1,708 research outputs found
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A comparison of in-sample forecasting methods
In-sample forecasting is a recent continuous modification of well-known forecasting methods based on aggregated data. These aggregated methods are known as age-cohort methods in demography, economics, epidemiology and sociology and as chain ladder in non-life insurance. Data is organized in a two-way table with age and cohort as indices, but without measures of exposure. It has recently been established that such structured forecasting methods based on aggregated data can be interpreted as structured histogram estimators. Continuous in-sample forecasting transfers these classical forecasting models into a modern statistical world including smoothing methodology that is more efficient than smoothing via histograms. All in-sample forecasting estimators are collected and their performance is compared via a finite sample simulation study. All methods are extended via multiplicative bias correction. Asymptotic theory is being developed for the histogram-type method of sieves and for the multiplicatively corrected estimators. The multiplicative bias corrected estimators improve all other known in-sample forecasters in the simulation study. The density projection approach seems to have the best performance with forecasting based on survival densities being the runner-up
Medicinal Plants Used as Home Remedies: A Family Survey by First Year Medical Students
Background: There is a hierarchical organisation of knowledge in the use of medicinal plants in communities. Medicinal use knowledge starts in thehome and is passed on to family members. Next in the hierarchy are neighbours, village elders and finally, traditional healers being the mostknowledgeable. For primary health care this hierarchy is actively followed in seeking remedies for ailments.Materials and Methods: This study was a survey of medicinal plant knowledge from family members of 1st year medical students registered atWalter Sisulu University. A total of 206 first year medical students participated in this study in 2010 and 2011.Results: Results revealed 47 species used as home remedies, 32% of which are food plants. Leaves and roots were reported as most commonly used. The top five ailments managed at home were gastrointestinal problems (25 plants), wounds (19 plants), respiratory tract problems (19 plants), infections, including sexually transmitted diseases (19 plants) and pain including headaches (19 plants). Chronic diseases such as hypertension, diabetes, cancer and reproductive ailments also formed a large group of diseases self-managed at home (29 plants).Conclusion: Family members hold knowledge of medicinal plant use. From this study, first year medical students were made aware of the relationship between common ailments and associated home remedies. This study forms a basis for further study of medicinal plants to validate theiruse as medicinal remedies.Key words: medicinal plants, home remedies, medical students, South Afric
Summary of the 2020 focused updates to U.S. Asthma Management Guidelines: What has changed and what hasn\u27t?
Despite the availability of effective medications, the majority of pediatric and adult patients with persistent asthma have uncontrolled symptoms. This has been attributed to patient nonadherence and poor self-management, but clinicians also contribute through inaccurate assessment of asthma and lack of familiarity with best practice guidelines for medication management. Thus, improving patient outcomes will require improving clinical management by health care providers, including utilization of evidence-based practice guidelines. In this report, we briefly summarize key points of the national guidelines for asthma management and delineate important changes enacted by 2020 Expert Panel Report-4 updates. These include revised recommendations on the use of fractional exhaled nitric oxide testing, indoor allergen mitigation, bronchial thermoplasty, adjunctive immunotherapy, and important modifications to medication management that are likely to have widespread impact on prescribing throughout the United States. In particular, for all patients aged five years and older taking stepwise therapy levels 3–4, it is now recommended to use Single Maintenance and Reliever Therapy, whereas the use of intermittent inhaled corticosteroids (ICSs) administered at the same time as short-acting beta agonist is recommended for step 2 to reduce symptom burden, improve control, and minimize total ICS dose
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In-Sample Forecasting Applied to Reserving and Mesothelioma Mortality
This paper shows that recent published mortality projections with unobserved exposure can be understood as structured density estimation. The structured density is only observed on a sub-sample corresponding to historical calendar time. The mortality forecast is obtained by extrapolating the structured density to future calendar times using that the components of the density are identified within sample. The new method is illustrated on the important practical problem of forecasting mesothelioma for the UK population. Full asymptotic theory is provided. The theory is given in such generality that it also introduces mathematical statistical theory for the recent continuous chain ladder model. This allows a modern approach to classical reserving techniques used every day in any non-life insurance company around the globe. Applications to mortality data and non-life insurance data are provided along with relevant small sample simulation studies
Obstacles and Challenges to Implementing Multi-departmental QI at a Large, Academic Training Center-Lessons Learned from a HCV Screening Program
Objectives:
We aimed to double the HCV screening rate of ‘baby-boomers’ admitted to the medicine teaching service at Methodist Hospital over the course of 6 months and demonstrate improved linkage to care for HCV RNA+ individuals.
Initial efforts were a collaboration between Emergency Medicine, where faculty had experience implementing an HIV screening program, and Gastroenterology, a key stakeholder in linkage to care. Our pilot period coincided with new state regulations mandating that hospitals implement HCV screening for inpatients. These new regulations dramatically altered the scope and goals of the project.https://jdc.jefferson.edu/patientsafetyposters/1030/thumbnail.jp
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In-Sample Forecasting with Local Linear Survival Densities
In this paper, in-sample forecasting is defined as forecasting a structured density to sets where it is unobserved. The structured density consists of one-dimensional in-sample components that identify the density on such sets. We focus on the multiplicative density structure, which has recently been seen as the underlying structure of non-life insurance forecasts. In non-life insurance the in-sample area is defined as one triangle and the forecasting area as the triangle that 20 added to the first triangle produces a square. Recent approaches estimate two one-dimensional components by projecting an unstructured two-dimensional density estimator onto the space of multiplicatively separable functions. We show that time-reversal reduces the problem to two one-dimensional problems, where the one-dimensional data are left-truncated and a one-dimensional survival density estimator is needed. This paper then uses the local linear density smoother with 25 weighted cross-validated and do-validated bandwidth selectors. Full asymptotic theory is provided, with and without time reversal. Finite sample studies and an application to non-life insurance are included
Health-related internet use among adolescents with uncontrolled persistent asthma
Objectives
To describe internet use for health information among adolescents with uncontrolled persistent asthma, and to examine whether health-related internet use is associated with responsibility for home asthma management. Methods
We analyzed baseline data from the School-Based Asthma Care for Teens (SB-ACT) Trial, which included adolescents (12–16 years) in an urban school district who had uncontrolled persistent asthma per caregiver report. We asked adolescents whether they had ever used the Internet to look for health or medical information (Y/N). Teens then described family responsibility for 9 asthma management tasks (e.g. full caregiver responsibility, shared responsibility, or full teen responsibility). We examined responsibility sum scores in addition to responsibility for individual management tasks. We used bivariate and multivariate analyses to compare health-related internet use with participant characteristics, teen-reported asthma symptoms, and management responsibility. Results
We examined data for 425 adolescents (mean age 13.4 years). Almost half (45%) reported seeking health information on the Internet. In adjusted analyses, health-related internet use was strongly associated with teen responsibility (sum score and tasks relating to carrying and using medications); internet use was also more likely among teens who were older, female, or reported uncontrolled disease. Conclusions
Adolescents with persistent asthma who share responsibility for home management or report uncontrolled disease are more likely to seek health information online. Future interventions to support teens who co-manage asthma should work to engage patients in both clinical and digital spaces, and ensure that all patients can access accurate, patient-centered asthma information when needed
Prevention for oneself or others? Psychological and social factors that explain social distancing during the COVID-19 pandemic
Identifying the underlying psychological and social factors of social distancing is crucial to foster preventive behavior during a pandemic effectively. We investigated the relative contribution of self-focused factors (fear of infection, fear of punishment) and other-focused factors (moral judgment, moral identity, empathy for unspecific others, empathy for loved ones) in an online study in Germany (N = 246) while COVID-19 was climaxing. Importantly, other-oriented factors were related to social distancing behavior beyond self-oriented factors. Moral judgment and empathy for loved ones remained the dominant factors while controlling for all aspects. These findings underline the relevance of interpersonal considerations when engaging in preventive behavior
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