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[PMID]:29377925
[Au] Autor:Thurman SM; Wasylyshyn N; Roy H; Lieberman G; Garcia JO; Asturias A; Okafor GN; Elliott JC; Giesbrecht B; Grafton ST; Mednick SC; Vettel JM
[Ad] Endereço:U.S. Army Research Laboratory, Human Research & Engineering Directorate, Aberdeen Proving Ground, Maryland, United States of America.
[Ti] Título:Individual differences in compliance and agreement for sleep logs and wrist actigraphy: A longitudinal study of naturalistic sleep in healthy adults.
[So] Source:PLoS One;13(1):e0191883, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is extensive laboratory research studying the effects of acute sleep deprivation on biological and cognitive functions, yet much less is known about naturalistic patterns of sleep loss and the potential impact on daily or weekly functioning of an individual. Longitudinal studies are needed to advance our understanding of relationships between naturalistic sleep and fluctuations in human health and performance, but it is first necessary to understand the efficacy of current tools for long-term sleep monitoring. The present study used wrist actigraphy and sleep log diaries to obtain daily measurements of sleep from 30 healthy adults for up to 16 consecutive weeks. We used non-parametric Bland-Altman analysis and correlation coefficients to calculate agreement between subjectively and objectively measured variables including sleep onset time, sleep offset time, sleep onset latency, number of awakenings, the amount of wake time after sleep onset, and total sleep time. We also examined compliance data on the submission of daily sleep logs according to the experimental protocol. Overall, we found strong agreement for sleep onset and sleep offset times, but relatively poor agreement for variables related to wakefulness including sleep onset latency, awakenings, and wake after sleep onset. Compliance tended to decrease significantly over time according to a linear function, but there were substantial individual differences in overall compliance rates. There were also individual differences in agreement that could be explained, in part, by differences in compliance. Individuals who were consistently more compliant over time also tended to show the best agreement and lower scores on behavioral avoidance scale (BIS). Our results provide evidence for convergent validity in measuring sleep onset and sleep offset with wrist actigraphy and sleep logs, and we conclude by proposing an analysis method to mitigate the impact of non-compliance and measurement errors when the two methods provide discrepant estimates.
[Mh] Termos MeSH primário: Actigrafia/métodos
Documentação
Fidelidade a Diretrizes
Sono
Punho
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Voluntários Saudáveis
Seres Humanos
Estudos Longitudinais
Masculino
Personalidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191883


  2 / 27062 MEDLINE  
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[PMID]:28460016
[Au] Autor:Kathirvel S; Tripathy JP; Tun ZM; Patro BK; Singh T; Bhalla A; Devnani M; Wilkinson E
[Ad] Endereço:Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
[Ti] Título:Physicians' compliance with the National Drug Policy on Malaria in a tertiary teaching hospital, India, from 2010 to 2015: a mixed method study.
[So] Source:Trans R Soc Trop Med Hyg;111(2):62-70, 2017 02 01.
[Is] ISSN:1878-3503
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: National drug policies are formulated to encourage rational use of drugs and to reduce drug resistance. This study assessed physicians' compliance with the National Drug Policy on Malaria at a tertiary care hospital in north India. Methods: This mixed method study extracted data from adult malaria inpatient records of the hospital from 2010-2015, and assessed drug supply at pharmacies. Physicians' practices and perspectives were explored by in-depth interviews. Compliance was assessed by severity, type of species and pregnancy status. Thematic analysis was done for the qualitative data. Results: A total of 247 case files were reviewed. Vivax malaria (41.0%) was more common than falciparum malaria (37.2%). The majority (90.8%) of cases were severe malaria. Overall compliance for use of schizonticidal drug was 73.0% in severe malaria and was only 9.5% in uncomplicated malaria. Compliance for use of gametocidal drug (primaquine) was 15.3%. Schizonticidal drugs were available in all pharmacies except the public one. Primaquine was available in only one. The main themes emerging in the thematic network analysis were physicians' misconceptions, physician-related factors, and hospital-related and drug access factors. Conclusions: The degree of compliance for severe malaria treatment was reasonably good but low for radical cure. Raising knowledge and awareness among health care providers, by using written treatment protocols and continuing medical education would improve compliance.
[Mh] Termos MeSH primário: Antimaláricos/uso terapêutico
Fidelidade a Diretrizes/estatística & dados numéricos
Malária/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Antimaláricos/provisão & distribuição
Atitude do Pessoal de Saúde
Feminino
Hospitais de Ensino/estatística & dados numéricos
Seres Humanos
Índia
Masculino
Meia-Idade
Farmácias/estatística & dados numéricos
Padrões de Prática Médica
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antimalarials)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1093/trstmh/trx020


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[PMID]:29424519
[Au] Autor:Primeau D; Hernandez VM
[Ti] Título:ICD-10 Coding Audits Reveal Error Trends to Avoid.
[So] Source:J AHIMA;88(6):26-9, 2017 06.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Codificação Clínica/normas
Classificação Internacional de Doenças
Controle de Qualidade
[Mh] Termos MeSH secundário: Auditoria Clínica
Documentação
Eficiência
Registros Eletrônicos de Saúde
Fidelidade a Diretrizes
Guias como Assunto
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29412563
[Au] Autor:Wiedemann LA
[Ti] Título:Are You Ready for a HIPAA Audit?
[So] Source:J AHIMA;88(4):26-7, 2017 04.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Health Insurance Portability and Accountability Act
Auditoria Administrativa
Administração da Prática Médica
[Mh] Termos MeSH secundário: Fidelidade a Diretrizes
Seres Humanos
Técnicas de Planejamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE


  5 / 27062 MEDLINE  
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[PMID]:29412561
[Au] Autor:Primeau D
[Ti] Título:How Small Organizations Handle HIPAA Compliance.
[So] Source:J AHIMA;88(4):18-21, 2017 04.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Health Insurance Portability and Accountability Act
Administração da Prática Médica/organização & administração
Medição de Risco
[Mh] Termos MeSH secundário: Conscientização
Segurança Computacional/legislação & jurisprudência
Fiscalização e Controle de Instalações
Fidelidade a Diretrizes
Técnicas de Planejamento
Privacidade/legislação & jurisprudência
Medidas de Segurança/legislação & jurisprudência
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE


  6 / 27062 MEDLINE  
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[PMID]:29400937
[Au] Autor:Washington L
[Ti] Título:Strategic Alignment: The Driving Force for Information Governance.
[So] Source:J AHIMA;88(1):40-3, 2017 Jan.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Segurança Computacional/normas
Confidencialidade/normas
Registros Eletrônicos de Saúde/normas
Gestão da Informação em Saúde
[Mh] Termos MeSH secundário: Acesso à Informação
Fidelidade a Diretrizes/normas
Seres Humanos
Liderança
Estudos de Casos Organizacionais
Cultura Organizacional
Washington
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


  7 / 27062 MEDLINE  
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[PMID]:29292914
[Au] Autor:Eberhard J
[Ti] Título:Grova anklagelser mot skånsk onkologi kan inte stå oemotsagda..
[So] Source:Lakartidningen;114, 2017 11 02.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Mh] Termos MeSH primário: Neoplasias Colorretais/tratamento farmacológico
Fidelidade a Diretrizes
[Mh] Termos MeSH secundário: Conflito de Interesses
Indústria Farmacêutica
Hospitais Universitários/normas
Seres Humanos
Suécia
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:29224641
[Au] Autor:Mangla A; Doukky R; Richardson D; Avery EF; Dawar R; Calvin JE; Powell LH
[Ad] Endereço:Department of Preventive Medicine, Rush University Medical Center, Chicago, IL; Division of Cardiology, Medicine, Rush University Medical Center, Chicago, IL.
[Ti] Título:Design of a bilevel clinical trial targeting adherence in heart failure patients and their providers: The Congestive Heart Failure Adherence Redesign Trial (CHART).
[So] Source:Am Heart J;195:139-150, 2018 Jan.
[Is] ISSN:1097-6744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Socioeconomically disadvantaged patients are at an increased risk for adverse heart failure (HF) outcomes based upon nonadherence to medications and diet. Physicians are also suboptimally adherent to prescribing evidence-based therapy for HF. METHODS: Congestive Heart Failure Adherence Redesign Trial (CHART) (NCT01698242) is a multicenter, bilevel, cluster randomized behavioral efficacy trial designed to assess the impact of intervening simultaneously on physicians and their socioeconomically disadvantaged patients (annual income <$30,000) having HF with reduced ejection fraction. Treatment arm physicians received individualized feedback on their adherence to prescribing evidence-based therapy. Their patients received weekly home visits from community health workers aimed at promoting understanding of HF and integrating adherence into daily life. Control arm physicians received regular updates on advances in HF management, and patients received monthly HF educational tip sheets produced by the American Heart Association. The primary outcome was all-cause hospital days over 30 months. RESULTS: A total of 72 physicians (treatment, 35; control, 37) and their 320 patients (treatment, 157; control, 163) were recruited within 2 years. Randomization of physicians with all of their patients being assigned to the same arm was feasible and did not compromise the comparability of patients by arm. Using 5 recruiting hospitals located within disadvantaged neighborhoods produced a cohort that was primarily African American and representative of low-income urban patients with HF with reduced ejection fraction. CONCLUSION: CHART will determine the value of intervening on low adherence simultaneously in physicians and their socioeconomically disadvantaged patients in reducing all-cause hospitalization days.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Fidelidade a Diretrizes
Insuficiência Cardíaca/terapia
Cooperação do Paciente
Relações Médico-Paciente/ética
[Mh] Termos MeSH secundário: Idoso
Feminino
Insuficiência Cardíaca/psicologia
Seres Humanos
Masculino
Fatores Socioeconômicos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29400430
[Ti] Título:Managing the Present on Admission Reporting Process.
[So] Source:J AHIMA;87(9):54-8, 2016 09.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Guias como Assunto
Admissão do Paciente
[Mh] Termos MeSH secundário: Lista de Checagem
Documentação
Eficiência Organizacional
Fidelidade a Diretrizes
Seres Humanos
Técnicas de Planejamento
Medição de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


  10 / 27062 MEDLINE  
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[PMID]:28459929
[Au] Autor:Sikkens JJ; van Agtmael MA; Peters EJG; Lettinga KD; van der Kuip M; Vandenbroucke-Grauls CMJE; Wagner C; Kramer MHH
[Ad] Endereço:Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.
[Ti] Título:Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals: The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) Participatory Intervention Study.
[So] Source:JAMA Intern Med;177(8):1130-1138, 2017 Aug 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals. Design, Setting, and Participants: The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) study was a prospective, stepped-wedge, participatory intervention study performed from October 1, 2011, through December 31, 2015. Outcomes were measured during a baseline period of 16 months and an intervention period of 12 months. The study was performed at 7 clinical departments (2 medical, 3 surgical, and 2 pediatric) in a tertiary care medical center and a general teaching hospital in the Netherlands. Physicians prescribing systemic antimicrobial drugs for any indication for patients admitted to the participating departments during the study period were included in the study. Interventions: We offered prescribers a free choice of how to improve their antimicrobial prescribing. Prescribers were stimulated to choose interventions with higher potential for success based on a root cause analysis of inappropriate prescribing. Main Outcomes and Measures: Appropriateness of antimicrobial prescriptions was determined using a validated approach based on guideline adherence and motivated guideline deviation and measured with repeated point prevalence surveys (6 per year). Appropriateness judgment was masked for the study period. Antimicrobial consumption was extracted from pharmacy records and measured as days of therapy per admission. We used linear and logistic mixed-model regression analysis to model outcomes over time. Results: A total of 1121 patient cases with 700 antimicrobial prescriptions were assessed during the baseline period and 882 patient cases with 531 antimicrobial prescriptions during the intervention period. The mean antimicrobial appropriateness increased from 64.1% at intervention start to 77.4% at 12-month follow-up (+13.3%; relative risk, 1.17; 95% CI, 1.04-1.27), without a change in slope. No decrease in antimicrobial consumption was found. Conclusions and Relevance: Use of a behavioral approach preserving prescriber autonomy resulted in an increase in antimicrobial appropriateness sustained for at least 12 months. The approach is inexpensive and could be easily transferable to various health care environments.
[Mh] Termos MeSH primário: Anti-Infecciosos/uso terapêutico
Atitude do Pessoal de Saúde
Infecções Bacterianas
Resistência Microbiana a Medicamentos/efeitos dos fármacos
Prescrição Inadequada
Melhoria de Qualidade/organização & administração
[Mh] Termos MeSH secundário: Infecções Bacterianas/tratamento farmacológico
Infecções Bacterianas/epidemiologia
Comportamento de Escolha
Fidelidade a Diretrizes
Hospitais/estatística & dados numéricos
Seres Humanos
Prescrição Inadequada/efeitos adversos
Prescrição Inadequada/prevenção & controle
Prescrição Inadequada/psicologia
Prescrição Inadequada/estatística & dados numéricos
Conduta do Tratamento Medicamentoso/organização & administração
Países Baixos/epidemiologia
Padrões de Prática Médica/estatística & dados numéricos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.0946



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