Improving Antibiotic Use in Argentine Pediatric Hospitals: A Process Evaluation Using Normalization Process Theory.

Introduction: In the pediatric setting, overprescribing of antibiotics contributes to the rise of multidrug-resistant organisms. Antimicrobial stewardship programs (ASPs) are recommended to optimize antibiotic use and combat resistance. However, the implementation of ASPs in low- and middle-income countries faces several challenges.

Assessing Training Needs and Self-Efficacy of Hospital Administrators in Western India.

Introduction: Effective training is required to enhance hospital administrators' abilities and improve performance. This study evaluates the training needs and their association with the self-efficacy of hospital administrators in public and private hospitals in Western India.

Methodology: This study evaluated the training needs of hospital administrators using a survey-based methodology and a descriptive cross-sectional design.

Development and validation of computable social phenotypes for health-related social needs.

Objective: Measurement of health-related social needs (HRSNs) is complex. We sought to develop and validate computable phenotypes (CPs) using structured electronic health record (EHR) data for food insecurity, housing instability, financial insecurity, transportation barriers, and a composite-type measure of these, using human-defined rule-based and machine learning (ML) classifier approaches.

Materials And Methods: We collected HRSN surveys as the reference standard and obtained EHR data from 1550 patients in 3 health systems from 2 states.

Lessons learned from the COVID-19 pandemic: identifying hesitant groups and exploring reasons for vaccination hesitancy, from adolescence to late adulthood.

Introduction: The COVID-19 (COronaVIrus Disease-2019) pandemic highlighted the importance of assessing the rationales behind vaccine hesitancy for the containment of pandemics. In this nationwide study, representative of the Luxembourgish population, we identified hesitant groups from adolescence to late adulthood and explored motivations both for and against vaccination.

Methods: We combined data collected via online surveys for the CON-VINCE (COvid-19 National survey for assessing VIral spread by Non-affected CarriErs) study, 1865 respondents aged 18-84, and for the YAC (Young people And Covid-19) study, 3740 respondents aged 12-29.

Translation of a longitudinal survey of veterans' well-being into action by a research-practice-policy partnership.

Introduction: Research-practice-policy partnerships are shifting the academic research paradigm toward collaboration and research-informed action at community and policy levels. In this case study, researchers partnered with philanthropic foundations to actualize data findings from a rigorous, longitudinal study.

Context: In 2016, a survey of post-9/11 military veterans began assessing veterans' well-being in key domains: health, vocation (education and employment), finances, and social relationships.

Challenges and Opportunities in Examining and Addressing Intersectional Stigma and Health.

Background: 'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research.

Cost effectiveness of different treatment strategies with natalizumab for pregnant women with multiple sclerosis.

Background: The management of multiple sclerosis (MS) during pregnancy poses significant challenges. This study aimed to evaluate the cost-effectiveness of three natalizumab treatment strategies during pregnancy from the UK healthcare system's perspective.

Methods: A Markov model was developed to assess the health outcomes and costs associated with three treatment strategies: continuous natalizumab treatment throughout pregnancy, treatment until the first trimester followed by discontinuation, and discontinuation at conception with resumption post-pregnancy.

Finding the Value: Identifying the Key Elements of Recorded Clinic Visits From the Perspective of Patients, Clinicians, and Caregivers.

Objective: We aimed to understand what patients, caregivers and clinicians identified as the most important information from their audio-recorded clinic visits and why.

Methods: We recruited patients, caregivers and clinicians from primary and speciality care clinics at an academic medical centre in New Hampshire, U.S.

Persistence of newly prescribed 5-aminosalicylic acid in patients with ulcerative colitis: A nationwide comprehensive database study.

The 5-aminosalicylic acid (5-ASA) agents are first-line drugs for ulcerative colitis (UC). However, intolerance as well as other issues have been reported for these drugs, making it difficult to sustain this treatment; accordingly, the persistence of 5-ASA is an important indicator of UC treatment strategy. We aimed to analyze the persistence of 5-ASA in patients with UC in Japan.

"From the territorial grounds": an interview with Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health.

In this interview, Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health in the Lula Government, discusses the process of reorganizing the Secretariat of Indigenous Health (SESAI) and Indigenous protagonism in the new administration. Among the points highlighted by the interviewee are the assessment of the Indigenous health scenario within the current political context of the Ministry of Health, dialogues with Indigenous movement organizations, as well as collaboration with research and educational institutions. The interview highlights the importance of developing strategies aimed at restructuring SESAI and improving Indigenous health public policy in Brazil through extensive coordination, involving planning, management, funding, and Indigenous social participation with Social Control.

Implementation of the Indigenous Health Policy: an ethnographic analysis of healthcare practices in the Upper Solimões River.

This study analyzes the implementation of the Indigenous Health Policy, focusing on the care practices of health teams of the Indigenous Health Care Subsystem in the Upper Solimões River in the Amazon region. Using ethnography as a methodological resource, the dynamics among participants, discourses, and power in the implementation of the policy are investigated, revealing a complex interconnection between practices and other contextual realities. Three phenomena emerge as critical influences on care practices: the medical-care model, the sanitation model, and the culture of performance.

Fibre: The Forgotten Carbohydrate in Sports Nutrition Recommendations.

Although dietary guidelines concerning carbohydrate intake for athletes are well established, these do not include recommendations for daily fibre intake. However, there are many scenarios in sports nutrition in which common practice involves the manipulation of fibre intake to address gastrointestinal comfort around exercise, or acute or chronic goals around the management of body mass or composition. The effect of fibre intake in overall health is also important, particularly in combination with other dietary considerations such as the elevated protein requirements in this population.

Utilising causal inference methods to estimate effects and strategise interventions in observational health data.

Randomised controlled trials (RCTs) are the gold standard for evaluating health interventions but often face ethical and practical challenges. When RCTs are not feasible, large observational data sets emerge as a pivotal resource, though these data sets may be subject to bias and unmeasured confounding. Traditional statistical (or non-causal) learning methods, while useful, face limitations in fully uncovering causal effects, i.

Hospital and physician-based mental healthcare during 12 months of opioid agonist treatment for opioid use disorder: Exploring costs and factors associated with acute care.

Background: Individuals with opioid use disorder (OUD) have a high prevalence of co-occurring mental health disorders; however, there exists little information on mental health service use for this population. We aimed to determine the prevalence of non-substance use-related mental health emergency department (ED) visits, hospitalizations, and outpatient physician visits for individuals receiving treatment for OUD over one year. We also explored individual-level characteristics associated with mental health care service use and estimated the costs of this care.

Survival machine learning methods for mortality prediction after heart transplantation in the contemporary era.

Although prediction models for heart transplantation outcomes have been developed previously, a comprehensive benchmarking of survival machine learning methods for mortality prognosis in the most contemporary era of heart transplants following the 2018 donor heart allocation policy change is warranted. This study assessed seven statistical and machine learning algorithms-Lasso, Ridge, Elastic Net, Cox Gradient Boost, Extreme Gradient Boost Linear, Extreme Gradient Boost Tree, and Random Survival Forests in a post-policy cohort of 7,160 adult heart-only transplant recipients in the Scientific Registry of Transplant Recipients (SRTR) database who received their first transplant on or after October 18, 2018. A cross-validation framework was designed in mlr.

Challenges and motivating factors for integrating geostatistical models in targeted schistosomiasis control: A qualitative case study in Northwestern Tanzania.

Introduction: To address problems of over- and under-treatment with preventive chemotherapy resulting in ongoing transmission of schistosomiasis, the World Health Organization (WHO) recommends targeted mass drug administration (MDA) interventions at a sub-district level. In Tanzania, the lack of sub-district (ward) prevalence data has inhibited a transition to targeted treatment. Model-based prevalence estimation combined with routine surveillance data can be used to overcome this gap.

Advancing Patient Advocacy in Mycology: Cultivating Collaboration in Education, Research, and Policy.

In the healthcare landscape, diseases such as cancer and HIV/AIDS have benefited from the patient's perspective. For fungal diseases, the patient voice remains absent in critical areas such as policy formulation, funding decisions, and research priorities. Patients affected by fungal disease, along with their caregivers and advocacy groups, possess invaluable insights into the challenges and unmet needs they face.

Randomized, observer-blind, controlled Phase 1 study of the safety and immunogenicity of the Na-GST-1/Alhydrogel hookworm vaccine with or without a CpG ODN adjuvant in hookworm-naïve adults.

Background: Recombinant Necator americanus Glutathione-S-Transferase-1 (Na-GST-1) formulated on Alhydrogel (Na-GST-1/Alhydrogel) is being developed to prevent anemia and other complications of N. americanus infection. Antibodies induced by vaccination with recombinant Na-GST-1 are hypothesized to interfere with the blood digestion pathway of adult hookworms in the host.

Protocol for a single-blind randomized controlled clinical trial to investigate the feasibility and safety of in-bed self-exercises based on electromyography sensor feedback in patients with subacute stroke.

Background: The dosage and intensity of physical therapy are crucial factors influencing the motor recovery of the hemiplegic lower limb in patients with subacute stroke. Biofeedback using wearable sensors may provide opportunities for patients with stroke to effectively guide self-exercises with monitoring of muscular activities in hemiplegic lower limbs. This study aims to explore the feasibility and safety of in-bed self-exercises based on electromyography sensor feedback in patients with subacute stroke.

Sepsis subtypes and differential treatment response to vitamin C: biological sub-study of the LOVIT trial.

Purpose: We hypothesised that the biological heterogeneity of sepsis may highlight sepsis subtypes with differences in response to intravenous vitamin C treatment in the Lessening Organ Dysfunction with VITamin C (LOVIT) trial. Our aims were to identify sepsis subtypes and to test whether sepsis subtypes have differences in treatment effect to vitamin C and describe putative biological effects of vitamin C treatment.

Methods: We measured biomarkers of inflammation, at baseline and at 7 days post-randomisation, in 457/863 (53.

Child welfare worker perspectives on documentation and case recording practices in Canada: A mixed-methods study protocol.

In health care and child welfare, clinical records and case notes serve multiple functions. When records are aggregated and processed to create administrative data, they can be analyzed and used to inform policy development and decision-making. To be useful, such data should be complete, accurate, and recorded in a standardized way.