Key Points Question What is the effectiveness of universal self-regulation–based interventions to improve self-regulation and affect health and social outcomes in children and adolescents? Findings This systematic review and meta-analysis of 49 randomized clinical trials evaluating 50 self-regulation interventions found that these interventions were effective in children and adolescents. Positive outcomes on health and social measures such as academic achievement, social skills, mental health, behavioral problems, conduct disorders, school suspensions, and substance abuse was also reported. Meaning Self-regulation interventions can be effective in children and adolescents with possible benefits in health and social outcomes.
Background:Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors.Objective:To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles.Materials and Methods:The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors.Results:The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4%) drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79%) prescriptions, while injectable drugs were prescribed in 22 (1.6%) prescriptions. The prescription error score varied significantly across prescriber profiles.Conclusion:The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country.
Context:The Workload Indicators of Staffi ng Need (WISN) human resource planning and management tool, developed by Shipp (1998) and popularized by the World Health Organization (WHO), gives health managers a way to analyze and calculate correct staffi ng levels in health facilities. In present study, WISN tool was used to assess a District Hospital in terms of staffi ng of laboratory technicians to understand the staffi ng need against the existing workload of health system. Aims: To assess the staffi ng needs of laboratory technicians in District Hospital using WISN method. Settings and Design: Hospital-based cross-sectional study. Materials and Methods:The present study is a cross-sectional survey involving observation, record review, and personal interview. Study was performed in a District Hospital of Madhya Pradesh. There were six laboratory technicians in the District Hospital and all of them were included in the study. The staffi ng pattern and need of laboratory technicians in District Hospital was estimated and WISN indicators calculated. Statistical Analysis Used: Rate ratio and proportions were calculated using Microsoft Excel 2007. Results: WISN calculation showed that District Hospital in which the study was done requires 16 laboratory technicians in order to provide the volume of health services in its annual statistics in accordance with the professional standards (activity standards) for these services, thus having a shortage of 10 technicians. Conclusion: The laboratory technicians in the District Hospital where study was conducted are constantly under pressure to match the existing workload due to shortage of manpower. Appropriate human resources management and planning can contribute greatly to the improvement of effi ciency of their work by ensuring optimum workload.
Introduction The safety and acceptability of medical abortion using mifepristone and misoprostol at home at ≤9+0 weeks’ gestation is well established. However, the upper gestational limit at which the procedure remains safe and acceptable at home is not known. To inform a national guideline on abortion care we conducted a systematic review to determine what gestational limit for expulsion at home offers the best balance of benefits and harms for women who are having medical abortion. Material and methods We searched Embase, MEDLINE, Cochrane Library, Cinahl Plus and Web‐of‐Science on 2 January 2020 for prospective and retrospective cohort studies with ≥50 women per gestational age group, published in English from 1995 onwards, that included women undergoing medical abortion and compared home expulsion of pregnancies of ≤9+0 weeks’ gestational age with pregnancies of 9+1‐10+0 weeks or >10+1 weeks’ gestational age, or compared the latter two gestational age groups. We assessed risk‐of‐bias using the Newcastle‐Ottowa scale. All outcomes were meta‐analyzed as risk ratios (RR) using the Mantel‐Haenszel method. The certainty of the evidence was assessed using GRADE. Results Six studies (n = 3381) were included. The “need for emergency care/admission to hospital” (RR = 0.79, 95% confidence interval [CI] 0.45‐1.4), “hemorrhage requiring transfusion/≥500 mL blood loss” (RR = 0.62, 95% CI 0.11‐3.55), patient satisfaction (RR = 0.99, 95% CI 0.95‐1.03), pain (RR = 0.91, 95% CI 0.82‐1.02), and “complete abortion without the need for surgical intervention” (RR = 1.03, 95% CI 1‐1.05) did not differ statistically significantly between the ≤9+0 and >9+0 weeks’ gestation groups. The rates of vomiting (RR = 0.8, 95% CI 0.69‐0.93) and diarrhea (RR = 0.85, 95% CI 0.73‐0.99) were statistically significantly lower in the ≤9+0 weeks group but these differences were not considered clinically important. We found no studies comparing pregnancies of 9+1‐10+0 weeks’ gestation with pregnancies of >10+0 weeks’ gestation. The certainty of this evidence was predominantly low and mainly compromised by low event rates and loss to follow up. Conclusions Women who are having a medical abortion and will be taking mifepristone up to and including 10+0 weeks’ gestation should be offered the option of expulsion at home after they have taken the misoprostol. Further research needs to determine whether the gestational limit for home expulsion can be extended beyond 10+0 weeks.
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