Study of Inappropriate Medication Prescribed to the Elderly Hospitalized Patients Using the START Screening Tool

Objectives Aging population is of global concern and care for the health and quality of life for people over 65 years of major issues and problems of today and the future will be . Medication is an essential component of care for elderly patients, and optimizing the treatment for elderly patients is challenging. The aim of this study was to evaluate the state of appropriate non-prescribed drugs in 60 elderly patients hospitalized in teaching and non-teaching hospitals in the University of Medical Sciences by using screening tool START. Methods & Materials This cross-sectional study included 400 randomly selected elderly patients of Parts common (CCU, ENT, ICU General, Orthopedics, Surgery General, The Internal) hospitalized within six months (from June to December 2013). The data from the hospital records of the selected patients were collected to determine the appropriate medications prescribed by the criterion START. The data was analyzed using software Excel 2013 and SPSS 18, and the relationship between variables was determined by using the chi-square test, Mann-Whitney, Spearman correlation coefficient, and Kolmogorov-Smirnov test. Results The average age of the elderly patients was 73.4 years. Cardiovascular disease had the largest prevalence (21.6%) and diabetes (3.0) had the lowest prevalence among the elderly patients. The total number of drugs prescribed for patients was 4744; of which, 158 patients (39.6%) were not prescribed with at least one appropriate medication. The most appropriate medications that were not prescribed according to START were related to bisphosphonates category (11.7% vs. 13.3%) and anti-diabetic category (8.3% vs. 11.4%) in non-training and training hospitals. There was a significant relationship between the average appropriate medication not prescribed and the length of stay of patients in teaching hospitals. The number of appropriate medication not prescribed with the increasing number of prescribed medications has increased significantly. Conclusion Since issues relating to the appropriate medications prescribed among the elderly can be serious, the drugs prescribed for the elderly are very important. Supervising the prescription, supply, and rational use of drugs is very vital and effective and as part of the health budget allocated to the drug. Therefore, hospitals can take advantage of physicians with medical consultants and expert opinions of clinical pharmacists in handling this problem

The association between adherence to alternative healthy Diet Index (AHEI) and severity, disability, duration, and frequency of migraine headache among women:a cross-sectional study

Abstract Background Migraine is a common brain disorder characterized by recurrent seizures lasting between 4 and 72 h. Dietary factors can affect migraine headaches. The Alternative Healthy Diet Index (AHEI) is a measure of diet quality and adherence to healthy dietary patterns. This study aimed to assess the association of adherence to AHEI and severity, disability, duration, and frequency of migraine headaches. Methods In this cross-sectional study, 266 women who suffered from migraines were selected. Usual dietary intakes were assessed using a semi-quantitative, 147-item, food frequency questionnaire (FFQ). AHEI was calculated based on FFQ. The Migraine Disability Assessments (MIDAS) and Visual Analog Scale (VAS) questionnaires were used to evaluate migraine disability, severity and the pain, duration and frequency of headaches. Results People with high adherence to AHEI, compared with low adherence, had a 43% reduction in headache duration in the crude model (OR = 0.57; 95% CI 0.34, 0.97; P = 0.03), which remained significant after adjusting for potential confounders (OR = 0.56; 95% CI 0.31, 0.99; P = 0.04). No association was found between the frequency of migraine and AHEI in both crude and adjusted models (OR = 1.19; 95% CI 0.66, 2.14; P = 0.55). In addition, no significant association was found between high adherence of AHEI and odds of severe and moderate headaches (P > 0.05). Conclusion The results of our study showed that people with high adherence of AHEI had a 43% reduction in duration of migraine. More studies are needed to evaluate and better understand this relationship

Disruption : a transdisciplinary user-centric framework for innovation through data design and analytics

University of Technology Sydney. Faculty of Engineering and Information Technology.While innovation has always been critical for competitiveness of businesses, fierce competition resulting from the global economy and constant waves of disruption has made innovation even more crucial for the survival of large organisations. Today, extremely large volumes of data from variety of sources are continuously created with immense speed. Containing deep information and insights into customer habits and needs, data has the potential to become a key enabler of competition and innovation. In the financial industry in particular, with no physical products, data is the most valuable asset that needs to be utilised to create competitive advantage and innovation. However, studies in literature as well as primary qualitative research that I have conducted in collaboration with Ernst and Young, reveal that financial institutions are falling short of exploiting data and analytics’ full potential for innovation and competition. This is due to the failure to discover high-value problems that may be solved using data analytics, which can have the potential to result in significant value for customers and business. The aim of this research is to develop and evaluate a holistic model that increases the probability of success of data analytics endeavours in large organisations, resulting in high value and innovative products and services. Using the research methodologies of interpretive case studies and grounded theory for data analysis, I derived the influencing factors for the success of developing innovation using data analytics and hence created a framework that mapped these success factors in a cohesive and clear way. The generated framework, referred to as Creative Data Analytics (CDA), provides a methodology that consists of both creative and analytical techniques which enable organisations to develop an end to end roadmap to creative data analytics innovations. The CDA Framework integrates customer needs and predictive data analytics, and directs the investigation of data towards an innovative solution with a higher probability of solving an important real customer need or business problem. The validity of the CDA framework was evaluated by conducting action research using three projects involving data analytics at the Commonwealth Bank of Australia. These projects were conducted according to the CDA framework principles and the degree of innovation of the solutions derived from these projects were evaluated qualitatively by interviewing managers and innovation experts involved in the projects

Study of Inappropriate Medication Prescribed to Elderly Hospitalized Patients Using the Screening Tool to Alert Doctors to Right Treatment

Objectives: Medication is an essential component of care for elderly patients, and optimizing their process of treatment is often a challenging task. The aim of this study was to evaluate the status of appropriate non-prescribed drugs in 60 elderly patients hospitalized in the teaching and non-teaching hospitals in the University of Medical Sciences employing the START screening tool. Methods & Materials: This cross-sectional study included 400 elderly patients who were randomly selected from various divisions of the hospital (CCU, ENT, ICU General, Orthopedics, Surgery General, and Internal) and were hospitalized within six months duration (from June to December 2013). The data of the selected patients were collected from the hospital records in order to determine the appropriate medications prescribed based on the criterion START. The data was analyzed- using software Excel 2013 and SPSS 18, and the relationship between the variables was determined using the chi-square test, Mann-Whitney, and Spearman correlation coefficient. Results: The average age of the elderly patients was reported to be 73.4 years. Cardiovascular disease had the largest prevalence (21.6%) and diabetes (3.0) had the lowest prevalence among the elderly patients. The total number of drugs prescribed for patients was 4744, of which 158 patients (39.6%) were not prescribed with at least one appropriate medication. In non-training and training hospitals, the most appropriate medications that were not prescribed according to START were related to the bisphosphonates (11.7% vs. 13.3%) and anti-diabetic (8.3% vs. 11.4%) categories. A significant relationship was noted between the average numbers of non-prescribed appropriate medications and the length of stay of patients in teaching hospitals.  Conclusion: Since issues relating to the appropriate medications prescribed among the elderly can have serious implications, the drugs prescribed for the elderly are very important. Supervising the prescription, supply, and rational use of drugs is very vital and effective and acts as an integral part of the health budget allocated to the drug. Therefore, hospitals need to readily consult with the trained physicians and consider the expert opinions of clinical pharmacists in handling this problem

Data_Sheet_1_The mediatory role of inflammatory markers on the relationship between the NOVA classification system and obesity phenotypes among obese and overweight adult women: a cross-sectional study.docx

BackgroundDiet and inflammation both play important roles in the occurrence of obesity. We aimed to investigate the role of inflammation in the development of both metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals.MethodsThis cross-sectional study included 221 overweight and obese women aged 18–56 years. The study assessed the metabolic health phenotypes of the participants using the Karelis criterion score. Additionally, dietary intakes were evaluated using a 147-item semi-quantitative questionnaire and the NOVA classification system (comprising 37 food groups and beverages). The study also collected and analyzed the blood parameters, as well as biochemical and anthropometric indices, for all participants.ResultsAmong the women included in the study, 22.9% had MHO phenotypes but 77.1% had MUHO phenotypes. A significant association between the third quartile of the NOVA classification system and the increased likelihood of having the MUHO phenotype was observed (OR = 1.40, 95% CI = 1.09–4.92, p = 0.04). Regarding the potential role of inflammatory markers, high-sensitivity C-reactive protein (hs-CRP) (p = 0.84), transforming growth factor-β (TGF-β) (p = 0.50), monocyte chemoattractant protein-1 (MCP-1) (p = 0.49), plasminogen activator inhibitor-1 (PAI-1) (p = 0.97), and homeostatic model assessment for insulin resistance (HOMA-IR) (p = 0.92) were found to be mediators.ConclusionWe observed a significant positive association between ultra-processed food (UPF) consumption and the MUHO phenotype in overweight and obese women. This association appeared to be mediated by some inflammatory markers, such as hs-CRP, TGF-β, MCP-1, PAI-1, and HOMA-IR. Additional studies are needed to validate these findings.</p