Journal of evaluation in clinical practice
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Defensive caesarean section (CS) has become one of the most common medical procedure worldwide. Additionally, performing CS in accordance with the patient's choice is an appropriate professional practice. ⋯ The results of our study indicate that defensive caesarean section is a widespread practice among obstetrics practitioners in Romania.
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Children with cerebral palsy (CP) can show an increase in gross motor function until the age of 9 to 10 years under the standard of care. Additionally, the motor development can have large individual fluctuations. Therefore, in clinical setting, it is not trivial to estimate the effect of an additional therapeutic intervention at this age interval. The study aim was to develop a method which allows quantification of the gross motor function changes over 6 months of the individual child with CP. ⋯ The presented method helps to guide the clinician to track the individual patient's gross motor development and assess the additional effect of an additionally applied intervention while taking into account the expected progression of gross motor function under standard of care.
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Inadequate awareness of oral health and related disciplines appears to be common among medical practitioners. This study was designed to evaluate the awareness of oral medicine (OM) specialty and its scope of practice among Jordanian medical practitioners and to outline potential strategies for improvement where appropriate. ⋯ This study provides evidence on the profound interdisciplinary gap between medicine and dentistry and highlights the importance of more focused education and training in oral health-related disciplines to be provided to clinicians and medical trainees as described.
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Bangladesh is an underdeveloped country that has recently joined the ranks of low-middle-income countries. This study aims to investigate how socioeconomic and developmental factors have influenced women towards a shift in their body mass index (BMI). ⋯ Rapid urbanization allied with growing wealth inequality and dietary alteration seems to have forced a change in the capacity of women in Bangladesh to control their weight. Additional information is still needed on such factors as the amount of time that women are inactive and sitting down, for example, as well as their daily calorie intake in order to assemble all the pieces for addressing necessary health policy changes in Bangladesh. These factors will also help to indicate a shift of focus from rural malnutrition to urban obesity.
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Interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single treatment unit's outcome is studied over time and the intervention is expected to "interrupt" the level and/or trend of the outcome, subsequent to its introduction. The internal validity of this analysis is strengthened considerably if the treated unit is contrasted with a comparable control group. However, multiple-group ITSA typically has small sample sizes, and parametric methods for multiple-group ITSA require strong assumptions that are unlikely to be met, possibly resulting in misleading P values. In this paper, randomization tests are introduced as a non-parametric, distribution-free option for computing exact P values. ⋯ In these data, randomization tests computed P values comparable with ITSAREG, bolstering confidence in the intervention effect. Routinely including randomization tests as a complement, or alternative, to parametric methods is therefore beneficial because randomization tests are free of assumptions regarding sample size and distribution and are extremely flexible in the choice of test statistic.