As a method of research, pragmatic trials are recommended so as to generate results that are applicable to real-world care. This intent is especially important for the millions of older adults who receive long-term care in thousands of nursing homes and assisted living communities across the country-and many millions more around the globe. This article presents key points raised by experts participating in a conference funded by the National Institute of Aging held at the 2021 conference of the Society for Post-Acute and Long-term Care Medicine. The purpose of the conference was to convene leading clinicians, researchers, and industry partners to address special considerations of pragmatic trials in long-term care. Cross-cutting and unique challenges and solutions to conducting pragmatic trials were discussed focusing on 3 areas of clinical relevance to long-term care: (1) functional care and outcomes, (2) psychosocial care and quality of life, and (3) medical care and outcomes, with a special focus on persons with dementia. Challenges and innovative solutions were organized across the 9 domains of the revised Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Tool, and future research recommendations for pragmatic trials in long-term care were identified.
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http://dx.doi.org/10.1016/j.jamda.2021.12.011 | DOI Listing |
Port J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
View Article and Find Full Text PDFJ Infect Dev Ctries
December 2024
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand.
Introduction: Coronavirus disease 2019 (COVID-19) is associated with long-term symptoms, but the spectrum of these symptoms remains unclear. We aimed to identify the prevalence and factors associated with persistent symptoms in patients at the post-COVID-19 outpatient clinic.
Methodology: This cross-sectional, observational study included hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients followed-up at a post-COVID-19 clinic between September 2021 and January 2022.
BMC Public Health
January 2025
Research Institute for Healthcare Policy, Korean Medical Association, Yongsan-gu, Seoul, South Korea.
Background: In 2024, the Korean Ministry of Health and Welfare enforced a policy to increase the number of medical school students by 2,000 over the next 5 years, despite opposition from doctors. This study aims to predict the trend of excess or shortage of medical personnel in Korea due to the policy of increasing the number of medical school students by 2035.
Methods: Data from multiple sources, including the Ministry of Health and Welfare, National Health Insurance Corporation, and the Korean Medical Association, were used to estimate supply and demand.
J Med Case Rep
January 2025
Department of Surgery, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, USA.
Background: Classic congenital adrenal hyperplasia, primarily due to 21-hydroxylase deficiency, leads to impaired cortisol and aldosterone production and excess adrenal androgens. Lifelong glucocorticoid therapy is required, often necessitating supraphysiological doses in youth to manage androgen excess and growth acceleration. These patients experience higher obesity rates, hypertension, and glucose metabolism issues, complicating long-term health management.
View Article and Find Full Text PDFEur J Clin Nutr
January 2025
Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Kallithea, Athens, Attica, Greece.
Background: The long-term effects of breakfast on childhood z-BMI remain inconclusive.
Objective: To prospectively assess the impact of stable and altered breakfast consumption habits on z-BMI change over two years, in school-aged children across six European countries.
Methods: Data of 6,528 children (8.
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