The Experts below are selected from a list of 108 Experts worldwide ranked by ideXlab platform
Jayne Webster - One of the best experts on this subject based on the ideXlab platform.
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intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy user acceptability
Malaria Journal, 2010Co-Authors: Lucy Smith, Caroline Jones, Rose Odotei Adjei, Gifty D Antwi, Nana A Afrah, B M Greenwood, Daniel Chandramohan, Harry Tagbor, Jayne WebsterAbstract:Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial. Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results. Five main themes emerged from participants' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker Attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor. Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy. The women were more concerned about quality of services received, in particular the polite and Patient Attitude of health staff, and positive health implications for themselves and their babies than about the nature of the intervention.
Harry Tagbor - One of the best experts on this subject based on the ideXlab platform.
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intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy user acceptability
Malaria Journal, 2010Co-Authors: Lucy Smith, Caroline Jones, Rose Odotei Adjei, Gifty D Antwi, Nana A Afrah, B M Greenwood, Daniel Chandramohan, Harry Tagbor, Jayne WebsterAbstract:Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial. Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results. Five main themes emerged from participants' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker Attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor. Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy. The women were more concerned about quality of services received, in particular the polite and Patient Attitude of health staff, and positive health implications for themselves and their babies than about the nature of the intervention.
Sedat Altug - One of the best experts on this subject based on the ideXlab platform.
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Patient Attitudes towards chemotherapy and survival: A prospective observational study in advanced non-small cell lung cancer
Lung Cancer, 2009Co-Authors: Jaromír Roubec, Shekhar Patil, Danail Damyanov, Teena M. West, Belinda J. Hall, Sedat AltugAbstract:This multicenter, non-interventional, prospective, observational study aimed to determine whether Patients’ Attitude to chemotherapy is an independent prognostic factor for survival in Patients with advanced non-small cell lung cancer (NSCLC) who are treated with gemcitabine–platinum. Chemonaive Patients (n = 1895) with stage IIIB or IV NSCLC not amenable to curative surgery or radiotherapy were treated with a combination of gemcitabine plus cisplatin/carboplatin and followed for a maximum of 18 months. Patients’ Attitude to treatment was measured on a 5-point scale and responses were used to assign Patients to one of the three need categories: A, maximum extension of survival with the acceptance of high toxicity (60.0% of Patients); B, maximum extension of survival only if coupled with normal lifestyle (26.1%); C, relief of symptoms (13.8%). Median survival varied significantly among the need categories (A = 13.00 months, B = 15.70 months, C = 15.33 months; log-rank test P = 0.0415). Patient Attitude to treatment (need categories) was not a significant prognostic factor for survival after adjusting for known prognostic factors (P = 0.0503). After adjusting for baseline differences, Patients in this study had a significantly lower risk of death than Patients in three randomized trials (hazard ratio 0.879; 95% confidence interval: 0.775, 0.998; P = 0.0458). In conclusion, in this observational study, Patient Attitude to chemotherapy was not an independent prognostic factor of survival.
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Patient Attitude and survival in advanced non-small cell lung cancer (NSCLC): Results of a prospective observational study
Journal of Clinical Oncology, 2006Co-Authors: Sedat Altug, Jaromír Roubec, Shekhar Patil, Danail Damyanov, L. Wang, Keunchil Park, William H.h. ReeceAbstract:7148 Background: A physician’s ability to accurately identify a Patient’s Attitude toward treatment is critical. The primary objective of this study (B9E-AA-JHSH) was to evaluate Patient Attitudes as predictors of survival independently of currently known predictive variables, and secondarily, whether physician-assessed Patient Attitudes differed from Patient-assessed Attitudes. Methods: This was a non-interventional, prospective, observational study of Patients from 19 countries of Asia, Central Eastern Europe, and Latin America. Eligible Patients had stage IIIB/IV NSCLC not amenable to curative surgery/radiotherapy, gemcitabine and cis/carboplatin as part of treatment, and were chemonaive. Physicians and Patients used a 7-item questionnaire to assign Patient Attitudes to 1 of 4 categories using a pre-defined algorithm: A = Cure; B = Maximum extension of survival with acceptance of high toxicity; C = Maximum extension of survival only if coupled with normal lifestyle; and D = Symptom relief. Enrolled Patients were followed until 18 months from enrolment, death, or loss to follow up. Results: From Sept 2002 to Dec 2003, 1,985 Patients were enrolled; the majority were male (73.4%), <70 yrs (83.9%), and had stage IV disease (79.2%), PS 0–1 (79.2%), and tumor-related symptoms (89.2%). Distribution of Patient-assessed Attitudes were A = 0%, B = 55%, C = 25%, and D = 20%. From category B-D, median survival (B = 14.6 months, C = 13.5, D = 12.5) and 1-year survival (B = 57.6%, C = 56.2%, D = 51.2%) both decreased but the differences were not statistically significant. Adjustment for known predictive variables eliminated this decreasing trend. Physician-assessed Patient Attitudes were lower than Patient-assessed Attitudes (p < .0001); however, the difference was less for Patients with disease-related symptoms (p = .03). Conclusions: This is the largest analysis to date of Patient Attitudes when treated with gemcitabine and cis/carboplatin. Patient Attitudes were not significant predictors of survival; however, physicians do underestimate Patients’ desire for extended survival compared to symptom relief. Also, it was interesting to see a comparatively longer median and 1-year survival in routine practice compared to reports in clinical trial settings. [Table: see text]
Lucy Smith - One of the best experts on this subject based on the ideXlab platform.
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intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy user acceptability
Malaria Journal, 2010Co-Authors: Lucy Smith, Caroline Jones, Rose Odotei Adjei, Gifty D Antwi, Nana A Afrah, B M Greenwood, Daniel Chandramohan, Harry Tagbor, Jayne WebsterAbstract:Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial. Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results. Five main themes emerged from participants' experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker Attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor. Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy. The women were more concerned about quality of services received, in particular the polite and Patient Attitude of health staff, and positive health implications for themselves and their babies than about the nature of the intervention.
P I Leppard - One of the best experts on this subject based on the ideXlab platform.
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intra operative Patient controlled sedation and Patient Attitude to control a crossover comparison of Patient preference for Patient controlled propofol and propofol by continuous infusion
Anaesthesia, 1994Co-Authors: G A Osborne, G E Rudkin, D A Jarvis, I G Young, J Barlow, P I LeppardAbstract:Summary Intra-operative Patient controlled sedation with propofol (bolus dose 18 mg over 5.4 s; lockout period 1 min) has been compared 10 continuous propofol infusion (3.6 nig.kg−1.h−1) in a randoniised crossover study of 38 ASA 1 or 2 day surgery Patients mdergoing two-stage bilateral extraction of third molar teeth under local anaesthesia (76 procedures). Mean (SD) propofol used (mg.kg−1) was less with Patient-controlled sedation (2.39 (1.28)) than with the infusion (2.58 (0.84)) but the difference was not statistically signifcant. There were only minor differences between the methods in postoperative recovery of cognitive tirnction and no differences for Patient cooperation and surgeon's satisfaction with sedation. Patient-controlled sedation was preferred by 19 Patients, continuous infusion by 10, with nine indifferent. Preferences, expressed as mild, moderate or strong, were significantly stronger for Patient-controlled sedation (p < 0.05). Sedation was no deeper than eyelid closure with response ro command in all 76 procedures. This level was reached in all 38 infusion cases but in only 26 cases with Patient-controlled sedation, where 12 Patients remained less sedated (p < 0.01). Patient-controlled sedation with propofol provided safe sedation and was strongly preferred over the infusion by a large proportion of Patients.