Risultati per: Passo 12. Ripulire in modo mirato le cartelle cliniche degli assisiti

Introduction
Despite Ethiopia’s policy intention to provide recommended vaccination services to underprivileged populations, inequity in polio immunisation persists.

Objective
This study examined inequity and trends in polio immunisation and determinant factors among children aged 12–23 months in Ethiopia between 2000 and 2019.

Methods
Cross-sectional data from 2000, 2005, 2011, 2016 and 2019 Ethiopian demographic and health surveys were analysed with the updated version of the WHO’s Health Equity Assessment Toolkit software. Six standard equity measures: equity gaps, equity ratios, population attributable risk, population attributable fraction, slope index of inequality and relative index of inequality were used. Datasets were analysed and disaggregated by the five equality stratifiers: economic status, education, place of residence, sex of the child and regions. Multilevel logistic regression analysis was used to identify determinant factors.

Results
Polio immunisation coverage was increased from 34.5% (2000) to 60.0% (2019). The wealth index-related inequity, in coverage of polio immunisation between quintiles 5 and 1, was 20 percentage points for most surveys. The population attributable risk and population attributable fraction measure in 2011 indicate that the national polio immunisation coverage in that year could have been improved by nearly 36 and 81 percentage points, respectively, if absolute and relative wealth-driven inequity, respectively, had been avoided. The absolute difference between Addis Ababa and Afar Region was 74 percentage points in 2000 and 60 percentage points in 2019. In multilevel analysis result, individual-level factors like wealth index, maternal education antenatal care and place of delivery showed statistical significance.

Conclusion
Although polio immunisation coverage gradually increased over time, in the 20-year survey periods, still 40% of children remained unvaccinated. Inequities in coverage by wealth, educational status, urban–rural residence and administrative regions persisted. Increasing service coverage and improving equitable access to immunisations services may narrow the existing inequity gaps.

Attese iscrizioni nel registro degli indagati

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Research taking place in care homes for older adults has rapidly increased in recent decades, which was seen even more during the COVID-19 pandemic. Challenges in including older adults, particularly those living with a level of cognitive decline, have prevented resident voices being at the forefront of research. Furthermore, lack of resources and time pressures within care homes create barriers to accessing staff and care homes. It is important to consider the whole care context within research, alongside resident voices, to consider lived experiences and provide productive and realistic suggestions for change. Co-production is becoming more common in research, and is committed to facilitating inclusion and overcoming individual, social or contextual barriers to communication and inclusivity. The CHAPPI (Care Home Activity Providers Facilitating Public Involvement in Research as a Meaningful Activity for Care Home Residents) project has collaborated with key stakeholders, including care home managers, activity providers and lived experience experts to ensure gaps in knowledge between academia and industry are bridged from project inception. During this ‘Q&A style’ presentation, we (a care home manager and a researcher) will present our experiences of participating in or conducting research, including during the COVID-19 pandemic. We will also highlight lessons learned within the CHAPPI project so far, to discuss how we (as researchers and industry experts) can creatively proceed together, to improve care home research. Finally, we will explore how we can adapt research to fit with care homes to bring an understanding of what is needed to succeed and how we can do better, even during times of extraordinary measures.

This case report describes a woman in her 30s who presented with a 3-year history of anti–PL-12 antisynthetase syndrome characterized by interstitial lung disease, arthritis, and myositis and was diagnosed with antisynthetase syndrome–associated panniculitis.

Oncologi, ma attenzione alla corretta comunicazione dei dati scientifici

Cartabellotta: ‘Oltre 14 milioni in attesa del provvedimento’

«Il via libera del governo allo scudo penale per i medici è un’ottima notizia, non solo per la categoria che in questi anni è letteralmente finita sotto attacco, ma anche per i pazienti con i quali nel tempo si è perso il valore del rapporto medico-paziente». Lo dice il segretario generale Fimmg, Silvestro Scotti

Sinpia: ‘Regole condivise, ma controproducente demonizzare’

Introduction
Concerns about falling (CaF) are common in older people and have been associated with avoidance of activities of daily life. Exercise designed to prevent falls can reduce CaF, but the effects are usually short-lived. Cognitive behavioural therapy (CBT) can reduce CaF for longer but is not readily available in the community and unlikely to prevent falls. A multidomain intervention that combines CBT, motivational interviewing and exercise could be the long-term solution to treat CaF and reduce falls in older people with CaF. This paper describes the design of a randomised controlled trial to test the effectiveness of two different 12 week self-managed eHealth programmes to reduce CaF compared with an active control.

Methods
A total of 246 participants (82 per group) aged 65 and over, with substantial concerns about falls or balance will be recruited from the community. They will be randomised into: (1) myCompass-Own Your Balance (OYB) (online CBT programme) intervention or (2) myCompass-OYB plus StandingTall intervention (an eHealth balance exercise programme), both including motivational interviewing and online health education or (3) an active control group (online health education alone). The primary outcome is change in CaF over 12 months from baseline of both intervention groups compared with control. The secondary outcomes at 2, 6 and 12 months include balance confidence, physical activity, habitual daily activity, enjoyment of physical activity, social activity, exercise self-efficacy, rate of falls, falls health literacy, mood, psychological well-being, quality of life, exercise self-efficacy, programme adherence, healthcare use, user experience and attitudes towards the programme. An intention-to-treat analysis will be applied. The healthcare funder’s perspective will be adopted for the economic evaluation if appropriate.

Ethics and dissemination
Ethical approval was obtained from the South Eastern Sydney Local Health District Human Research Ethics Committee (2019/ETH12840). Results will be disseminated via peer-reviewed journals, local and international conferences, community events and media releases.

Trial registration number
ACTRN12621000440820.