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Kenneth Munge, Stephen Mulupi, Edwine W Barasa, Jane Chuma
BACKGROUND: Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low- and middle-income countries (LMICs), and certainly not in Kenya. This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospital Insurance Fund (NHIF) as a case study. METHODS: We applied a principal-agent relationship framework, which identifies three pairs of principal-agent relationships (government-purchaser, purchaser-provider, and citizen-purchaser) and specific actions required within them to achieve strategic purchasing...
July 18, 2017: International Journal of Health Policy and Management
Gabriel T Bosslet, Bernard Lo, Douglas B White
The word futile has been a touchstone in debates regarding resolution of disputes regarding life-prolonging treatments since the 1980s. Here, we respond to several criticisms of the Multiorganization Policy Statement, "An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units" (Bosslet et al. 2015). This response highlights the need for a strict definition of the word futile in order to avoid undue treatment differences when end-of-life interventions are contested...
2018: Perspectives in Biology and Medicine
Cheryl Robbins, Sheree L Boulet, Isabel Morgan, Denise V D'Angelo, Lauren B Zapata, Brian Morrow, Andrea Sharma, Charlan D Kroelinger
PROBLEM/CONDITION: Preconception health is a broad term that encompasses the overall health of nonpregnant women during their reproductive years (defined here as aged 18-44 years). Improvement of both birth outcomes and the woman's health occurs when preconception health is optimized. Improving preconception health before and between pregnancies is critical for reducing maternal and infant mortality and pregnancy-related complications. The National Preconception Health and Health Care Initiative's Surveillance and Research work group suggests ten prioritized indicators that states can use to monitor programs or activities for improving the preconception health status of women of reproductive age...
January 19, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
Esther Jean Langdon, Luiza Garnelo
This paper contributes to the dialogue between the social sciences and social medicine in Latin America by exploring therapeutic pluralism in indigenous health policies and services in Brazil. It reviews recent anthropological research, concepts and current debates to critically examine Brazilian indigenous health policy and its concept of "differentiated care," which proposes articulation between official health practices and indigenous therapies. A number of contradictions and tensions are present in the structural organizational of the indigenous health subsystem at the national level and in the daily practices of health teams at the local level...
July 2017: Salud Colectiva
Francis K L Chan, Khean-Lee Goh, Nageshwar Reddy, Kazuma Fujimoto, Khek Yu Ho, Seiji Hokimoto, Young-Hoon Jeong, Takanari Kitazono, Hong Sik Lee, Varocha Mahachai, Kelvin K F Tsoi, Ming-Shiang Wu, Bryan P Yan, Kentaro Sugano
This Guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society for Digestive Endoscopy (APSDE). It was developed in response to the increasing use of antithrombotic agents (antiplatelet agents and anticoagulants) in patients undergoing gastrointestinal (GI) endoscopy in Asia. After reviewing current practice guidelines in Europe and the USA, the joint committee identified unmet needs, noticed inconsistencies, raised doubts about certain recommendations and recognised significant discrepancies in clinical practice between different regions...
March 2018: Gut
Janet Glowicz, Matthew Crist, Carolyn Gould, Heather Moulton-Meissner, Judith Noble-Wang, Tom J B de Man, K Allison Perry, Zachary Miller, William C Yang, Stephen Langille, Jessica Ross, Bobbiejean Garcia, Janice Kim, Erin Epson, Stephanie Black, Massimo Pacilli, John J LiPuma, Ryan Fagan
BACKGROUND: Outbreaks of health care-associated infections (HAIs) caused by Burkholderia cepacia complex (Bcc) have been associated with medical devices and water-based products. Water is the most common raw ingredient in nonsterile liquid drugs, and the significance of organisms recovered from microbiologic testing during manufacturing is assessed using a risk-based approach. This incident demonstrates that lapses in manufacturing practices and quality control of nonsterile liquid drugs can have serious unintended consequences...
January 9, 2018: American Journal of Infection Control
Des Gorman, T Michael Kashner
The authors propose that the provision of state-of-the-art, effective, safe, and affordable health care requires medical school graduates not only to be competent practitioners and scientists, but also to be policy makers and professional leaders. To meet this challenge in the era of big data and cloud computing, these graduates must be able to understand and critically interpret analyses of large, observational datasets from electronic health records, third party claims files, surveys, and epidemiologic health datasets...
December 26, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Esther Rincon, Francisco Monteiro-Guerra, Octavio Rivera-Romero, Enrique Dorronzoro-Zubiete, Carlos Luis Sanchez-Bocanegra, Elia Gabarron
BACKGROUND: Mobile phone health apps are increasingly gaining attention in oncological care as potential tools for supporting cancer patients. Although the number of publications and health apps focusing on cancer is increasing, there are still few specifically designed for the most prevalent cancers diagnosed: breast and prostate cancers. There is a need to review the effect of these apps on breast and prostate cancer patients' quality of life (QoL) and well-being. OBJECTIVE: The purposes of this study were to review the scientific literature on mobile phone apps targeting breast or prostate cancer patients and involving QoL and well-being (anxiety and depression symptoms) and analyze the clinical and technological characteristics, strengths, and weaknesses of these apps, as well as patients' user experience with them...
December 4, 2017: JMIR MHealth and UHealth
E Droog, C Foley, O Healy, C Buckley, M Boyce, S McHugh, J P Browne
BACKGROUND: There is an increasing tendency to reconfigure acute hospital care towards a more centralised and specialised model, particularly for complex care conditions. Although centralisation is presented as "evidence-based", the relevant studies are often challenged by groups which hold perspectives and values beyond those implicit in the literature. This study investigated stakeholder perspectives on the rationale for the reconfiguration of urgent and emergency care in Ireland. Specifically, it considered the hypothesis that individuals from different stakeholder groups would endorse different positions in relation to the motivation for, and goals of, reconfiguration...
October 26, 2017: International Journal of Health Planning and Management
Chitra Lalloo, Ushma Shah, Kathryn A Birnie, Cleo Davies-Chalmers, Jordan Rivera, Jennifer Stinson, Fiona Campbell
BACKGROUND: Recently, the use of smartphones to deliver health-related content has experienced rapid growth, with more than 165,000 mobile health (mHealth) apps currently available in the digital marketplace. With 3 out of 4 Canadians currently owning a smartphone, mHealth apps offer opportunities to deliver accessible health-related knowledge and support. Many individuals experience pain after surgery, which can negatively impact their health-related quality of life, including sleep, emotional, and social functioning...
October 23, 2017: JMIR MHealth and UHealth
Arunabh Talwar, Joe G N Garcia, Halley Tsai, Matthew Moreno, Tim Lahm, Roham T Zamanian, Roberto Machado, Steven M Kawut, Mona Selej, Stephen Mathai, Laura Hoyt D'Anna, Sonu Sahni, Erik J Rodriquez, Richard Channick, Karen Fagan, Michael Gray, Jessica Armstrong, Josanna Rodriguez Lopez, Vinicio de Jesus Perez
BACKGROUND: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. OBJECTIVES: The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research...
October 15, 2017: American Journal of Respiratory and Critical Care Medicine
Sandeep S Rakhra, Helen I Opdam, Laura Gladkis, Byron Arcia, Michael A Fink, John Kanellis, Peter S Macdonald, Gregory I Snell, David V Pilcher
OBJECTIVE: To determine the potential for organ donation after circulatory death (DCD) in Australia by applying ideal and expanded organ suitability criteria, and to compare this potential with actual DCD rates. DESIGN: Retrospective cohort study. Setting, methods: We analysed DonateLife audit data for patients aged 28 days to 80 years who died between July 2012 and December 2014 in an intensive care unit or emergency department, or who died within 24 hours of discharge from either, in the 75 Australian hospitals contributing data to DonateLife...
September 2, 2017: Medical Journal of Australia
Paulo Alexandre de Souza São Bento, Martha Cristina Nunes Moreira
This paper conjures up the centrality of the relational category of gender to shed a light on women's life narratives with a chronic disease named endometriosis. It aims to discuss the meaning of the illness experience of women with endometriosis in the interface with institutional violence. Based on Bertaux reference, in the Narratives of Life method, twenty women participated in this research. They were invited from two virtual spaces of discussion and gatherings about living with endometriosis. Interviews were conducted in person in the States of Rio de Janeiro, São Paulo and Minas Gerais circuit...
September 2017: Ciência & Saúde Coletiva
Kim Joergensen, Jeanette Praestegaard
Patient participation is one of the most prevalent focus areas in the Danish healthcare debate. Patient participation is generally presented as a fundamental democratic right, and is stated in an objective language with legal requirements for healthcare professionals to ensure that patients systematically participate in their own courses of care and treatment. In the research literature, it is not clear what is meant by 'patient participation', and several discourses on patient participation exist side by side...
September 21, 2017: Nursing Inquiry
Michael W Hess
Since 1998, the Global Initiative for Obstructive Lung Disease (GOLD) has worked with health care professionals, medical researchers, and public health officials around the world to optimize the prevention, treatment, and management of COPD. GOLD has continually worked to ensure COPD management strategy recommendations are aligned with current published research. The 2017 GOLD report represents a major revision to GOLD strategy guidelines, the first such major revision in the last 5 years. As such, the 2017 report has significant implications for the diagnosis of COPD, the management of stable disease, and the treatment of exacerbations...
November 2017: Respiratory Care
Jawad M Khalifeh, Haytham M A Kaafarani
CONTEXT AND AIMS: The evolving influence of social media in trauma, acute, and critical care surgery (TACCS) cannot be ignored. We sought to investigate the extent and patterns of use of social networks by major regional, national and international TACCS societies. MATERIALS AND METHODS: The two leading social networking sites, Facebook (FB) and Twitter (TW), were thoroughly examined for the presence of official accounts for each of the major TACCS societies. An official FB or TW account was defined as one which has a blue verified badge and/or is linked the society's official website...
July 2017: Journal of Emergencies, Trauma, and Shock
Evan P Kransdorf, Marcelo J Pando, Loren Gragert, Bruce Kaplan
HLAs are fundamental to the adaptive immune response and play critical roles in the cellular and humoral response in solid organ transplantation. The genes encoding HLA proteins are the most polymorphic within the human genome, with thousands of different allelic variants known within the population. Application of the principles of population genetics to the HLA genes has resulted in the development of a numeric metric, the calculated panel-reactive antibody (CPRA) that predicts the likelihood of a positive crossmatch as a function of a transplant candidate's unacceptable HLA antigens...
September 2017: Transplantation
Barbara C Hansen, Sylvia Gografe, Stacy Pritt, Kai-Lin Catherine Jen, Camille A McWhirter, Susan M Barman, Anthony Comuzzie, Molly Greene, Justin A McNulty, Daniel Eugene Michele, Naz Moaddab, Randall J Nelson, Karen Norris, Karen D Uray, Ron Banks, Karin N Westlund, Bill J Yates, Jerald Silverman, Kenneth D Hansen, Barbara Redman
Every institution that is involved in research with animals is expected to have in place policies and procedures for the management of allegations of noncompliance with the Animal Welfare Act and the U.S. Public Health Service Policy on the Humane Care and Use of Laboratory Animals. We present here a model set of recommendations for institutional animal care and use committees and institutional officials to ensure appropriate consideration of allegations of noncompliance with federal Animal Welfare Act regulations that carry a significant risk or specific threat to animal welfare...
October 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Stephen R Connor
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at
August 8, 2017: Journal of Pain and Symptom Management
Addmore Chadambuka, Leila Katirayi, Auxilia Muchedzi, Esther Tumbare, Reuben Musarandega, Agnes I Mahomva, Godfrey Woelk
BACKGROUND: Zimbabwe's Ministry of Health and Child Care (MOHCC) adopted 2013 World Health Organization (WHO) prevention of mother-to-child HIV transmission (PMTCT) guidelines recommending initiation of HIV-positive pregnant and breastfeeding women (PPBW) on lifelong antiretroviral treatment (ART) irrespective of clinical stage (Option B+). Option B+ was officially launched in Zimbabwe in November 2013; however the acceptability of life-long ART and its potential uptake among women was not known...
July 25, 2017: BMC Public Health
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