Fattibilità della terapia telefonica per problemi di salute mentale comuni incorporati nelle cliniche per l'epilessia pediatrica

Fattibilità della terapia telefonica per problemi di salute mentale comuni incorporati nelle cliniche per l’epilessia pediatrica

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Il trattamento della salute mentale e fisica dovrebbe essere fornito insieme ai bambini e ai giovani con epilessia. La formazione degli operatori sanitari (HCP) nei servizi per l’epilessia per fornire interventi di salute mentale è un modo importante per facilitare l’assistenza integrata. Tredici operatori sanitari sono stati formati sulla fornitura dell’intervento. Un pneumologo pediatrico ha determinato la gravità e il controllo dell’asma di ogni partecipante durante una visita clinica. Per ogni paziente sono stati generati un punteggio CASI e ACT / C-ACT.

determinare la fattibilità della valutazione e del trattamento psicologico forniti a distanza per le difficoltà di salute mentale forniti dagli operatori sanitari nelle cliniche pediatriche per l’epilessia con una formazione formale limitata in interventi psicologici. Abbiamo ipotizzato che sarebbe stato (i) possibile formare gli operatori sanitari per fornire l’intervento psicologico e (ii) che i partecipanti che ricevevano la terapia psicologica avrebbero riportato riduzioni dei sintomi di difficoltà di salute mentale tra cui ansia, depressione e difficoltà comportamentali e migliorato la qualità della vita .

Trentaquattro bambini e giovani con epilessia che presentavano sintomi alteranti di una difficoltà di salute mentale comune (ansia, depressione, comportamento dirompente e / o trauma) sono stati assegnati a ricevere 6 mesi di un intervento cognitivo comportamentale modulare fornito da un operatore sanitario con limitata esperienza di terapia psicologica formale.La competenza degli operatori sanitari è stata valutata in un processo a due fasi. Le misurazioni riferite dai genitori dei sintomi di salute mentale e della qualità della vita sono state completate al basale e dopo l’intervento. Sono stati utilizzati test t accoppiati per analizzare i cambiamenti nei sintomi nel tempo.

tutti i tredici operatori sanitari che hanno partecipato alla formazione sono stati considerati competenti nell’erogazione terapeutica entro la fine del periodo di formazione. Ventitré pazienti hanno completato le misure pre e post intervento e sono stati inclusi nell’analisi. Ci sono stati miglioramenti statisticamente significativi in: sintomi di problemi di salute mentale (p = 0,01; d di Cohen = 0,62), impatto totale dei problemi di salute mentale (p = 0,03; d di Cohen = 0,52), sintomi di ansia e depressione (p = 0,02; d = 0,57) e qualità della vita (p = 0,01; d di Cohen = 0,57).

un trattamento cognitivo comportamentale modulare fornito per telefono da operatori sanitari con esperienza limitata di terapia psicologica era fattibile ed efficace nel trattamento dei problemi di salute mentale nei bambini e nei giovani con epilessia. Anche la qualità della vita correlata alla salute è migliorata durante la durata del trattamento. È necessario uno studio randomizzato controllato (RCT) per dimostrare l’efficacia dell’intervento.

Migliori pratiche di prescrizione di antibiotici per infezioni respiratorie attraverso l’uso di set di ordini computerizzati e sessioni educative nelle cliniche pediatriche

 

I sistemi computerizzati di supporto alle decisioni cliniche (CDSS) hanno mostrato un’efficacia promettente nel migliorare la prescrizione ambulatoriale di antibiotici. Abbiamo sviluppato un intervento sotto forma di set di ordini EPIC (Verona, WI, USA) comprendenti percorsi di trattamento ambulatoriale per 3 infezioni respiratorie acute batteriche pediatriche (ARI) accoppiati a sessioni educative. Quattro cliniche pediatriche sono state randomizzate in bracci di intervento e di controllo durante periodi di studio pre e postimplementazione.

Nelle cliniche di intervento, l’istruzione è stata fornita tra i 2 periodi di studio e le serie di ordini EPIC sono diventate disponibili all’inizio del periodo postimplementazione. L’endpoint primario era la percentuale di prescrizione di antibiotici di prima linea e gli endpoint secondari includevano la durata dell’antibiotico e la modifica della prescrizione di antibiotici entro 14 giorni.
sono state incluse un totale di 2690 prescrizioni di antibiotici.

Durante la fase di pre-implementazione, non vi era alcuna differenza nella prescrizione di antibiotici di prima linea o nella durata dell’antibiotico tra i studiare le armi. Dopo l’implementazione, le cliniche di intervento avevano una percentuale più alta di prescrizione di antibiotici di prima linea e una durata dell’antibiotico più breve ispetto a le cliniche di controllo. La percentuale di antibiotici modificati era piccola in tutte le cliniche (1,1% -1,6%) e non differiva prima e dopo l’intervento.

un CDSS computerizzato che coinvolge percorsi di trattamento sotto forma di set di ordini accoppiati a sessioni educative è stato associato a una percentuale più alta di prescrizione di antibiotici di prima linea e una durata più breve dell’antibiotico per il trattamento ambulatoriale delle ARI batteriche pediatriche. Metodi I bambini di età compresa tra 5 e 18 anni con una diagnosi medica di asma persistente sono stati reclutati da un centro di assistenza terziaria.

Fattibilità della terapia telefonica per problemi di salute mentale comuni incorporati nelle cliniche per l'epilessia pediatrica

La proporzione di casi di malattie infettive, i suoi fattori associati e l’appropriatezza della prescrizione di antimicrobici tra i pazienti pediatrici rifugiati Rohingya nelle cliniche mobili IMARET

 

I Rohingya sono fuggiti dalla loro casa per sfuggire alla persecuzione etnica. A causa del loro status di rifugiati, hanno difficoltà ad accedere all’assistenza sanitaria che porta a mortalità e morbilità evitabili. Si dice che le malattie infettive siano tra le cause. Per facilitare l’accesso all’assistenza sanitaria, IMAM Response and Relief Team (IMARET) fornisce loro una clinica mensile gratuita. L’obiettivo di questo studio è determinare la proporzione di malattie infettive e l’adeguatezza dell’uso di antimicrobici tra i suoi pazienti pediatrici. È stato condotto nel 2017, tramite campionamento universale.

Le informazioni recuperate sono state ottenute tramite interviste e cartelle cliniche. La maggior parte delle diagnosi erano malattie infettive (57,1%), che includono infezioni respiratorie (77,3%), pelle (13,6%), infezioni gastrointestinali (4,5%), occhi e orecchie (entrambe 1%). L’albendazolo (40,7%) era il più prescritto. Solo al 7,4% sono stati prescritti antimicrobici in modo appropriato. L’età (p = 0,005) e il BMI (p = 0,006) erano significativamente associati alle infezioni.

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Rabbit Aquaporin 0,AQP-0 ELISA kit
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E08A1918-48 1 plate of 48 wells
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E06A1918-192T 192 tests
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E06A1918-48 1 plate of 48 wells
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E06A1918-96 1 plate of 96 wells
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201-12-1285 96 tests
EUR 440
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E05A1918-192T 192 tests
EUR 1270
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E05A1918-96 1 plate of 96 wells
EUR 685
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EUR 534
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EUR 354
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KTE100611-5platesof96wells 5 plates of 96 wells
EUR 2252
Description: Quantitative sandwich ELISA for measuring Rat Aquaporin 0 (AQP-0) in samples from cell culture supernatants, serum, whole blood, plasma and other biological fluids.

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KTE100611-96T 96T
EUR 572
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70R-50059 100 ul
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Description: Purified Polyclonal Aquaporin 0 antibody

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DAG-H10377 1 ml dry ice
EUR 1105

RSV Positive Sample
DAG-H10378 1 ml dry ice
EUR 1105

ELISA Sample Diluent
ESD125 125 ml
EUR 80

ELISA Sample Diluent
ESD500 500 ml
EUR 109

ELISA Sample Diluent
ESD999 1000 ml
EUR 157

Human Comp IgG/IgM Depleted Pooled (mL)
34010-0 mL
EUR 65

Human Comp IgG/IgM Depl Single Donor(mL)
34013-0 mL
EUR 103.06

Human Serum IgG/IgM Depl Pooled (mL)
34014-0 mL
EUR 82.4

Rabbit BRAIN ACETONE POWDER VARISENS (1-g)
41170-0 1g
EUR 104.15

CK PANCREAS POWDER LYOPH 1g*
43032-0 1g
EUR 122.64

Human Topoisomerase I ICE Assay Kit (No Antibody)
TG1020-0 24 Tests
EUR 425

Rabbit Serum, Sterile, Non-hemolized (56-84 days old)
31125-4 1L
EUR 355
Description: Produced from whole blood collected from young healthy rabbits (New Zealand White or Californian), 6+ months old. Pooled serum from male and female rabbits that are fasted prior to collection. The serum is processed, bottled, and stored at -20°C. Then the serum was thawed, pooled, passed through a 0.22-micron filter, bottled and returned to -20°C.

Tetrakis(triphenylphosphine)palladium(0)
20-abx186040
  • EUR 258.00
  • EUR 954.00
  • EUR 425.00
  • 1 g
  • 25 g
  • 5 g

Bis(dibenzylideneacetone)palladium(0)
20-abx182380
  • EUR 801.00
  • EUR 328.00
  • 25 g
  • 5 g

Tris(dibenzylideneacetone)dipalladium(0)
20-abx184467
  • EUR 1497.00
  • EUR 495.00
  • EUR 230.00
  • 100 g
  • 25 g
  • 5 g

Aquaporin-0 (AQP0) Antibody
20-abx002119
  • EUR 411.00
  • EUR 592.00
  • EUR 182.00
  • EUR 314.00
  • 100 ul
  • 200 ul
  • 20 ul
  • 50 ul

Aquaporin 0 Blocking Peptide
20-abx062934
  • EUR 272.00
  • EUR 411.00
  • 1 mg
  • 5 mg

Aquaporin 0 (AQP0) Antibody
20-abx008991
  • EUR 300.00
  • EUR 439.00
  • EUR 189.00
  • 100 ul
  • 200 ul
  • 30 ul

ViaCheck Viability Control 0%
VC10B-20 20 ml
EUR 484.58
Description: ViaCheck Viability Control 0% mimic the characteristics of live and dead cells in the trypan blue dye exclusion method and may be used to support validation and QC of image-based cell viability analyzers 

Anti-SP2/0 HCP
SP110 1 ml
EUR 334
Description: Anti-SP2/0 HCP by Cygnus Technologies is available in Europe via Gentaur.

Anti-SP2/0 HCP
SP110-AF 1 mg
EUR 1913
Description: Anti-SP2/0 HCP by Cygnus Technologies is available in Europe via Gentaur.

Anti-SP2/0 HCP
SP110-PA 1 ml
EUR 488
Description: Anti-SP2/0 HCP by Cygnus Technologies is available in Europe via Gentaur.

Per valutare, in un contesto ambulatoriale, se un punteggio CASI predice accuratamente la gravità / il controllo dell’asma come determinato tramite la valutazione subspecialista. I punteggi del test di controllo dell’asma (ACT) e dei punteggi ACT (C-ACT) dell’infanzia sono stati generati per fornire un contesto aggiuntivo per i punteggi CASI in relazione alle valutazioni utilizzando un altro strumento clinico.