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Fineman S.,Emory University | Dowling P.,University of Kansas | O'Rourke D.,One Public
Annals of Allergy, Asthma and Immunology | Year: 2013

Background Anaphylaxis is life-threatening and requires rapid medical intervention. Knowledge of treatment guidelines and addressing barriers to care are essential for appropriate management. Objective To investigate allergists' self-reported practices in managing patients at risk for anaphylaxis, specifically in following practice parameters for diagnosis, treatment, and appropriate use of epinephrine, and to identify perceived barriers to care. Methods Online questionnaires were distributed to members of the American College of Allergy, Asthma, and Immunology. The US physicians who self-identified as "allergist/immunologist" were eligible to participate. The first 500 completed questionnaires were analyzed. Results Nearly all (≥95%) reported adherence to practice parameters in prescribing an epinephrine auto-injector and instructing patients on its use, taking a detailed allergy history, counseling patients on avoidance measures, and educating patients on the signs and symptoms of anaphylaxis. More than 90% stated they determined the best diagnostic procedures to identify triggers and coordinated laboratory and allergy testing. Adherence to practice parameters was less robust for providing patients with written action plans and in-office anaphylaxis preparedness. Perceived barriers to care included a significant proportion of patients who were uncomfortable using epinephrine auto-injectors and inadequate knowledge of anaphylaxis among referral physicians. Conclusion Allergists overwhelmingly adhere to practice parameter recommendations for the treatment and management of anaphylaxis, including appropriate use of epinephrine as first-line treatment, educating patients, and testing to diagnose anaphylaxis and identify its triggers. Opportunities for improvement include preparing staff and patients for anaphylactic events, providing written action plans, and improving knowledge of referring physicians. © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. Source

Colantonio S.,University of Ottawa | Bracken M.B.,One Public | Beecker J.,University of Ottawa
Journal of the American Academy of Dermatology | Year: 2014

Background Tanning beds are associated with increased risk of melanoma. Objective We sought to update the evidence of the association of melanoma and indoor tanning focusing on frequency of use and exposure to newer tanning beds. Methods We searched Scopus, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature on August 14, 2013. We included all observational studies that included patients with melanoma who had indoor tanned. Odds ratios (OR) with 95% confidence intervals (CI) were extracted and combined using generic inverse variance methods assuming a random effects model. Results In all, 31 studies were included with data available on 14,956 melanoma cases and 233,106 controls. Compared with never using, the OR for melanoma associated with ever using indoor tanning beds was 1.16 (95% CI 1.05-1.28). Similar findings were identified in recent studies with enrollment occurring in the year 2000 onward (OR 1.22, 95% CI 1.03-1.45) and in subjects attending more than 10 tanning sessions (OR 1.34, 95% CI 1.05-1.71). Limitations The quality of evidence contributing to review results ranges from poor to mediocre. Conclusion Using tanning beds is associated with a subsequent melanoma diagnosis. Exposure from more than 10 tanning sessions is most strongly associated and there was no statistically significant difference in this association before and after 2000, suggesting that newer tanning technology is not safer than older models. © 2014 by the American Academy of Dermatology, Inc. Source

This study critically reviewed empirical literature examining nutrition education intervention studies with community-dwelling older adults over the period 2003-2012 to: (1) determine the number, (2) evaluate the research designs, and (3) report the study outcomes. A search of online databases yielded 74 studies six of which met our criteria. The studies reported favorable intervention outcomes. Because of the number, variability in the types, designs, measures, scope, educational and behavioral strategies, results can only inform future studies and encourage scholars to use strong evaluation design. We recommend the utilization of an ecological conceptual model when conducting nutrition interventions studies and discussed implications in terms of research and practice. © 2013 Springer Science+Business Media New York. Source

Kinfu Y.,University of Canberra | Sawhney M.,One Public
BMC Health Services Research | Year: 2015

Background: Institutional delivery is one of the key and proven strategies to reduce maternal deaths. Since the 1990s, the government of India has made substantial investment on maternal care to reduce the huge burden of maternal deaths in the country. However, despite the effort access to institutional delivery in India remains below the global average. In addition, even in places where health investments have been comparable, inter- and intra-state difference in access to maternal care services remain wide and substantial. This raises a fundamental question on whether the sub-national units themselves differ in terms of the efficiency with which they use available resources, and if so, why? Methods: Data obtained from round 3 of the country's District Level Health and Facility Survey was analyzed to measure the level and determinants of inefficiency of institutional delivery in the country. Analysis was conducted using spatial stochastic frontier models that correct for heterogeneity and spatial interactions between sub-national units. Results: Inefficiency differences in maternal care services between and within states are substantial. The top one third of districts in the country has a mean efficiency score of 90 per cent or more, while the bottom 10 per cent of districts exhibit mean inefficiency score of as high as over 75 per cent or more. Overall mean inefficiency is about 30 per cent. The result also reveals the existence of both heterogeneity and spatial correlation in institutional delivery in the country. Conclusions: Given the high level of inefficiency in the system, further progress in improving coverage of institutional delivery in the country should focus both on improving the efficiency of resource utilization-especially where inefficiency levels are extremely high-and on bringing new resources in to the system. The additional investment should specifically focus on those parts of the country where coverage rates are still low but efficiency levels are already at a high level. In addition, given that inefficiency was also associated inversely with literacy and urbanization and positively related with proportion of households belonging to poor households, investment in these areas can also improve coverage of institutional delivery in the country. © 2015 Kinfu and Sawhney; licensee BioMed Central. Source

It used to cost a lot of money to license a solid Facebook marketing platform, but One Public thinks even small businesses should be able to afford these tools. So today with TechCrunch it launches PageCentrex, a free platform for self-serve management of Pages, ads, Insights, ecommerce, and social CRM from a single interface. For businesses with more money to spend, it offers an enterprise managed service with custom app development. This disruptive shift to free has been a long time coming.  It’s not just deep pocketed brands doing Facebook marketing anymore. The long-tail of local business, SMBs, and fledgling brands have arrived. Facebook’s marketing capabilities are getting more powerful but also more complicated. With last week’s launch of Timelime for Pages, brands need to be thinking about which posts to pin and feature. Sponsored Stories can now appear in the news feed on web and mobile, and businesses need to know which posts they should pay to amplify. Real-time analytics, offsite Facebook integrations, e-commerce — there’s too much to handle effectively without tools. One Public’s PageCentrex might not be perfect, but it will probably be sufficient for many. Enterprises meanwhile need to stand out. For them, platforms can produce somewhat cookie-cutter apps. One Public’s custom app development can help a brand create experiences unique to their business that can work as a supplement to a top tier social marketing platform. I admire the zeal of One Public’s founder Fahad Khan. It takes guts to try and release such a range of products through a bootstrapped company with just 15 stateside employees and 50 in Lahore, Pakistan. I’m a bit skeptical he can pull it off, and I typically advise a “niche to win” strategy. However, One Public has worked with some huge clients including Chrysler, Samsung, NBC, and Digitas. We’ll have to wait and see if the enterprise sales can support the free products. But in the meantime, smaller businesses can use PageCentrex to get serious about social without spending much.

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