4). %). Se obtuvo un valor de Chi cuadrado de 42.406, el valor del grado de libertad fue 1 y se alcanzó un valor de P de <0.001 que se encontró que era altamente significativo. Las inyecciones de azul de metileno demostraron grupos tanto en el antebrazo proximal como en el distal y también marcaron el territorio cutáneo del colgajo. La angiografía tomográfica computarizada tridimensional revela una red de vasos enlazantes que se comunican entre los perforadores adyacentes y que corren paralelos a la arteria radial. Un total de 15 pacientes fueron reconstruidos con un colgajo de antebrazo radial con forma modificada después de resecciones oncológicas. La curación de heridas en los 15 pacientes fue buena, y la evaluación de la cicatriz fue mejor que el colgajo radial tradicional del antebrazo. No hubo déficit sensorial o nervioso. Aunque la longitud del pedículo fue comparativamente más corta en el colgajo modificado en forma, sin embargo, no hubo ningún problema en la anastomosis a los vasos del cuello. Conclusión: El aumento en el conocimiento del territorio vascular de los perforadores de la arteria radial con respecto a los números, el tamaño, la ubicación y el territorio cutáneo puede llevar al uso expandido del colgajo del antebrazo radial basado solo en el perforador distal o proximal. La técnica de forma modificada para la recolección del colgajo del antebrazo radial permite el cierre primario del sitio donante. El sitio donante está mejor curado y muestra un patrón predicho, que es funcional y estéticamente bueno.
Resume and background of the study: Several modifications are described in harvesting a radial forearm flap. In order to achieve a reliable, safe flap harvest & design one must have a very clear understanding of radial artery perforators, relative to its distribution, territory & flow. The purpose of this study is to determine the location, size & vascular territory of the radial artery cutaneous perforators & to demonstrate application of shape modification of radial forearm free flap based on its distal & proximal perforators in various in head & neck defects. Materials & Methods: Anatomical Study: 12 fresh human cadavers & 24 cadaveric forearms were dissected to determine the number, location, size & vascular territory of radial artery perforator. The cutaneous territory of distally dominant perforators was analyzed using methylene blue injections & three-dimensional computed tomographic angiogram to determine the vascular network. Clinical Study: 15 patients with various head neck defects following oncological resections were reconstructed with shape modified adipo-fascio cutaneous free forearm flap. All these patients were prospectively followed for donor site healing, motor & sensory nerve deficit, function & quality of life questioner for donor site assessment. Results: 24 cadaveric forearms were dissected, a total of 222 perforators were dissected for an average of 18.5 perforators per forearm.127 perforators (57.20%) were radially distributed and 95 perforators (42.79%) had ulnar distribution. 90 perforators (40.54%) were identified on distal side (Radial styloid) and 132 perforators (59.45%) were identified on proximal side (Lateral epicondyle). Mean number of perforators, on radial side was 10.6 and 7.9 on ulnar side, comparison of both using student t paired test gives a P value of 0.006, which is significant. Comparison of mean number of perforators on the distal side was 7.5 and proximal side was 11.0, Student Paired t test gives a P value of 0.003, which was statistically significant. Comparison of mean Diameter of perforators on Distal side (1.11) and Proximal side (0.86), side using Student Paired t test gives a P value of 0.01 which was statistically significant. A chi square test was done to compare mean diameter of perforators on distal side, which were more than 1mm (80%) and less than 1mm (20%) and on proximal side more than 1mm (35.6%) and less than 1mm (64.4%). Chi square value of 42.406 was obtained, degree of freedom value was 1 and P value of <0.001 was achieved which was found to be highly significant. Methylene blue injections demonstrated clusters both in proximal and distal forearm and also marked the cutaneous territory of flap. Three- dimensional computed tomographic angiography reveals a network of linking vessels found to communicate between adjacent perforators and running parallel to radial artery. A total of 15 patients were reconstructed with shape modified radial forearm flap following oncologic resections. Wound healing in all 15 patients was good, with scar assessment faring better than traditional radial forearm flap. There was no sensory or motor nerve deficit. Although pedicle length was comparatively shorter in shape- modified flap, nevertheless there was no problem in anastomosing to neck vessels. Conclusion: Increase in knowledge of vascular territory of radial artery perforators with regards to numbers, size, location, and cutaneous territory can lead to expanded use of radial forearm flap based on either distal or proximal perforator alone. Shape modified technique for harvesting radial forearm flap allows primary closure of donor site. Donor site is better healed and shows a predicted pattern, which is functionally and aesthetically good.
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In-Uba, Mariana José Manuel. « Curricular training report : 7 months as a study coordinator at Blueclinical LTD ». Master's thesis, Universidade de Aveiro, 2015. http://hdl.handle.net/10773/15773.

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Mestrado em Biomedicina Farmacêutica
The present report describes in detail the activities undertaken under the coordination of clinical and observational studies during the curricular internship at Blueclinical Ltd., inserted in the Master of Pharmaceutical Biomedicine. Blueclinical Ltd.company operates in three different areas: R&D consultancy, management and coordination of trial centers, and a phase I unit. The curricular internship had the duration of seven months during which I was able to perform different tasks relating to coordination of clinical trials in Centro Hospitalar do Baixo Vouga, E.P.E., (CHBV) in Aveiro, Portugal. This academic internship allowed me to develop theoretical and practical skills in the field of clinical trials and observational studies. I also had the opportunity to further the knowledge I gained throughout my academic journey. During this internship, I had the opportunity to interact with different health professionals and develop my knowledge in the field of several therapeutic indications. I also could interact with distinct monitors and sponsors. This experience allowed me to improve time management, communication and problems resolution skills.
O presente relatório descreve de forma detalhada as atividades realizadas no âmbito da coordenação de estudos clínicos e observacionais durante o estágio curricular na empresa Blueclinical Lda., inserido no Mestrado de Biomedicina Farmacêutica. A empresa Blueclinical Lda. opera em três áreas distintas: consultadoria em investigação e desenvolvimento, gestão e coordenação dos centros de ensaio, e unidade de Fase I. O estágio curricular teve a duração de sete meses ao longo dos quais tive a possibilidade de executar diferentes tarefas relacionadas com a coordenação de ensaios clínicos no Centro Hospitalar do Baixo Vouga, E.P.E., em Aveiro (CHBV). Este estágio curricular permitiu-me desenvolver competências teóricas e práticas em matéria de coordenação de ensaios clínicos e estudos observacionais. Também tive a oportunidade de aprofundar o conhecimento que adquiri ao longo do meu percurso académico. Durante esta experiência, eu tive ainda oportunidade de interagir com diversos profissionais de saúde e desenvolver o meu conhecimento no campo de diferentes indicações terapêuticas. Também pude interagir com vários monitores e promotores. Esta experiência permitiu-me desenvolver as minhas competências relativas à gestão de tempo, comunicação e resolução de problemas.
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Hearnshaw, Sarah. « A Prospective, Observational Study Describing Patients Characteristic, Endoscopic Diagnoses and Therapies, and the use and effetcs on Clinical Outcomes of Red Blood Cell Transfusion ». Thesis, University of Newcastle Upon Tyne, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499334.

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Livres sur le sujet "Clinical observational study"

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Body and mind in old age and decay : Problems in dementia senilis, a study in literature, followed by longitudinal clinical observations. Assen, Netherlands : Van Gorcum, 1986.

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Prout, Jeremy, Tanya Jones et Daniel Martin. Statistical basis of clinical trials. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199609956.003.0009.

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This chapter summarizes some aspects of study design and statistical analysis to allow the anaesthetist to appraise research. Types of observational study are described and aspects of interventional studies such as sample size calculation and power are explained. Research governance, phases of drug trials and levels of evidence are described. A section on statistical analysis includes expression of proportion for binary data (odds ratio, number needed to treat) and use of probability and confidence intervals to measure statistical significance.
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Ray, Sumantra (Shumone), Sue Fitzpatrick, Rajna Golubic, Susan Fisher et Sarah Gibbings, dir. Navigating research methods : quantitative and clinical/epidemiological methods. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199608478.003.0003.

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This chapter focuses on various types of study design used in clinical and healthcare research with an emphasis on observational studies whilst randomised controlled trials are explained in Chapter 15. Within observational studies, the distinction between descriptive and analytical studies is made and different sources of error in epidemiological studies are reviewed. Main features, advantages and disadvantages of analytical observational studies are described for the following designs: ecological studies, cohort studies, case-control studies and cross-sectional studies. A brief overview of experimental studies is also given. Measures of disease occurrence (prevalence, cumulative incidence, incidence rate) as well as effect measures (1.difference measures, ie. attributable risk, and 2. ratio measures, i.e. relative risk, odds ratio, relative risk reduction, attributable fraction) are reviewed. The chapter also presents major characteristics of meta-analysis.
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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Alper, Joe, Claudia Grossmann, Roundtable on Value and Science-Driven Health Care, Institute of Medicine et A Learning Health System Activity. Observational Studies in a Learning Health System : Workshop Summary. National Academies Press, 2013.

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Gray, Nathan A., et Thomas W. LeBlanc. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0030.

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This chapter provides an overview and commentary on the SUPPORT trial main report, which began in 1989 and was published in 1995 and studied quality of care and communication in serious illness. It describes both the observational and interventional phases of this study, reviewing background and potential reasons for its negative findings. The chapter includes concise commentary on the study design and a brief review of relevant subsequent studies. Additionally, a short clinical case is included that highlights the impact of this study’s findings for similar interventions at the end-of-life and summarizes this large trial’s importance in forming a foundation for future study.
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Dahm, Philipp, dir. 50 Studies Every Urologist Should Know. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190655341.001.0001.

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This book describes the most influential studies that have shaped today’s clinical practice of urology. Its scope spans the spectrum of clinical urology, including genitourinary oncology (prostate, renal, bladder, and testis cancer), stone disease, benign prostatic hyperplasia, erectile dysfunction, and female urology. Most included studies are landmark randomized controlled trials related to questions of therapy, but the selection also includes prospective observational cohort studies as well as some case series that have resulted in paradigm-shifting changes in patient management. Each individual study is succinctly presented using a standardized format that focuses on the most important aspects relating to its design and main findings. This is followed by a summary of relevant, closely related studies as well as a brief critique of each study’s limitations. The evidence-based format of this book is further underscored by the frequent reference to relevant clinical practice guidelines. Each chapter closes with a clinical scenario that presents a management question for which an expert clinician proposes an answer based on the current best evidence.
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Arthur, Joseph. Palliative Sedation Therapy and Survival (DRAFT). Sous la direction de Nathan A. Gray et Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0045.

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Patients with advanced illness sometimes experience severe and debilitating physical and psychological symptoms at the end of life that may be refractory to all kinds of conventional treatments available for symptom relief. In such situations, palliative sedation therapy (PST) may be indicated. However, its utilization has been subject to debate. One viewpoint is that PST may hasten death. However, some studies have indicated otherwise. This chapter discusses a multicenter, prospective, observational, nonrandomized population-based study that compared the overall survival of a cohort of terminally ill patients who received PST with a similar group of patients who did not. The study showed that PST does not shorten life when used to relieve refractory symptoms. The chapter also presents a clinical case scenario to illustrate who should receive PST.
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Chapitres de livres sur le sujet "Clinical observational study"

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Puddu, Paolo Emilio, John M. Morgan, Concetta Torromeo, Nick Curzen, Michele Schiariti et Silvio Bonfiglio. « A Clinical Observational Study in the CHIRON Project : Rationale and Expected Results ». Dans Impact Analysis of Solutions for Chronic Disease Prevention and Management, 74–82. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-30779-9_10.

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A, Tsartsalis, George I. Lambrou, Athanasia Samartzi, Eugenia Vlachou, Ioannis Papassotiriou, Styliani A. Geronikolou, Christina Kanaka-Gantenbein, George P. Chrousos et Antonis Kattamis. « Genotypic and Clinical Analysis of a Thalassemia Major Cohort : An Observational Study ». Dans GeNeDis 2020, 65–76. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-78787-5_10.

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Kewitz, H., G. Härter, U. Feldmann, G. Kreutz, M. Nitz et E. Unger. « Observational Cohort Study in General Practice : Differences and Equivalences Among Analgesics for Treatment of Colic Pain ». Dans Epidemiological Concepts in Clinical Pharmacology, 73–86. Berlin, Heidelberg : Springer Berlin Heidelberg, 1987. http://dx.doi.org/10.1007/978-3-642-71043-8_9.

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Deroma, Laura, Annalisa Sechi, Andrea Dardis, Daniela Macor, Giulia Liva, Giovanni Ciana et Bruno Bembi. « Did the Temporary Shortage in Supply of Imiglucerase Have Clinical Consequences ? Retrospective Observational Study on 34 Italian Gaucher Type I Patients ». Dans JIMD Reports, 117–22. Berlin, Heidelberg : Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/8904_2012_158.

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Eliava, Shalva, Vadim Gorozhanin, Oleg Shekhtman, Yuri Pilipenko et Olga Kuchina. « Surgical Treatment of Unruptured Brain AVMs : Short- and Long-Term Results ». Dans Acta Neurochirurgica Supplement, 87–90. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63453-7_13.

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AbstractUnruptured brain AVMs (bAVMs) remain a controversial subject for practicing neurosurgeons, especially in the light of ARUBA and other observational studies. This retrospective study aims to analyze our experience with unruptured bAVMs to see whether it is beneficial in the long-term and how it corresponds to large literature trials. The study comprised 160 adult patients with unruptured bAVMs surgically treated in Burdenko NMC (Moscow) in 2009–2017. Mean age: 33.4 ± 10лет. Clinical presentations were: seizures in 99 (61.9%), chronical headaches—49 (30.6%), ischemic symptoms—4 (2.5%), asymptomatic in 8 (5%) patients. Spetzler-Martin scale: I—18 pt. (11.3%), II—71 pt. (44.4%), III—60 pt. (37.5%), IV—11 pt. (6.8%). Good outcomes (mRS = 0–2) at discharge were achieved in 149 (93.1%), satisfactory (mRS—3)—9 (5.6%). Follow-up was complete for 97 (60.6%) patients, mean—59.3 (13–108 month). Excellent outcomes (mRS = 0–1) reached in 94.8%. For epilepsy patients, Engel I outcome was found in 50 (84.8%); for chronic headaches, 43 (66.1%) patients reported improvement. Postoperative visual field defects were followed in 22 of 55 (40%), complete recovery was reported in 6 (27%) and partial recovery in 8 (36%) patients. Overall, our results support the conclusion that surgery for low-grade bAVMs (S-M I–II) is a beneficial, low-risk option.
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Nundy, Samiran, Atul Kakar et Zulfiqar A. Bhutta. « What Are the Types of Study Design ? » Dans How to Practice Academic Medicine and Publish from Developing Countries ?, 71–80. Singapore : Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-5248-6_8.

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AbstractThe quality, reliability, dependability, and publishability of a study depend on its design. A clinical study design includes the preparation of trials, ]experiments, and observations in research involving human beings. The various types of study designs are depicted in Fig. 8.1.
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Ludwicki, Kristin, Leto L. Riebel, Sophia Ohnemus, Frida M. E. Westby, Nickolas Forsch et Gabriel Balaban. « An Automated Cardiac Constitutive Modelling Framework with Evolutionary Strain Energy Functions ». Dans Computational Physiology, 1–17. Cham : Springer Nature Switzerland, 2023. http://dx.doi.org/10.1007/978-3-031-25374-4_1.

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AbstractHeart disease is the leading cause of mortality worldwide. Many cardiac diseases are associated with altered elastic energy relations of the heart tissue. However, the strain energy functions describing these characteristics are limited since they were designed manually for highly specific experimental setups. In this study, we develop CHESRA (Cardiac Hyperelastic Evolutionary Symbolic Regression Algorithm), an automated constitutive modelling framework, to derive cardiac elastic strain energy functions directly from experimental data. Our results indicate that CHESRA finds functions that reproduce mechanical tissue properties from experimental data whilst controlling function complexity. Our novel approach has the potential to find strain-energy functions that fit to various experimental data sets and may contribute to automatically building mathematical models to understand clinical observations of heart diseases.
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Rostaher, Ana, Natalie Hofer-Inteeworn, Claudia Kümmerle-Fraune, Nina Maria Fischer et Claude Favrot. « Triggers, risk factors and clinico-pathological features of urticaria in dogs - a prospective observational study of 24 cases ». Dans Advances in Veterinary Dermatology, 39–46. Chichester, UK : John Wiley & Sons, Ltd, 2017. http://dx.doi.org/10.1002/9781119278368.ch2.4.

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Taneda, M., N. Shimada, Y. Kinoshita, J. Taguchi et K. Kuboyama. « Radioisotopic Observations on Volume Changes in Cranial Versus Spinal CSF in Response to Intracranial Pressure Changes. A Clinical Study ». Dans Intracranial Pressure VI, 128–31. Berlin, Heidelberg : Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-642-70971-5_23.

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Djannatian, Minou, Clarissa Valim, Andre Brunoni et Felipe Fregni. « Observational Studies ». Dans Critical Thinking in Clinical Research, sous la direction de Raquel Ajub Moyses, Valeriam Angelim, Scott Evans, Rui Imamura et Felipe Fregni, 324–61. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199324491.003.0016.

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This chapter on observational studies provides an understanding of the main concepts in epidemiology, introduces common study designs, such as cross-sectional, case-control, and cohort studies, and outlines their importance for clinical research. The hallmark of epidemiological research is that it observes unexposed and exposed individuals under “real-life conditions” without intervening itself. The chapter emphasizes the important role of bias and confounding in interpreting results from such studies and explains how bias and confounding can be controlled. It furthermore discusses specific aspects of sample size determination that are relevant to observational studies. The chapter concludes with a brief review of the special nature of surgical research.
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Actes de conférences sur le sujet "Clinical observational study"

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Harb, Hadeer S., Nabila Ibrahim Laz, Hoda Rabea et Mohamed E. A. Abdelrahim. « Prevalence and clinical predictors of inhaler discordance in COPD : an observational study ». Dans ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.1020.

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Poletti, Venerino, Carlo Vancheri, Carlo Albera, Sergio Harari, Alberto Pesci, Paola Rottoli, Benedetta Campolo, De Santi Lorenzo et Roncari Barbara On Behalf Of Fibronet Study Group. « Clinical course of IPF Italian patients during 12-month of observation : results from the FIBRONET observational study ». Dans ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa4708.

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Romero Ortiz, Ana Dolores, Maria Jesús Rodríguez-Nieto, Ana Villar, Esteban Cano-Jiménez, Alba Ramón, Silvia Armengol, Elena Alhaja et Maite Artés. « Characteristics and clinical management of IPF patients in Spain : prospective, observational, multicentric study (OASIS study) ». Dans ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.1839.

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Ramirez, Giuseppe Alvise, Andrea Sorce, Francesca Cicero, Mona-Rita Yacoub, Valentina Canti, Giselda Colombo, Enrica Bozzolo et Lorenzo Dagna. « SAT0177 CLINICAL AND EPIDEMIOLOGICAL RELEVANCE OF ALLERGY IN SYSTEMIC LUPUS ERYTHEMATOSUS : AN OBSERVATIONAL STUDY ». Dans Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.6763.

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Haughney, John, Amanda J. Lee, Mintu Nath, Hana Müllerová, Ulf Holmgren, Enrico De Nigris et Bo Ding. « The long-term clinical and economic impact of COPD exacerbations : an observational study (SHERLOCK) ». Dans ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.4910.

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Davies, Joanne, Mona Bafadhel, Helen Jeffers, Simon Cartwright, Christine A'Court, Nick Thomas et Robin Fox. « Clinical and inflammatory characteristics of patients with COPD in primary care : an observational study ». Dans ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa1095.

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Cushen, B., G. Greene, I. Sulaiman, K. Bennett, E. MacHale, MC Mokoka, JF VanBoven et RW Costello. « P268 Relationship of inhaler adherence behaviour to clinical outcomes in copd : an observational study ». Dans British Thoracic Society Winter Meeting 2017, QEII Centre Broad Sanctuary Westminster London SW1P 3EE, 6 to 8 December 2017, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2017. http://dx.doi.org/10.1136/thoraxjnl-2017-210983.410.

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Korukonda, Krishnaprasad, Pralhad Prabhudesai, Bhattacharya Parthasarathi, Bhanupratap Singh et Subodh Katiyar. « Clinical Assessment of Glycopyrronium in COPD phenotypes and ACOS : Prospective, case control, observational study ». Dans ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa2478.

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Dholke, Harshal, et Mohanrao Kamaraju. « Clinical Presentation and Outcome of Midline Posterior Fossa Tumors : A Single Center Prospective Observational Study ». Dans 19th Annual Conference of the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC). Thieme Medical and Scientific Publishers Private Limited, 2018. http://dx.doi.org/10.1055/s-0038-1636409.

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Gianella, Pietro, Elia Rigamonti, Marco Marando, Adriana Tamburello, Lorenzo Grazioli, Gianluca Argentieri, Carla Puligheddu, Alberto Pagnamenta, Marco Pons et Tanja Fusi-Schmidhauser. « Clinical, radiological and functional outcomes in patients with COVID-19 pneumonia : A prospective observational study ». Dans ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa3240.

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Rapports d'organisations sur le sujet "Clinical observational study"

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Gupta, Aditya, Maanasa Venkataraman et Mary Bamimore. The relative efficacy of monotherapies for dermatophyte toenail onychomycosis : a systematic review with quantitative syntheses of the evidence base. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, avril 2022. http://dx.doi.org/10.37766/inplasy2022.4.0157.

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Review question / Objective: The objective of the proposed study is to examine the relative efficacy of monotherapies for dermatophyte toenail onychomycosis, as per mycological, clinical and/or complete cure rates. Condition being studied: Dermatophyte toenail onychomycosis. Eligibility criteria: A randomized or observational study with at least one arm investigating the efficacy of antifungal monotherapy for dermatophyte toenail onychomycosis in terms of mycological cure, complete cure and/or clinical cure.
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Gupta, Tejpal, Riddhijyoti Talukdar, Sadhana Kannan, Archya Dasgupta, Abhishek Chatterjee et Vijay Patil. Meta-Analysis of Standard Temozolomide versus Extended Adjuvant Temozolomide following concurrent Radiochemotherapy in newly-diagnosed Glioblastoma (MASTER-G). INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, décembre 2021. http://dx.doi.org/10.37766/inplasy2021.12.0114.

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Review question / Objective: To assess the safety and efficacy of extended adjuvant temozolomide compared to standard adjuvant temozolomide after concurrent radiochemotherapy in patients with newly-diagnosed glioblastoma. Condition being studied: Newly-diagnosed glioblastoma. Eligibility criteria: Prospective clinical trials randomly assigning patients to extended (>6-cycles) adjuvant TMZ (experimental arm) or standard (6-cycles) adjuvant TMZ will be included. Randomization in an individual study may have been done upfront before concurrent phase (RT/TMZ), after completion of concurrent RT/TMZ and before starting adjuvant phase, or after completion of standard adjuvant TMZ (6-cycles). Emulated RCTs, quasi-randomized trials, propensity matched analyses, non-randomized comparative studies, or observational studies will not be considered in this review.
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Ismaiel, Abdulrahman, Ayman Jaaouani, Daniel-Corneliu Leucuta, Stefan-Lucian Popa et Dan-Lucian Dumitrascu. The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis — Systematic Review and Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, décembre 2021. http://dx.doi.org/10.37766/inplasy2021.12.0056.

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Review question / Objective: The objective of the study was to compare the mean difference and AUROC of Visceral Adiposity Index (VAI) in NAFLD/NASH/liver fibrosis patients and controls in observational studies. Condition being studied: Nonalcoholic fatty liver disease (NAFLD) is a multi-system disease, being mainly a liver pathology involving excessive hepatic fat accumulation unrelated to alcohol consumption or other secondary causes of hepatic steatosis. It is an emerging cause of concern and increasing clinical burden, imposing a public health challenge. NAFLD is the most common chronic liver disease and is predicted to be the most common indication for a liver transplant in Western countries by 2030, owing to a prevalence of 25% worldwide. The visceral adiposity index (VAI) is a scoring system based on body mass index, triglycerides, high-density lipoproteins (HDLs), and waist circumferences (WCs).
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Cantor, Amy, Heidi D. Nelson, Miranda Pappas, Chandler Atchison, Brigit Hatch, Nathalie Huguet, Brittny Flynn et Marian McDonagh. Effectiveness of Telehealth for Women’s Preventive Services. Agency for Healthcare Research and Quality (AHRQ), juin 2022. http://dx.doi.org/10.23970/ahrqepccer256.

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Objectives. To evaluate the effectiveness, use, and implementation of telehealth for women’s preventive services for reproductive healthcare and interpersonal violence (IPV), and to evaluate patient preferences and engagement for telehealth, particularly in the context of the coronavirus (COVID-19) pandemic. Data sources. Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL databases (July 1, 2016, to March 4, 2022); manual review of reference lists; suggestions from stakeholders; and responses to a Federal Register Notice. Review methods. Eligible abstracts and full-text articles of telehealth interventions were independently dual reviewed for inclusion using predefined criteria. Dual review was used for data abstraction, study-level risk of bias assessment, and strength of evidence (SOE) rating using established methods. Meta-analysis was not conducted due to heterogeneity of studies and limited available data. Results. Searches identified 5,704 unique records. Eight randomized controlled trials, one nonrandomized trial, and seven observational studies, involving 10,731 participants, met inclusion criteria. Of these, nine evaluated IPV services and seven evaluated contraceptive care, the only reproductive health service studied. Risk of bias was low in one study, moderate in nine trials and five observational studies, and high in one study. Telehealth interventions were intended to replace usual care in 14 studies and supplement care in 2 studies. Delivery modes included telephone (5 studies), online modules (5 studies), and mobile applications (1 study), and was unclear or undefined in five studies. There were no differences between telehealth interventions to supplement contraceptive care and comparators for rates of contraceptive use, sexually transmitted infection, and pregnancy (low SOE); evidence was insufficient for abortion rates. There were no differences between telehealth IPV services versus comparators for outcomes measuring repeat IPV, depression, post-traumatic stress disorder, fear of partner, coercive control, self-efficacy, and safety behaviors (low SOE). The COVID-19 pandemic increased telehealth utilization. Barriers to telehealth interventions included limited internet access and digital literacy among English-speaking IPV survivors, and technical challenges and confidentiality concerns for contraceptive care. Telehealth use was facilitated by strategies to ensure safety of individuals who receive IPV services. Evidence was insufficient to evaluate access, health equity, or harms outcomes. Conclusions. Limited evidence suggests that telehealth interventions for contraceptive care and IPV services result in equivalent clinical and patient-reported outcomes as in-person care. Uncertainty remains regarding the most effective approaches for delivering these services, and how to best mobilize telehealth, particularly for women facing barriers to healthcare.
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Parsons, Helen M., Hamdi I. Abdi, Victoria A. Nelson, Amy M. Claussen, Brittin L. Wagner, Karim T. Sadak, Peter B. Scal, Timothy J. Wilt et Mary Butler. Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs. Agency for Healthcare Research and Quality (AHRQ), mai 2022. http://dx.doi.org/10.23970/ahrqepccer255.

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Objective. To understand the evidence base for care interventions, implementation strategies, and between-provider communication tools among children with special healthcare needs (CSHCN) transitioning from pediatric to adult medical care services. Data sources. We searched Ovid MEDLINE, Ovid Embase, the Cochrane Central trials (CENTRAL) registry, and CINAHL to identify studies through September 10, 2021. We conducted grey literature searches to identify additional resources relevant to contextual questions. Review methods. Using a mixed-studies review approach, we searched for interventions or implementation strategies for transitioning CSHCN from pediatric to adult services. Two investigators screened abstracts and full-text articles of identified references for eligibility. Eligible studies included randomized controlled trials, quasi-experimental observational studies, and mixed-method studies of CSHCN, their families, caregivers, or healthcare providers. We extracted basic study information from all eligible studies and grouped interventions into categories based on disease conditions. We summarized basic study characteristics for included studies and outcomes for studies assessed as low to medium risk of bias using RoB-2. Results. We identified 9,549 unique references, 440 of which represented empirical research; of these, 154 (16 major disease categories) described or examined a care transition intervention with enough detail to potentially be eligible for inclusion in any of the Key Questions. Of these, 96 studies met comparator criteria to undergo risk of bias assessment; however only 9 studies were assessed as low or medium risk of bias and included in our analytic set. Low-strength evidence shows transition clinics may not improve hemoglobin A1C levels either at 12 or 24 months in youth with type 1 diabetes mellitus compared with youth who received usual care. For all other interventions and outcomes, the evidence was insufficient to draw meaningful conclusions because the uncertainty of evidence was too high. Some approaches to addressing barriers include dedicating time and resources to support transition planning, developing a workforce trained to care for the needs of this population, and creating structured processes and tools to facilitate the transition process. No globally accepted definition for effective transition of care from pediatric to adult services for CSHCN exists; definitions are often drawn from principles for transitions, encompassing a broad set of clinical aspects and other factors that influence care outcomes or promote continuity of care. There is also no single measure or set of measures consistently used to evaluate effectiveness of transitions of care. The literature identifies a limited number of available training and other implementation strategies focused on specific clinical specialties in targeted settings. No eligible studies measured the effectiveness of providing linguistically and culturally competent healthcare for CSHCN. Identified transition care training, and care interventions to
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing et Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, décembre 2022. http://dx.doi.org/10.23970/ahrqepccer254.

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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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Carney, Nancy, Tamara Cheney, Annette M. Totten, Rebecca Jungbauer, Matthew R. Neth, Chandler Weeks, Cynthia Davis-O'Reilly et al. Prehospital Airway Management : A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), juin 2021. http://dx.doi.org/10.23970/ahrqepccer243.

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Objective. To assess the comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) by emergency medical services in the prehospital setting, and how the benefits and harms differ based on patient characteristics, techniques, and devices. Data sources. We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020 and reference lists, and posted a Federal Register notice request for data. Review methods. Review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center Program methods guidance. Using pre-established criteria, studies were selected and dual reviewed, data were abstracted, and studies were evaluated for risk of bias. Meta-analyses using profile-likelihood random effects models were conducted when data were available from studies reporting on similar outcomes, with analyses stratified by study design, emergency type, and age. We qualitatively synthesized results when meta-analysis was not indicated. Strength of evidence (SOE) was assessed for primary outcomes (survival, neurological function, return of spontaneous circulation [ROSC], and successful advanced airway insertion [for SGA and ETI only]). Results. We included 99 studies (22 randomized controlled trials and 77 observational studies) involving 630,397 patients. Overall, we found few differences in primary outcomes when airway management approaches were compared. • For survival, there was moderate SOE for findings of no difference for BVM versus ETI in adult and mixed-age cardiac arrest patients. There was low SOE for no difference in these patients for BVM versus SGA and SGA versus ETI. There was low SOE for all three comparisons in pediatric cardiac arrest patients, and low SOE in adult trauma patients when BVM was compared with ETI. • For neurological function, there was moderate SOE for no difference for BVM compared with ETI in adults with cardiac arrest. There was low SOE for no difference in pediatric cardiac arrest for BVM versus ETI and SGA versus ETI. In adults with cardiac arrest, neurological function was better for BVM and ETI compared with SGA (both low SOE). • ROSC was applicable only in cardiac arrest. For adults, there was low SOE that ROSC was more frequent with SGA compared with ETI, and no difference for BVM versus SGA or BVM versus ETI. In pediatric patients there was low SOE of no difference for BVM versus ETI and SGA versus ETI. • For successful advanced airway insertion, low SOE supported better first-pass success with SGA in adult and pediatric cardiac arrest patients and adult patients in studies that mixed emergency types. Low SOE also supported no difference for first-pass success in adult medical patients. For overall success, there was moderate SOE of no difference for adults with cardiac arrest, medical, and mixed emergency types. • While harms were not always measured or reported, moderate SOE supported all available findings. There were no differences in harms for BVM versus SGA or ETI. When SGA was compared with ETI, there were no differences for aspiration, oral/airway trauma, and regurgitation; SGA was better for multiple insertion attempts; and ETI was better for inadequate ventilation. Conclusions. The most common findings, across emergency types and age groups, were of no differences in primary outcomes when prehospital airway management approaches were compared. As most of the included studies were observational, these findings may reflect study design and methodological limitations. Due to the dynamic nature of the prehospital environment, the results are susceptible to indication and survival biases as well as confounding; however, the current evidence does not favor more invasive airway approaches. No conclusion was supported by high SOE for any comparison and patient group. This supports the need for high-quality randomized controlled trials designed to account for the variability and dynamic nature of prehospital airway management to advance and inform clinical practice as well as emergency medical services education and policy, and to improve patient-centered outcomes.
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Sistac, Sistac, Lliteras M et Sistac Palacín JM. Study in a Simulated Scenario of the Influence of Training and Personality in the Resolution of Critical Situations in Anaesthesiology Residents. Science Repository, janvier 2023. http://dx.doi.org/10.31487/j.acr.2022.04.01.sup.

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Introduction: Empowerment of simulations in emergent situations by resident medical interns has positively demonstrated the acquisition of clinical skills [1]. Even so, it remains unclear what psychological factors influence when assuming leadership in carrying out these simulations or in a real situation. This study aims to analyse, by simulating critical situations in the operating room, the influence of training and personality among anaesthesiology residents on the predisposition to assume such leadership Materials and Methods: A study was carried out on 22 residents both trained (11) and untrained in simulation, assessing their personality and degree of stress using the Typi and Stay Trait. By observation it was determined that he was the leader, when entering a simulated model of ventricular fibrillation in pairs. Resolution capacity was not valued, but rather the characteristics that define the personality of the resident who assumed leadership. Results: Regarding personality, measured with the TIPI test, the leaders turned out to score high in agreeableness but low in extraversion compared to the helpers. This suggests that they are altruistic, compassionate, trusting, frank, empathic and sensitive to others and on the other hand reserved, socially distant except with close friends. In the trained group, the Stai Trait test revealed a slightly lower mean in helpers compared to the total mean, in addition to a significantly higher SD in leaders (4.57) than in helpers (2.87), obtaining a p> 0.02. In Stai Estado, the opposite occurred in terms of the averages, lower in the group of leaders with respect to the global average. And a very similar SD was obtained in both groups (4.91 and 4.21). In the TIPI test, the leading group stands out with a low score in extraversion, compared to the total mean and compared to assistants, justified data with a p>0.02. Conclusion: The residents of the trained group turned out to have lower anxiety in the stressful situation of the simulation compared to the other group. In addition, the women who turned out to be leaders in the trained group demonstrated control of the situation with lower HRs than the leaders in the untrained group, thus demonstrating the influence of training in resolving critical situations.
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Svynarenko, Radion, Theresa L. Profant et Lisa C. Lindley. Effectiveness of concurrent care to improve pediatric and family outcomes at the end of life : An analytic codebook. Pediatric End-of-Life (PedEOL) Care Research Group, College of Nursing, University of Tennessee, Knoxville, 2022. http://dx.doi.org/10.7290/m5fbbq.

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Implementation of the section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) enabled children enrolled in Medicaid/Children's Health Insurance Program with a prognosis of 6 months to live to use hospice care while continuing treatment for their terminal illness. Although concurrent hospice care became available more than a decade ago, little is known about the socio-demographic and health characteristics of children who received concurrent care; health care services they received while enrolled in concurrent care, their continuity, management, intensity, fragmentation; and the costs of care. The purpose of this study was to answer these questions using national data from the Centers of Medicare and Medicaid Services (CMS), which covered the first three years of ACA – from January 1, 2011, to December 31, 2013.The database included records of 18,152 children younger than the age of 20, who were enrolled in Medicaid hospice care in the sampling time frame. Children in the database also had a total number of 42,764 hospice episodes. Observations were excluded if the date of birth or death was missing or participants were older than 21 years. To create this database CMS data were merged with three other complementary databases: the National Death Index (NDI) that provided information on death certificates of children; the U.S. Census Bureau American Community Survey that provided information on characteristics of communities where children resided; CMS Hospice Provider of Services files and CMS Hospice Utilization and Payment files were used for data on hospice providers, and with a database of rural areas created by the Health Resources and Services Administration (HRSA). In total, 130 variables were created, measuring demographics and health characteristics of children, characteristics of health providers, community characteristics, clinical characteristics, costs of care, and other variables.
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Woods, Rachel, Alison Zhong et Madelyn Vincent. Factors Associated with Influenza & ; Tdap Vaccine Uptake in Pregnant Patients at the UT Family Medicine Clinic in Memphis. University of Tennessee Health Science Center, 2021. http://dx.doi.org/10.21007/com.lsp.2020.0003.

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INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (>50,000,000 annual US cases affecting all ages) and pertussis (>15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates. OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family Medicine Clinic at Memphis (UTFMC-M), compare those rates with national pregnancy flu/Tdap vaccination rates, and to generate recommendations based off observed factors associated with vaccine uptake to improve flu/Tdap vaccination rates in UTFMC-M pregnant patients. METHODS: This was a retrospective chart review of UTFMC-M patients who were pregnant from September 1, 2019-April 24, 2020 (included 2019-2020 flu season) (n=465). Variables studied included demographic data (race, age, insurance), immunization history (vaccine status, history of physician encouragement), and prenatal history (parity, number of prenatal visits, trimester at first visit, high risk clinic (HRC) admittance status). Vaccination status was based on ACIP recommendations (Flu shot eligible = any gestational age; Tdap eligible = ≥27 weeks). Positive HRC admittance was noted for patients with ≥2 visits to the UTFMC-M HRC, a clinic that specializes in high risk pregnant patient care. RESULTS: The patient sample was predominantly black (84.3%) and insured by Medicaid programs (88%). Among eligible UTFMC-M pregnant patients, 50.1% were flu-vaccinated (n=465); 73.8% were Tdap-vaccinated (n=317); and 52.1% were Flu+Tdap-vaccinated (n=317). No significant associations were found between vaccine uptake and HRC status, parity, and age. However, statistically significant relationships were found between vaccine uptake and physician encouragement (positive relationship with flu shot: X2(1, N = 465) =131, p < 0.001, Tdap: X2 (6, N = 465) =476, p < 0.001), number of prenatal visits (flu shot group median 8 visits, Tdap group median 9 visits vs. unvaccinated group median 4 visits; p < 0.001), and early trimester age at first prenatal visit (X2(6, N = 465) =47.635 , p CONCLUSION: 2019-2020 UTFMC-M vaccination rates were on par with 2018-2019 US flu vaccine rates and higher than 2018-2019 US Tdap and Flu+Tdap rates. There were statistically significant relationships between vaccine uptake at UTFMC-M and physician encouragement, number of prenatal visits, and early trimester age at first prenatal visit but no significant relationships with UTFMC-M HRC admittance, parity, or age. Recommendations following from our observations to address further vaccine rate improvement include: continue vaccine encouragement, continue booking multiple visits (8 for flu, 9 for Tdap), prioritize Tdap vaccine higher for late trimester intake patients, and focus on flu vaccine encouragement and education.
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