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Expanded practice

Michelle Wong, Esther Bejarano, Graeme Carvlin, Katie Fellows, Galatea King, Humberto Lugo, Michael Jerrett, Dan Meltzer, Amanda Northcross, Luis Olmedo, Edmund Seto, Alexa Wilkie, Paul English
Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities...
March 15, 2018: International Journal of Environmental Research and Public Health
Kenzie A Cameron, Elaine R Cohen, Joelle R Hertz, Diane B Wayne, Debi Mitra, Jeffrey H Barsuk
OBJECTIVES: The aims of the study were to identify perceived barriers and facilitators to central venous catheter (CVC) insertion among healthcare providers and to understand the extent to which an existing Simulation-Based Mastery Learning (SBML) program may address barriers and leverage facilitators. METHODS: Providers participating in a CVC insertion SBML train-the-trainer program, in addition to intensive care unit nurse managers, were purposively sampled from Veterans Administration Medical Centers located in geographically diverse areas...
March 14, 2018: Journal of Patient Safety
Da Wei Zhang, Jing Wei Li, Jia Xian Luo, Pei Man Xu, Li Cheng Wei, Dan Zhou, Wei Ming Xu, Dingsheng Yuan
It is essential to synthesize low-cost, earth-abundant bifunctional electrocatalysts
 for both hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) for
 water electrolysis. Herein, we present a one-step sulfurization method to fabricate
 Ni3S2 nanowires directly grown on Ni foam (Ni3S2 NWs/Ni) as such an electrocatalyst.
 This synthetic strategy has several advantages including facile preparation, low cost
 and even can be expanded to large-scale preparation in the practical application...
March 15, 2018: Nanotechnology
Nancy D Campbell
Using the ethical and legal concept of shared responsibility for healthy births, this article considers social, cultural, and historical contexts in which medicalization and criminalization have worked in tandem to widen surveillance in ways that intensify scrutiny of women's lives under the guise of child protection, bringing women who are pregnant, postpartum, or parenting under criminal justice control. Although pregnant and postpartum women are prime candidates for medication-assisted treatment (MAT), the expanding carceral system has not prioritized drug treatment or reproductive justice...
March 1, 2018: AMA Journal of Ethics
Christine Larsen, Mads Lange, Kim Jørgensen, Kristen Kistrup, Lone Petersen
In 2010, the Regional Council of the Capital Region of Denmark endorsed a vision of mental health services based on personal recovery, rehabilitation, and the involvement of caregivers. Programs to achieve this vision include hiring peer support workers, a Recovery College, and service user participation at the organizational level. This column describes a cornerstone of these initiatives-an education program in the recovery model for mental health professionals. In 2013-2014, the Capital Region implemented 148 workshops on recovery-oriented services for all practitioner staff in mental health services in the region...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Sebastian T Tong, Camille J Hochheimer, Wendy B Barr, Matteo Leveroni-Calvi, Nicholas M Lefevre, Jordyn T Wallenborn, Lars E Peterson
BACKGROUND AND OBJECTIVES: Prior research found that 24% of graduating family medicine residents intend to provide obstetrical deliveries, but only 9% of family physicians 1 to 10 years into practice are doing so. Our study aims to describe the individual and residency program characteristics associated with intention to provide obstetrical deliveries and prenatal care. METHODS: Cross-sectional data on 2014-2016 graduating residents were obtained from the American Board of Family Medicine certification examination demographic questionnaire that asked about intended provision of specific clinical activities...
March 8, 2018: Family Medicine
William R Phillips, Toby Keys
BACKGROUND AND OBJECTIVES: Primary care (PC) requires interprofessional teamwork and training. Although clinical training in PC settings is well developed in some professions, classroom teaching on the principles and practice of PC provides additional opportunities for interprofessional education. METHODS: We offered an elective one-credit classroom course on PC over 3 years, 2013 through 2015, enrolling students from dentistry, medicine, nursing, pharmacy, physician assistant, public health, social work, and other fields...
March 2018: Family Medicine
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue includes several excellent observational studies prompted by physicians' clinical questions. Many people use lots of menthol cough drops-does the menthol overall lengthen the cough duration? When should we intensify treatment of older individuals with diabetes? Do occipital nerve blocks work for acute migraine headaches? Did you know that the plantar fascia can rupture? What happens to those patients with chest pain but low pretest probability for serious cardiac disease who are admitted to the hospital? Acupuncture can work well-for the patients-but how can we incorporate it into the usual pace of the family medicine office? Is it a win-lose situation when medical assistant roles are expanded? How many practice sites do physicians have and does that make a difference in the number or type of health personnel shortage areas? What would you guess on the presence of humor in the medical office-more or less than half of the visits; introduced by doctors or patients; primary care or specialty doctors?...
March 2018: Journal of the American Board of Family Medicine: JABFM
Matthew C Bunte, Mehdi H Shishehbor
Endovascular therapy (EVT) of symptomatic peripheral artery disease (PAD) offers relief of symptoms and enhanced quality of life. Advancements in technique and technology have increased the feasibility and practicality of EVT, which now represents the preferred mode of revascularization over surgical procedures in many centers across the world. In this review, we consider the future of EVT in context of a rapidly expanding population of patients with symptomatic PAD.
March 10, 2018: Progress in Cardiovascular Diseases
Adriana Rodriguez, Anna S Lau, Blanche Wright, Jennifer Regan, Lauren Brookman-Frazee
BACKGROUND: Understanding program leader perspectives on the sustainment of evidence-based practice (EBP) in community mental health settings is essential to improving implementation. To date, however, much of the literature has focused on direct service provider perspectives on EBP implementation. The aim of this mixed-method study was to identify factors associated with the sustainment of multiple EBPs within a system-driven implementation effort in children's mental health services...
March 13, 2018: Implementation Science: IS
Zhi-Bei Qu, Ling-Fei Lu, Min Zhang, Guoyue Shi
Graphene and its derivatives were found to be efficient modulators of enzymes in various systems. However, the modulating mechanism was not well discussed for long time. Inspired by the artificial enzyme enhancing property of graphene oxide (GO) towards cytochrome c (cyt. c), we have successfully fabricated a protein/GO hybrid structure via a layer-by-layer (LbL) strategy. The obtained LbL assemblies showed great enhancement in peroxidase activity of cyt. c, as well as excellent stability, resistance to extreme environment change, and also possibility for recycling by simple centrifugation without any obvious activity loss...
March 13, 2018: ACS Applied Materials & Interfaces
Jian-An Li, Jinghong Zhou, Zhu Mao, Zongliang Xie, Zhan Yang, Bingjia Xu, Cong Liu, Xin Chen, Dingyang Ren, Hui Pan, Guang Shi, Yi Zhang, Zhenguo Chi
Persistent luminescence from purely organic materials is basically triggered by light and electricity, which largely confines its practical applications. Herein, we present a purely organic AIEgen that exhibited not only persistent photoluminescence, but also transient and persistent room-temperature mechanoluminescence. By simply turning on and off the UV lamp, tricolor emission switching between blue, white and yellow was also achieved. The data from single-crystal structure analysis and theoretical calculation suggest that mechanism of the observed persistent mechanoluminescence (pML) is correlated with the strong spin-orbit coupling of bromine atom, as well as the formation of H-aggregates and restriction of intramolecular motions in noncentrosymmetric crystal structure...
March 13, 2018: Angewandte Chemie
Lauren H Supplee, Jenita Parekh, Makedah Johnson
Precision medicine and precision public health focus on identifying and providing the right intervention to the right population at the right time. Expanding on the concept, precision prevention science could allow the field to examine prevention programs to identify ways to make them more efficient and effective at scale, including addressing issues related to engagement and retention of participants. Research to date on engagement and retention has often focused on demographics and risk factors. The current paper proposes using McCurdy and Daro (Family Relations, 50, 113-121, 2001) model that posits a complex mixture of individual, provider, program, and community-level factors synergistically affect enrollment, engagement, and retention...
March 12, 2018: Prevention Science: the Official Journal of the Society for Prevention Research
Cary Cuncic, Glenn Regehr, Heather Frost, Joanna Bates
INTRODUCTION: The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs). METHODS: We drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution...
March 12, 2018: Perspectives on Medical Education
Valentina Coccè, Anna Brini, Aldo Bruno Giannì, Valeria Sordi, Angiola Berenzi, Giulio Alessandri, Carlo Tremolada, Silvia Versari, Antonio Bosetto, Augusto Pessina
The adipose tissue is a good source of mesenchymal stromal cells that requires minimally invasive isolation procedures. To ensure reproducibility, efficacy, and safety for clinical uses, these procedures have to be in compliant with good manufacturing practices. Techniques for harvesting and processing human adipose tissue have rapidly evolved in the last years, and Lipogems® represents an innovative approach to obtain microfragmented adipose tissue in a short time, without expansion and/or enzymatic treatment...
2018: Stem Cells International
Rumina Hasan, Sadia Shakoor, Johanna Hanefeld, Mishal Khan
Many low- and middle-income countries facing high levels of antimicrobial resistance, and the associated morbidity from ineffective treatment, also have a high burden of tuberculosis. Over recent decades many countries have developed effective laboratory and information systems for tuberculosis control. In this paper we describe how existing tuberculosis laboratory systems can be expanded to accommodate antimicrobial resistance functions. We show how such expansion in services may benefit tuberculosis case-finding and laboratory capacity through integration of laboratory services...
March 1, 2018: Bulletin of the World Health Organization
Pooya Mobadersany, Safoora Yousefi, Mohamed Amgad, David A Gutman, Jill S Barnholtz-Sloan, José E Velázquez Vega, Daniel J Brat, Lee A D Cooper
Cancer histology reflects underlying molecular processes and disease progression and contains rich phenotypic information that is predictive of patient outcomes. In this study, we show a computational approach for learning patient outcomes from digital pathology images using deep learning to combine the power of adaptive machine learning algorithms with traditional survival models. We illustrate how these survival convolutional neural networks (SCNNs) can integrate information from both histology images and genomic biomarkers into a single unified framework to predict time-to-event outcomes and show prediction accuracy that surpasses the current clinical paradigm for predicting the overall survival of patients diagnosed with glioma...
March 12, 2018: Proceedings of the National Academy of Sciences of the United States of America
Arife Çimen Atalar, Yüksel Erdal, Betül Tekin, Muhammed Yıldız, Özlem Akdoğan, Ufuk Emre
BACKGROUND: Multiple sclerosis (MS) is a common chronic neurological disease that causes disability. MS can have various clinical manifestations, one of which is olfactory dysfunction. In clinical practice, olfactory disturbances are usually underdiagnosed. The aim of our study is to assess olfactory function and its relationship with MS disease duration, disability and cognition. METHOD: We assessed 31 MS patients and 24 healthy controls matched in sex and age at our MS outpatient clinic of the Istanbul Education and Research Hospital Neurology Department...
March 3, 2018: Multiple Sclerosis and related Disorders
Chunqing Lin, Chiao-Wen Lan, Li Li, Keming Rou
BACKGROUND: Methadone maintenance treatment (MMT) programs have expanded rapidly in China during the last decade. However, variance in service providers' practice may have an impact on the quality of care received by the patients. This study examined Chinese service providers' adherence to the MMT protocol and its associated factors. METHODS: The study used baseline data from a randomized intervention trial implemented in MMT clinics in five provinces of China. The data were collected from January 2012 to August 2013...
March 9, 2018: International Journal on Drug Policy
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