It is unclear to me how expanding surveillance will contribute to reducing the occurrence of birth defects; many countries, states, and provinces have robust surveillance programs but have not been able to use the data to affect periconceptional behaviors or exposures.
As a clergy spouse, I was amused to see this sentence: "In a particularly insightful interview, a seasoned pastor reminded us that 'clergy are people, too.'" I'm pretty sure that's true.
It is quite possible, and anecdotally, probable, that IM symptoms go undiagnosed unless there is a crisis. I'm glad to see this article say that "Many patients had ongoing abdominal discomforts since childhood, while others encountered a relatively sudden onset of symptoms leading to chronic episodes of abdominal pain."
I have long been puzzled by journals don't insist on these guidelines being followed before an article is accepted for publication. This would greatly improve the quality of peer-reviewed articles.
I have long been puzzled by journals don't insist on these guidelines being followed before an article is accepted for publication. This would greatly improve the quality of peer-reviewed articles.
There are two phenomena at work here--the influence of social desirability on revealing that one has a neuropsychiatric disorder to an interviewer, and the failure to obtain care for such disorders. It is interesting, however, that respondents would be unwilling to say that they were affected by a neuropsychiatric conditions, knowing that the field interviewer will be entering data from their Medicare and insurance statements, and would be able to draw that conclusion themselves.
"Clinicians should also be aware of the financial barriers to the therapies they recommend and how different patients may cope with the costs differently." This is enormously important, and an actionable conclusion/recommendation arising from this study. Both research and anecdotes suggest that prescribers rarely consider it their responsibility to ask about patients' ability to pay for the drugs they prescribe.
It is unfortunate that the survey information collected through the MCBS cannot be relied upon for determining outcomes among dual-eligibles. One has to wonder why the survey requires respondents to answer this question, rather than linking the administrative data before fielding it.
Given that NSAIDS may also pose an increased risk for birth defects, what alternatives should be or have been explored for treating fever in the first trimester?
The finding on daily contact with interviewers is interesting, but not clear as to whether supervisors are in contact with *every* interviewer *every* day, or whether they are in contact with *interviewers* every day.
I imagine these findings would vary a great deal by country, as they would be strongly affected by sociocultural norms regarding how acceptable it is to discuss one's income.
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