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In arrivo nel Ddl semplificazioni la possibilità per il farmacista di erogare nuove prestazioni come vaccinazioni per over 12, test diagnostici o la scelta del medico di famiglia. Sì anche a locali separati
Nella sede di Palidoro
Il pubblico target nel 2024 è quello tra i 10 e i 14 anni di età
Il pubblico target nel 2024 è quello tra i 10 e i 14 anni di età
Lanciata da Pfizer e Ail, al centro storia pescatore resiliente
Per la settimana della prevenzione oncologica dal 16 al 24 marzo
Studio dell’Università di Trieste su 2.314 dipendenti comunali
Studio dell’Università di Trieste su 2.314 dipendenti comunali
Un convegno all’Università di Padova il 21 e 22 marzo
Autore/Fonte: NICE
We read Kennedy et al1’s findings with interest, and report in-depth analyses of antibody and T cell responses in patients with inflammatory bowel disease (IBD) to COVID-19 vaccination. We prospectively recruited 100 SARS-CoV-2-uninfected patients with IBD on varying treatments at the Royal Melbourne Hospital (HREC/74403/MH-2021). Healthcare workers who did not have IBD and were not on immunosuppressive medication were enrolled as controls with approvals from Melbourne Health (HREC/68355/MH-2020) and University of Melbourne (HREC 22268, 21626). Participant characteristics are outlined in table 1. IBD medication regimens needed to be stable for at least 8 weeks prior to enrolment. Only one participant was on concomitant low-dose systemic corticosteroids with anti-TNF combination therapy. Eighty-nine patients received BNT162b2 (Pfizer–BioNTech), and 11 received ChAdOx1 nCoV-19 (Oxford–AstraZeneca). No participants had a clinical history of SARS-CoV-2 infection at enrolment. Anti-S1/2 and anti-RBD SARS-CoV-2-specific antibodies were measured at baseline and at five time…
New England Journal of Medicine, Volume 390, Issue 10, March 2024.
Objective
To compare the efficacy and safety of different anti-vascular endothelial growth factor (VEGF) agents combined with different delivery methods for neovascular glaucoma (NVG).
Design
Systematic review and Bayesian network meta-analysis (NMA).
Data sources
PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, ISRCTN and Chinese databases including the China National Knowledge Infrastructure, China Science Periodical Database (Wanfang Database), VIP Journal Integration Platform and China Biology Medicine Database were searched from inception to 5 September 2022.
Eligibility criteria
We included randomised controlled trials (RCTs) that investigated the treatment of NVG using different anti-VEGF agents combined with various methods of drug administration, without any language limitations. All patients included underwent panretinal laser photocoagulation and there were no restrictions on prior glaucoma surgery.
Data extraction and synthesis
Two independent reviewers extracted data and assessed the risk of bias. Random-effect Bayesian NMA was conducted to compare the efficacy and safety and rank priority of anti-VEGF regimens. The source of heterogeneity and the related factors affecting the stability of the results were also explored. CINeMA (Confidence in Network Meta-Analysis) was used to assess the certainty of evidence.
Results
Our analysis included 17 RCTs involving a total of 1311 eyes from 1228 patients. We examined five different treatment regimens, which used three different anti-VEGF drugs. The following treatments showed a significant decrease in intraocular pressure (IOP) compared with the control group at 1 month after glaucoma surgery: simultaneous intravitreal and intracameral injection of conbercept (ICCIVC) (mean difference (MD)=–11.56, 95% credible interval (CrI) –20.8 to –2.24), intravitreal injection of conbercept (MD=–8.88, 95% CrI –13.93 to –3.78), intravitreal injection of ranibizumab (MD=–7.62, 95% CrI –10.91 to –4.33) and intravitreal injection of bevacizumab IVB) (MD=–5.51, 95% CrI –10.79 to –0.35). The surface under the cumulative ranking curve (SUCRA) analysis indicated that ICCIVC (82.0%) may be the most effective regimen in reducing IOP. In terms of safety, there were no statistically significant differences among the interventions. According to the SUCRA analysis, ICCIVC (68.0%) was considered the safest choice with the fewest complications. Subgroup and meta-regression analyses showed that mean age was the main source of heterogeneity. Sensitivity analysis demonstrated the robustness of the study results.
Conclusion
ICCIVC was more effective and safer than other anti-VEGF regimens for NVG. Simultaneous intravitreal and intracameral injection was found to be the best route of administration, and conbercept was found to be the superior drug selection when compared with ranibizumab and bevacizumab.
PROSPERO registration number
CRD42022309676.
BackgroundPrimary Health Centers (PHCs) in Nigeria often have inconsistent and deficient supplies of resources (drugs, medical supplies and equipment), funds and staff, a situation which is underpinned by lack of investment, governance fragmentation and political inference. Rent-seeking remains a major, albeit unexplored, problem. This study explored whether accountability mechanisms in PHCs could be adapted to the local socio-political context in order to reduce rent-seeking among staff, improve the supply of commodities and ensure better delivery of essential services.MethodWe employed a qualitative approach, conducting 8 weeks of participant observation in 6 PHCs and 2 Local Government Health departments (n=2). We followed this up with in-depth interviews (N = 40) with facility health managers, policy makers and Health Facility Committee Chairmen in Enugu, south east, Nigeria. Data were analyzed thematically.ResultsStaff at PHCs have multiple intersecting and conflicting relationships with actors at different levels of the political and health ecosystems. The relationships underpinning funding flows, salaries, supervision, reporting, implementation, security arrangements, capacity building, infrastructure development and supply of medical equipment and drugs are complex. The intertwining of the informal relationships with the formal rules disrupts existing accountability mechanisms. We identified how conflict of interests, and political interferences are managed – often leading to inefficient formal complaint and feedback mechanisms, affecting provider-patient relationships and trust in the system.ConclusionExamining the intricate web of accountability mechanisms, identifying the role of the formal vis-à-vis informal mechanisms and building on these, can help to improve access to primary healthcare in Nigeria through addressing rent-seeking and enabling effective responses to the ongoing crisis.
A Bologna un evento per fare il punto della situazione
Objectives
To assess the evidence for anti-racist interventions which aim to reduce ethnic disparities in healthcare, with a focus on implementation in the UK healthcare system.
Design
Umbrella review.
Data sources
Embase, Medline, Social Policy and Practice, Social Care Online and Web of Science were searched for publications from the year 2000 up to November 2023.
Eligibility criteria
Only systematic and scoping reviews of anti-racist interventions reported in English were included. Reviews were excluded if no interventions were reported, no comparator interventions were reported or the study was primarily descriptive.
Data extraction and synthesis
A narrative synthesis approach was used to integrate and categorise the evidence on anti-racist interventions for healthcare. Quality appraisal (including risk of bias) was assessed using the AMSTAR-2 tool.
Results
A total of 29 reviews are included in the final review. 26 are from the healthcare sector and three are from education and criminal justice. The most promising interventions targeting individuals include group-based health education and providing culturally tailored interventions. On a community level, participation in all aspects of care pathway development that empowers ethnic minority communities may provide an effective approach to reducing ethnic health disparities. Interventions to improve quality of care for conditions with disproportionately worse outcomes in ethnic minority communities show promise. At a policy level, structural interventions including minimum wage policies and integrating non-medical interventions such as housing support in clinical care has some evidence for improving outcomes in ethnic minority communities.
Conclusions
Many of the included studies were low or critically low quality due to methodological or reporting limitations. For programme delivery, different types of pathway integration, and providing a more person-centred approach with fewer steps for patients to navigate can contribute to reducing disparities. For organisations, there is an overemphasis on individual behaviour change and recommendations should include a shift in focus and resources to policies and practices that seek to dismantle institutional and systemic racism through a multilevel approach.
