| 1. |
- Schwartz, K. L., et al.
(författare)
-
Best practice guidance for antibiotic audit and feedback interventions in primary care: a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN)
- 2023
-
Ingår i: Antimicrobial Resistance and Infection Control. - 2047-2994. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrimary care is a critical partner for antimicrobial stewardship efforts given its high human antibiotic usage. Peer comparison audit and feedback (A & F) is often used to reduce inappropriate antibiotic prescribing. The design and implementation of A & F may impact its effectiveness. There are no best practice guidelines for peer comparison A & F in antibiotic prescribing in primary care.ObjectiveTo develop best practice guidelines for peer comparison A & F for antibiotic prescribing in primary care in high income countries by leveraging international expertise via the Joint Programming Initiative on Antimicrobial Resistance-Primary Care Antibiotic Audit and Feedback Network.MethodsWe used a modified Delphi process to achieve convergence of expert opinions on best practice statements for peer comparison A & F based on existing evidence and theory. Three rounds were performed, each with online surveys and virtual meetings to enable discussion and rating of each best practice statement. A five-point Likert scale was used to rate consensus with a median threshold score of 4 to indicate a consensus statement.ResultsThe final set of guidelines include 13 best practice statements in four categories: general considerations (n = 3), selecting feedback recipients (n = 1), data and indicator selection (n = 4), and feedback delivery (n = 5).ConclusionWe report an expert-derived best practice recommendations for designing and evaluating peer comparison A & F for antibiotic prescribing in primary care. These 13 statements can be used by A & F designers to optimize the impact of their quality improvement interventions, and improve antibiotic prescribing in primary care.
|
|
| 2. |
|
|
| 3. |
- Nordenström, J, et al.
(författare)
-
Hyperparathyroidism associated with treatment of manic-depressive disorders by lithium.
- 1992
-
Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 158:4, s. 207-211
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To clarify the association between treatment of affective psychiatric disorders with lithium, and the development of secondary hyperparathyroidism.DESIGN: Retrospective review of medical records, 1973-89.SUBJECTS: 17 patients with affective psychiatric disorders who were treated with lithium (n = 6) or with tricyclic antidepressant, or neuroleptic, drugs (n = 11) all of whom were operated on for hyperparathyroidism.MAIN OUTCOME MEASURE: Duration of lithium therapy and parathyroid histology.RESULTS: Parathyroid hyperplasia was present in 5 patients who had taken lithium during a median period of 13 years. A parathyroid adenoma was found in one patient treated with lithium for three years. Ten of the 11 patients who had been treated with tricyclic antidepressant, or neuroleptic drugs had a parathyroid adenoma and the remaining one had an adenoma as an underlying cause of hyperparathyroidism.CONCLUSION: Hyperparathyroidism in patients who have undergone long term treatment with lithium is associated with parathyroid hyperplasia. This indicates that lithium may exert a chronic stimulus that results in secondary hyperparathyroidism.
|
|
| 4. |
- Harms-Ringdahl, K, et al.
(författare)
-
Assessment of jet pilots' upper trapezius load calibrated to maximal voluntary contraction and a standardized load.
- 1996
-
Ingår i: Journal of Electromyography & Kinesiology. - : Elsevier BV. - 1050-6411 .- 1873-5711. ; 6:1, s. 67-72
-
Tidskriftsartikel (refereegranskat)abstract
- Electromyographic (EMG) recording of the myoelectrical activity level in the trapezius muscle is often used as one method of assessing neck and shoulder muscle workload. To analyse how the normalization value influences interpretation of upper trapezius load during a work task, two different reference values for normalization were applied - one obtained during a maximum voluntary contraction (MVE) and the other during a standardized muscular load (RVE). Nine jet pilots (ages 30-48 yr) flew two sorties in a 37 Viggen aircraft using either of two types of head garment while 3-D acceleration and muscular activity were recorded. In each sortie twice in the programme a steep left turn at 5-6 +G(Z) was performed. The highest activity level (MVE) obtained during shoulder elevation combined with an isometric heavy resistance (maximum) against arm flexion/abduction was used as one normalization value. Before, between, and after the two flights, 15 s EMG recordings (RVE) during a dumbbell test in the same arm position were also taken. The muscular activity in the upper trapezius during a given task varied a great deal between individuals, but the reliability of the amplitude levels on different occasions during a work day was good, given the same electrode location and application. If muscular activity during a standardized loading force (e.g. dumbbell test) is used to normalize the recordings for workload assessments related to utilized muscular capacity, a subject with high muscular strength and comparatively low workload might in some situations be assessed as having the same workload as, or a higher load than a subject with less strength and a comparatively high workload. While normalization using a standardized force can be used to assess changes in workload, for assessing workload related to the individual's capacity recording the myoelectrical activity during maximal contraction is preferable.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Linder, J, et al.
(författare)
-
Long-term sick-leavers with fibromyalgia : Comparing their multidisciplinarily assessed characteristics with those of others with chronic pain conditions and depression
- 2009
-
Ingår i: Journal of Multidisciplinary Healthcare. - 1178-2390 .- 1178-2390. ; 2, s. 23-37
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to gain knowledge of fibromyalgia (FM) patients on long-term sick leave and with particular difficulties in resuming work, and to compare them with patients with myalgia, back or joint diagnoses, and depression.Methods: Patients were identified by and referred from social insurance offices and were multidisciplinarily examined by three board-certified specialists in psychiatry, orthopedic surgery and rehabilitation medicine. Ninety-two women were diagnosed with FM only. Three female comparison groups were chosen: depression, back/joint diagnoses, and myalgia.Results and conclusions: Ceaseless pain was reported by 73% of FM patients, 54% of back/joint diagnoses patients, 43% of myalgia patients, and 35% of depression patients. The distribution of pain (>50%) in FM patients was to almost all regions of the body, and in depression patients to the lower dorsal neck, upper shoulders and lumbosacral back but not in the anterior body. Reduced sleep was more evident in FM patients. FM patients did not meet more criteria for personality disorder than patients with the other somatic pain conditions. The most common dimension of “personality traits” of somatic pain conditions was the “obsessive compulsive” but at a level clearly below that indicating a personality disorder. More FM patients experienced disabilities, the most common being in the mobility and domestic-life areas.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
