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Goal setting

Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
P Alex Smith, Yaxin Wang, Ralph W Metcalfe, Luiz C Sampaio, Daniel L Timms, William E Cohn, O H Frazier
PURPOSE: A minimally invasive, partial-assist, intra-atrial blood pump has been proposed, which would unload the left ventricle with a flow path from the left atrium to the arterial system. Flow modulation is a common strategy for ensuring washout in the pump, but it can increase power consumption because it is typically achieved through motor-speed variation. However, if a pump's performance curve had the proper gradient, flow modulation could be realized passively. To achieve this goal, we propose a pump performance operating curve as an alternative to the more standard operating point...
March 2018: International Journal of Artificial Organs
Lauren Brookman-Frazee, Chanel Zhan, Nicole Stadnick, David Sommerfeld, Scott Roesch, Gregory A Aarons, Debbie Innes-Gomberg, Lillian Bando, Anna S Lau
Evidence-based practice (EBP) implementation requires substantial resources in workforce training; yet, failure to achieve long-term sustainment can result in poor return on investment. There is limited research on EBP sustainment in mental health services long after implementation. This study examined therapists' continued vs. discontinued practice delivery based on administrative claims for reimbursement for six EBPs [Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Child-Parent Psychotherapy, Managing and Adapting Practices (MAP), Seeking Safety (SS), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and Positive Parenting Program] adopted in a system-driven implementation effort in public mental health services for children...
2018: Frontiers in Public Health
Nathan H Schumaker, Allen Brookes
Context: Simulation models are increasingly used in both theoretical and applied studies to explore system responses to natural and anthropogenic forcing functions, develop defensible predictions of future conditions, challenge simplifying assumptions that facilitated past research, and to train students in scientific concepts and technology. Researcher's increased use of simulation models has created a demand for new platforms that balance performance, utility, and flexibility. Objectives: We describe HexSim, a powerful new spatially-explicit, individual-based modeling framework that will have applications spanning diverse landscape settings, species, stressors, and disciplines (e...
February 1, 2018: Landscape Ecology
Ayesha Sohail, O A Bég, Zhiwu Li, Sebahattin Celik
The mathematics of imaging is a growing field of research and is evolving rapidly parallel to evolution in the field of imaging. Imaging, which is a sub-field of biomedical engineering, considers novel approaches to visualize biological tissues with the general goal of improving health. "Medical imaging research provides improved diagnostic tools in clinical settings and supports the development of drugs and other therapies. The data acquisition and diagnostic interpretation with minimum error are the important technical aspects of medical imaging...
March 12, 2018: Progress in Biophysics and Molecular Biology
Antonia-Sophie Skierka, Karin B Michels
BACKGROUND: In October 2013, the Declaration of Helsinki was revised a seventh time in its 50 year history. While it is the most widely accepted set of ethical principles for the protection of patients participating in medical research, the Declaration of Helsinki has also been subject of constant controversy. In particular, its paragraph on the use of placebo controls in clinical trials divides the research community into active-control and placebo orthodox proponents, both continuously demanding revisions of the Declaration of Helsinki in favour of their position...
March 15, 2018: BMC Medical Ethics
Qian-Wen Deng, Xiang-Dong Luo, Ya-Ling Chen, Yi Zhou, Fan-Tao Zhang, Biao-Lin Hu, Jian-Kun Xie
BACKGROUND: Low phosphorus availability is a major factor restricting rice growth. Dongxiang wild rice (Oryza rufipogon Griff.) has many useful genes lacking in cultivated rice, including stress resistance to phosphorus deficiency, cold, salt and drought, which is considered to be a precious germplasm resource for rice breeding. However, the molecular mechanism of regulation of phosphorus deficiency tolerance is not clear. RESULTS: In this study, cDNA libraries were constructed from the leaf and root tissues of phosphorus stressed and untreated Dongxiang wild rice seedlings, and transcriptome sequencing was performed with the goal of elucidating the molecular mechanisms involved in phosphorus stress response...
March 15, 2018: Biological Research
P Karen Simmavong, Loretta M Hillier, Robert J Petrella
Health eSteps is a pragmatic, evidence-based lifestyle prescription program aimed at reducing the rates of chronic disease, in particular, type 2 diabetes. A process evaluation was completed to assess the feasibility of the implementation of HealtheSteps in primary care and community-based settings across Canada. Key informant interviews (program providers and participants) were conducted to identify facilitators and barriers to implementation and opportunities for future program adaptation and improvement...
March 1, 2018: Health Promotion Practice
Nikki Kiyimba, Michelle O'Reilly, Jessica Nina Lester
The National Health Service (UK) offers initial screening appointments for children referred to child and adolescent mental health services to determine clinical need and assess risk. Conversation analysis was utilized on 28 video recordings of these assessments, lasting approximately 90 minutes each with a multidisciplinary team. This article focuses on the agenda setting strategies used to establish relevant goals with children and adolescents; specifically, the technique of offering 'three wishes'. For example, ' if you had three wishes, what would you like to make happen?' In cases where children initially volunteered an assessment-relevant wish, they tended not to articulate further wishes...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
Scott Vuocolo, Paul Balmer, William C Gruber, Kathrin U Jansen, Annaliesa S Anderson, John L Perez, Laura J York
Routine prophylactic vaccination and mass vaccination strategies have been used to control both endemic and epidemic disease caused by Neisseria meningitidis globally. This review discusses real-world examples of these vaccination strategies, their implementation, and outcomes of these efforts, with the overall goal of providing insights on how to achieve optimal control of meningococcal disease through vaccination in varied settings. Tailoring immunization programs to fit the needs of the target population has the potential to optimally reduce disease incidence...
March 15, 2018: Human Vaccines & Immunotherapeutics
Thomas A Haugen, Paul A Solberg, Carl Foster, Ricardo Morán-Navarro, Felix Breitschädel, Will G Hopkins
The aim of this study was to quantify peak age and improvements over the preceding years to peak age in elite athletic contestants according to athlete performance level, sex and discipline. Individual season bests for world-ranked top 100 athletes from 2002 to 2016 (14937 athletes and 57049 individual results) were downloaded from the International Association of Athletics Federations' web site. Individual performance trends were generated by fitting a quadratic curve separately to each athlete's performance and age data using a linear modeling procedure...
March 15, 2018: International Journal of Sports Physiology and Performance
Galina Gheihman, Tomi Jun, Grace J Young, Daniel Liebman, Krishan Sharma, Eileen Brandes, Barbara Ogur, David A Hirsh
BACKGROUND: Longitudinal clinical experiences are a common component of undergraduate medical curricula, yet these programs have not been systematically characterized in US medical schools. OBJECTIVE: Our study sought to identify and characterize longitudinal clinical programs (LCPs) in US medical schools and measure associations between programs' structures and goals. DESIGN: Using a mixed-methods approach, we conducted a secondary analysis of data from publicly available websites...
December 2018: Medical Education Online
Manoj Kumar Sharma, Thamil Selvan Palanichamy
Increase in the use of technology has led to an increase in various kinds of technological addictions. A range of psychological and behavioural theories has been proposed to explain technology addictions. These include learning theories, reward-deficiency hypothesis, impulsivity, cognitive-behavioural models and social skills deficiency theories. While no particular form of psychological intervention has been suggested as being the golden standard for its treatment, the most frequently investigated approaches have been cognitive behavioural therapy (CBT) and motivational enhancement therapy...
February 2018: Indian Journal of Psychiatry
Prasanthi Nattala, Pratima Murthy, K S Meena
A major goal of long-term management of substance use disorders is to empower recovering individuals in resisting drug use when confronted with real-world high-risk situations (cues). Since opportunities to reproduce and learn from real-life situations are limited in treatment settings, the key is to bring those real-world drug use cues to the treatment setting through vicarious learning. Cue-exposure approaches achieve this by presenting these cues while the usual drug-use response is prevented. This provides opportunity to practice how to deal with the cues before being discharged from the treatment setting...
February 2018: Indian Journal of Psychiatry
Fred Stephen Sarfo, Osei Sarfo-Kantanka, Sheila Adamu, Vida Obese, Jennifer Voeks, Raelle Tagge, Vipin Sethi, Bruce Ovbiagele
BACKGROUND: There is an unprecedented rise in the prevalence of stroke in sub-Saharan Africa (SSA). Secondary prevention guidelines recommend that antihypertensive, statin and antiplatelet therapy be initiated promptly after ischemic stroke and adhered to in a persistent fashion to achieve optimal vascular-risk reduction. However, these goals are seldom realized in routine clinical care settings in SSA due to logistical challenges. We seek to assess whether a polypill containing fixed doses of three antihypertensive agents, a statin and antiplatelet therapy taken once daily per os for 12 months among recent stroke survivors would result in carotid intimal thickness regression compared with usual care (UC)...
March 14, 2018: Trials
Bonnie L Westra, Steven G Johnson, Samira Ali, Karen M Bavuso, Christopher A Cruz, Sarah Collins, Meg Furukawa, Mary L Hook, Anne LaFlamme, Kay Lytle, Lisiane Pruinelli, Tari Rajchel, Theresa Tess Settergren, Kathryn F Westman, Luann Whittenburg
BACKGROUND:  Secondary use of electronic health record (EHR) data can reduce costs of research and quality reporting. However, EHR data must be consistent within and across organizations. Flowsheet data provide a rich source of interprofessional data and represents a high volume of documentation; however, content is not standardized. Health care organizations design and implement customized content for different care areas creating duplicative data that is noncomparable. In a prior study, 10 information models (IMs) were derived from an EHR that included 2...
January 2018: Applied Clinical Informatics
Alexandra Henteleff, Helena Wall
INTRODUCTION: HANS KAI is a unique health promotion intervention to improve participants' health by focussing on interrelated chronic disease prevention behaviours through peer support and strengthening of social support networks. The study objective was to determine the effectiveness of HANS KAI in an urban Canadian setting. METHODS: We used a mixed methods intervention research design that involved multiple sites from November 2010 to April 2015. Data was obtained from participant surveys as well as in-person interviews at zero, 6, 12 and 24 months...
March 2018: Health Promotion and Chronic Disease Prevention in Canada
Marie-Laure Amram, Pierre-Yves Dietrich, Florence Rochon, Mylène Bolmont, Francesco Bianchi-Demicheli
Cancer itself and its treatments can result in physical and/or psychological adverse events which include disorders of sexual health. Both clinicians and patients are reluctant to talk about sexual issues, body image or intimacy between partners. Barriers from the clinician's perspective include feeling inadequately trained, lack of time or privacy. On the patients' side, embarrassment or belief that their sexual health are an untreatable complication of their disease and its treatment are the main barriers...
March 14, 2018: Revue Médicale Suisse
Liliana Angelica Ponguta, Muneera Abdul Rasheed, Chin Regina Reyes, Aisha Khizar Yousafzai
The international community has set forth global targets that include calls for universal access to high-quality early childhood care and education (ECCE), as indicated in the United Nations' Sustainable Development Goals. One major impediment to achieving this target is the lack of a skilled workforce. In this paper, we argue the case for leveraging youth as an untapped resource for supplying the workforce the ECCE system needs. Youth comprise a large proportion of the global population, and historically, although youth experience higher unemployment rates than their adult counterparts, youth are important agents of social awareness, social transformation, and community mobilization in multiple global contexts...
March 2018: New Directions for Child and Adolescent Development
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