Tyleripsen4894
The 2013-2016 Ebola virus (EBOV) outbreak in West Africa and the ongoing cases in the Democratic Republic of the Congo have spurred development of a number of medical countermeasures, including rapid Ebola diagnostic tests. The likelihood of transmission increases as the disease progresses due to increasing viral load and potential for contact with others. Early diagnosis of EBOV is essential for halting spread of the disease. Polymerase chain reaction assays are the gold standard for diagnosing Ebola virus disease (EVD), however, they rely on infrastructure and trained personnel that are not available in most resource-limited settings. Rapid diagnostic tests that are capable of detecting virus with reliable sensitivity need to be made available for use in austere environments where laboratory testing is not feasible. The goal of this study was to produce candidate lateral flow immunoassay (LFI) prototypes specific to the EBOV glycoprotein and viral matrix protein, both targets known to be present during EVD. The LFI platform utilizes antibody-based technology to capture and detect targets and is well suited to the needs of EVD diagnosis as it can be performed at the point-of-care, requires no cold chain, provides results in less than twenty minutes and is low cost. Monoclonal antibodies were isolated, characterized and evaluated in the LFI platform. Top performing LFI prototypes were selected, further optimized and confirmed for sensitivity with cultured live EBOV and clinical samples from infected non-human primates. Comparison with a commercially available EBOV rapid diagnostic test that received emergency use approval demonstrates that the glycoprotein-specific LFI developed as a part of this study has improved sensitivity. The outcome of this work presents a diagnostic prototype with the potential to enable earlier diagnosis of EVD in clinical settings and provide healthcare workers with a vital tool for reducing the spread of disease during an outbreak.
Risk factors for in-hospital mortality in confirmed COVID-19 patients have been summarized in numerous meta-analyses, but it is still unclear whether they vary according to the age, sex and health conditions of the studied populations. This study explored these variables as potential mortality predictors.
A systematic review was conducted by searching the MEDLINE, Scopus, and Web of Science databases of studies available through July 27, 2020. The pooled risk was estimated with the odds ratio (p-OR) or effect size (p-ES) obtained through random-effects meta-analyses. Subgroup analyses and meta-regression were applied to explore differences by age, sex and health conditions. The MOOSE guidelines were strictly followed.
The meta-analysis included 60 studies, with a total of 51,225 patients (12,458 [24.3%] deaths) from hospitals in 13 countries. A higher in-hospital mortality risk was found for dyspnoea (p-OR = 2.5), smoking (p-OR = 1.6) and several comorbidities (p-OR range 1.8 to 4.7) and laboratory paracritical patients (p-OR = 1.8).
The prognostic effect of clinical conditions on COVID-19 mortality vary substantially according to the mean age of patients.
CRD42020176595.
CRD42020176595.
To develop a scale for evaluating knowledge and practice of midwives on Respectful Maternity Care (RMC).
An exploratory sequential mixed method study was conducted from January 2018 to July 2019 in two non-teaching public hospitals in Tehran, Iran. In the first part of the study, a literature review and qualitative study were carried out in order to develop the preliminary item pool. Then face, content and construct validity and reliability (internal consistency and test-retest) were assessed.
The MKP-RMC scale has 23-item in knowledge and 23-item in practice section that loaded in three factors Giving emotional support, providing safe care and preventing mistreatment. Exploratory factor analysis accounted for 43.47% and 58.62% of observed variance in knowledge and practice sections, respectively. The internal consistency and internal correlation coefficient of both section of MKP-RMC indicated acceptable reliability.
The MKP-RMC is a valid and reliable tool for measuring midwives' knowledge and practice of respectful care during labor and childbirth. The MKP-RMC could be used in maternity services to evaluate and improve quality of childbirth care through development of educational interventions for effective behavioral change. Confirmation of validity and reliability of translated version of the scale in other maternity care providers and different contexts is recommended.
The MKP-RMC is a valid and reliable tool for measuring midwives' knowledge and practice of respectful care during labor and childbirth. The MKP-RMC could be used in maternity services to evaluate and improve quality of childbirth care through development of educational interventions for effective behavioral change. Confirmation of validity and reliability of translated version of the scale in other maternity care providers and different contexts is recommended.
Low health literacy is associated with poorer health outcomes. A key strategy to address health literacy is a universal precautions approach, which recommends using health-literate design for all health interventions, not just those targeting people with low health literacy. This approach has advantages Health literacy assessment and tailoring are not required. AZD3514 However, action plans may be more effective when tailored by health literacy. This study evaluated the impact of health literacy and action plan type on unhealthy snacking for people who have high BMI or type 2 diabetes (Aim 1) and the most effective method of action plan allocation (Aim 2).
We performed a 2-stage randomised controlled trial in Australia between 14 February and 6 June 2019. In total, 1,769 participants (mean age 49.8 years [SD = 11.7]; 56.1% female [n = 992]; mean BMI 32.9 kg/m2 [SD = 8.7]; 29.6% self-reported type 2 diabetes [n = 523]) were randomised to 1 of 3 allocation methods (random, health literacy screening, or participant al improvements in effectiveness of action plans tailored to health literacy; however, these improvements did not reach statistical significance, and the costs associated with such strategies compared with universal precautions need further investigation. This study highlights the importance of considering differential effects of health literacy on intervention effectiveness.
Australia and New Zealand Clinical Trial Registry ACTRN12618001409268.
Australia and New Zealand Clinical Trial Registry ACTRN12618001409268.