Plos One
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The main objective of this study was to evaluate community pharmacists' awareness and perception about medication reconciliation service and to assess the completeness of collecting patients' medication histories in the community pharmacy setting. ⋯ Community pharmacists in Jordan showed a low awareness about the medication reconciliation concept and demonstrated a modest role in obtaining medication histories in community pharmacies. But still, they showed a positive attitude towards their role in implementing the different steps of medication reconciliation. This suggests that educational workshops to increase pharmacists' awareness about their role and responsibilities in collecting a complete and accurate medication history are warrented.
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Identify patient subgroups defined by trajectories of pain and disability following surgery for degenerative lumbar spinal stenosis, and investigate the construct validity of the subgroups by evaluating for meaningful differences in clinical outcomes. ⋯ Subgroups of patients with degenerative lumbar spinal stenosis can be identified by their trajectories of pain and disability following surgery. Although most patients experienced important reductions in pain and disability, 29% to 42% of patients were classified as members of an outcome trajectory subgroup that experienced little to no benefit from surgery. These findings may inform appropriate expectation setting for patients and clinicians and highlight the need for better methods of treatment selection for patients with degenerative lumbar spinal stenosis.
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Observational Study
A validation of the PAWPER XL-MAC tape for total body weight estimation in preschool children from low- and middle-income countries.
The PAWPER tape system is one of the three most accurate paediatric weight estimation systems in the world. The latest version of the tape, which does not rely on a subjective assessment of habitus, is the PAWPER XL-MAC method which uses length and mid-arm circumference (MAC) to estimate weight. It was derived and validated in a population in the USA and has not yet been fully validated in a population from a resource-limited setting. ⋯ The PAWPER XL-MAC tape performed well in this study and was statistically significantly more accurate than both the Broselow tape editions and the Ralston method. This difference was substantial and clinically important. The tape did not perform as well at extremes of habitus-type, however, and might benefit from recalibration.
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The Sequential Organ Failure Assessment (SOFA) score is commonly used in ICUs around the world, designed to assess the severity of the patient's clinical state based on function/dysfunction of six major organ systems. The goal of this work is to build a computational model to predict mortality based on a series of SOFA scores. In addition, we examined the possibility of improving the prediction by incorporating a new component designed to measure the performance of the gastrointestinal system, added to the other six components. ⋯ Our findings indicate that gastrointestinal parameters carry significant information as a mortality predictor in addition to the conventional SOFA score. This information improves the predictive power of machine learning models by extending the SOFA to include information related to gastrointestinal organ system. The described method improves mortality prediction by considering the dynamics of the extended SOFA score. Although tested on a limited data set, the results' stability across different models suggests robustness in real-time use.
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Frontline providers around the world deliver emergency care daily, often without prior dedicated training. In response to multiple country requests for open-access, basic emergency care training materials, the World Health Organization (WHO), in collaboration with the International Committee of the Red Cross (ICRC) and the International Federation for Emergency Medicine (IFEM), undertook development of a course for health care providers-Basic Emergency Care: Approach to the acutely ill and injured (BEC). As part of course development, pilots were performed in Uganda, the United Republic of Tanzania, and Zambia to evaluate course feasibility and appropriateness. Here we describe participant and facilitator feedback and pre- and post-course exam performance. ⋯ This pilot demonstrates that a low-fidelity, open-access course taught by local instructors can be successful in knowledge transfer. The BEC course was well-received and deemed context-relevant by pilot facilitators and participants in three East African countries. Further studies are needed to evaluate this course's impact on clinical practice and patient outcomes.