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https://www.readbyqxmd.com/read/28432089/preparing-future-doctors-for-palliative-care-views-of-course-organisers
#1
Steven Walker, Jane Gibbins, Paul Paes, Stephen Barclay, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee
BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS: An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28421681/early-clinical-xenotransplantation-experiences-an-interview-with-thomas-e-starzl-md-phd
#2
REVIEW
David K C Cooper
Dr Thomas E. Starzl, who died on March 4, 2017, was one of the great pioneers of organ transplantation. He was also a pioneer in the field of xenotransplantation. In 1964, he carried out baboon kidney transplants in six patients with terminal renal disease for whom no living or deceased donor became available; graft survival was for 19-60 days, the grafts being lost largely through continuous complement activation. Between 1966 and 1974, he carried out one ex vivo liver perfusion and three orthotopic liver transplants using chimpanzees as sources of organs; graft survival was for <14 days...
March 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28418524/evaluating-testing-strategies-for-identifying-youths-with-hiv-infection-and-linking-youths-to-biomedical-and-other-prevention-services
#3
Robin Lin Miller, Cherrie B Boyer, Danielle Chiaramonte, Peter Lindeman, Kate Chutuape, Bendu Cooper-Walker, Bill G Kapogiannis, Craig M Wilson, J Dennis Fortenberry
Importance: Most human immunodeficiency virus (HIV)-infected youths are unaware of their serostatus (approximately 60%) and therefore not linked to HIV medical or prevention services. The need to identify promising and scalable approaches to promote uptake of HIV testing among youths at risk is critical. Objective: To evaluate a multisite HIV testing program designed to encourage localized HIV testing programs focused on self-identified sexual minority males and to link youths to appropriate prevention services after receipt of their test results...
April 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28382858/new-japanese-regulatory-frameworks-for-clinical-research-and-marketing-authorization-of-gene-therapy-and-cellular-therapy-products
#4
Sumimasa Nagai, Keiya Ozawa
In Japan, the Pharmaceuticals and Medical Devices Law was passed in 2014. In this new law, regenerative medical products were defined, and a conditional and term-limited approval system only for regenerative medical products was instituted. Gene therapy and adoptive cellular therapy are categorized as regenerative medical products. This law is intended for registration trials for marketing authorization. The Act on the Safety of Regenerative Medicine was also implemented in 2014. This act is intended for clinical research and medical practice involving processed cells other than registration trials...
April 6, 2017: Current Gene Therapy
https://www.readbyqxmd.com/read/28381721/regulatory-science-in-practice-pharmaceuticals-and-medical-devices-agency
#5
Taisuke Hojo
 Review, safety, and relief services of the Pharmaceuticals and Medical Devices Agency are primarily focused on scientifically evaluating pharmaceuticals, medical devices, and cellular and tissue-based products referring to their quality, efficacy, and safety, which requires a variety of scientific knowledge and methods. Pharmaceutical regulation should be established based on the most advanced scientific expertise at all times. In order to evaluate products that use cutting-edge technology such as induced pluripotent stem cells and information and communication technology adequately, since fiscal year 2012 the Science Committee has been established as a platform to exchange opinions among members from top-ranking domestic and international academia and to enhance personnel exchanges through the Initiative to Facilitate Development of Innovative Drugs...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#6
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28366309/hip-arthroplasty-for-fracture-vs-elective-care-one-bundle-does-not-fit-all
#7
Richard S Yoon, Siddharth A Mahure, Lorraine H Hutzler, Richard Iorio, Joseph A Bosco
BACKGROUND: To quantify how baseline differences in patients undergoing hip arthroplasty for fracture vs elective care potentially lead to significant differences in immediate health care outcomes and whether these differences affect feasibility of current bundled payment models. METHODS: New York Statewide Planning and Research Cooperative System database for the years 2000-2014. RESULTS: A total of 76,654 patients underwent total hip arthroplasty or hemiarthroplasty between 2010 and 2014; 82...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28359718/impact-of-surgeon-and-hospital-experience-on-outcomes-of-abdominal-aortic-aneurysm-repair-in-new-york-state
#8
Andrew J Meltzer, Peter H Connolly, Darren B Schneider, Art Sedrakyan
OBJECTIVE: This study aimed to assess the impact of the surgeon's and hospital's experience on the outcomes of open surgical repair (OSR) and endovascular aneurysm repair (EVAR) of intact and ruptured abdominal aortic aneurysms (AAAs) in New York State. METHODS: New York Statewide Planning and Research Cooperative System data were used to identify patients undergoing AAA repair from 2000 to 2011. Characteristics of the provider and hospital were determined by linkage to the New York Office of Professions and National Provider Identification databases...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28356772/chinese-health-care-system-and-clinical-epidemiology
#9
REVIEW
Yuelian Sun, Hans Gregersen, Wei Yuan
China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28353501/cooperative-extension-as-a-framework-for-health-extension-the-michigan-state-university-model
#10
Jeffrey W Dwyer, Dawn Contreras, Cheryl L Eschbach, Holly Tiret, Cathy Newkirk, Erin Carter, Linda Cronk
PROBLEM: The Affordable Care Act charged the Agency for Healthcare Research and Quality to create the Primary Care Extension Program, but did not fund this effort. The idea to work through health extension agents to support health care delivery systems was based on the nationally known Cooperative Extension System (CES). Instead of creating new infrastructure in health care, the CES is an ideal vehicle for increasing health-related research and primary care delivery. APPROACH: The CES, a long-standing component of the land-grant university system, features a sustained infrastructure for providing education to communities...
March 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28349240/the-human-gene-mutation-database-towards-a-comprehensive-repository-of-inherited-mutation-data-for-medical-research-genetic-diagnosis-and-next-generation-sequencing-studies
#11
REVIEW
Peter D Stenson, Matthew Mort, Edward V Ball, Katy Evans, Matthew Hayden, Sally Heywood, Michelle Hussain, Andrew D Phillips, David N Cooper
The Human Gene Mutation Database (HGMD(®)) constitutes a comprehensive collection of published germline mutations in nuclear genes that underlie, or are closely associated with human inherited disease. At the time of writing (March 2017), the database contained in excess of 203,000 different gene lesions identified in over 8000 genes manually curated from over 2600 journals. With new mutation entries currently accumulating at a rate exceeding 17,000 per annum, HGMD represents de facto the central unified gene/disease-oriented repository of heritable mutations causing human genetic disease used worldwide by researchers, clinicians, diagnostic laboratories and genetic counsellors, and is an essential tool for the annotation of next-generation sequencing data...
March 27, 2017: Human Genetics
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#12
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28335689/trends-of-occupational-hygiene-in-finland
#13
Rauno Pääkkönen, Milja Koponen
The aim of this work is to evaluate and describe the current status of, and prospects for, the future of occupational hygiene in Finland. The main sources of information include a seminar held in the annual meeting of Finnish Occupational Hygiene Society, and interviews with different stakeholders. Nanotechnology and other new materials, changing work environments, circular economy including green jobs, new medical methods, and advances of construction methods were recognised as future challenges. Future work opportunities for occupational hygiene experts included exposure assessments in indoor air surveys, private consulting and entrepreneurship in general, international activities, and product safety issues...
March 24, 2017: International Journal of Occupational Safety and Ergonomics: JOSE
https://www.readbyqxmd.com/read/28325238/radiation-oncology-quality-and-safety-considerations-in-low-resource-settings-a-medical-physics-perspective
#14
REVIEW
Jacob Van Dyk, Ahmed Meghzifene
The past few years have seen a significant growth of interest in the global radiation therapy (RT) crisis. Various organizations have quantified the need and are providing aid in support of addressing the shortfalls existing in many low-to-middle income countries. With the tremendous demand for new facilities, equipment, and personnel, it is very important to recognize the quality and safety challenges and to address them directly. An examination of publications on quality and safety in RT indicates a consistency in a number of the recommendations; however, these authoritative reports were generally based on input from high-resourced contexts...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28288623/assessment-of-hospital-length-of-stay-and-direct-costs-of-type-2-diabetes-in-hubei-province-china
#15
Dajie Chen, Shuai Liu, Xiaodong Tan, Qihan Zhao
BACKGROUND: The incidence of type 2 diabetes is increasing, creating a huge burden for China's social healthcare system. This study aimed to evaluate hospital length of stay (LOS) based on admission characteristics and direct costs correlated with various types of complications for type 2 diabetic inpatients in Hubei Province, China. METHODS: A total of 1528 inpatients diagnosed with type 2 diabetes discharged between April 1, 2013, and March 31, 2014, were included in this study...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28278358/health-seeking-behaviour-and-health-expenditure-in-adults-aged-45-years-and-older-in-china-2011-2013
#16
Jiasen Li, Xing Lin Feng
OBJECTIVES: To provide an assessment of China's progress to universal health care from the perspective of people-centred care. METHODS: We obtained data on 28,103 participants from the China Health and Retirement Longitudinal Study during 2011-2013. Logistic regressions and generalized linear models were used to analyse care-seeking behaviours and medical expenditure. RESULTS: Insurance coverage was 95.5% in 2013. Nearly 60% subjects in need of medical care were self-medicated...
March 9, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28271489/the-pyruvate-dehydrogenase-complex-and-related-assemblies-in-health-and-disease
#17
Olwyn Byron, John Gordon Lindsay
The family of 2-oxoacid dehydrogenase complexes (2-OADC), typified by the pyruvate dehydrogenase multi-enzyme complex (PDC) as its most prominent member, are massive molecular machines (Mr, 4-10 million) controlling key steps in glucose homeostasis (PDC), citric acid cycle flux (OGDC, 2-oxoglutarate dehydrogenase) and the metabolism of the branched-chain amino acids, leucine, isoleucine and valine (BCOADC, branched-chain 2-OADC). These highly organised mitochondrial arrays, composed of multiple copies of three separate enzymes, have been widely studied as paradigms for the analysis of enzyme cooperativity, substrate channelling, protein-protein interactions and the regulation of activity by phosphorylation ...
2017: Sub-cellular Biochemistry
https://www.readbyqxmd.com/read/28254998/association-of-centre-volume-and-in-hospital-mortality-in-heart-failure-hospitalisations
#18
Shivank Madan, Daniel Sims, Omar Saeed, Snehal R Patel, Jooyoung J Shin, Ulrich P Jorde
BACKGROUND: Centre volume is an important determinant of outcomes in patients requiring complex medical treatments or surgical procedures. Heart failure hospitalisation (HFH) has become an increasingly complex and resource intensive clinical event. We evaluated the effect of centre volume on mortality and costs in patients with HFH. METHODS: This was a retrospective registry-based analysis of adult patients discharged with a primary diagnosis of HF from hospitals across New York (NY) State over a 5-year period, between January 2009 and December 2013, using the Statewide Planning and Research Cooperative System inpatient discharge files...
March 2, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28252618/-the-progressive-models-of-educational-activities-as-a-basis-for-the-training-of-forensic-medical-experts-of-the-new-generation
#19
S A Smirnova, O A Yastrebov
The authors interpret forensic expertology as a synthetic science and propose the models for the training of professionals in the field of forensic medical expertise. They provide a rationale for the realization of such systematic training in the framework of the model of the three-level system based at the educational institutions of higher professional education. Characteristic features of the existing standards of professional training in the sphere of forensic medical expertise are considered with special reference to the organization of education of future forensic medical experts based at the many-level programs adopted in the Russian University of People's Friendship...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28242434/rural-general-surgery-a-38-year-experience-with-a-regional-network-established-by-an-integrated-health-system-in-the-midwestern-united%C3%A2-states
#20
Thomas H Cogbill, Marilu Bintz
BACKGROUND: General surgeon (GS) workforce shortages are predicted to worsen, particularly in rural areas. We report on a sustainable model for delivery of GS services within a large rural region that includes an integrated health system. STUDY DESIGN: We conducted a longitudinal study of a rural GS network from 1978 to 2016. Employment data and rural GS survey results were reviewed to document methods of recruitment, retention, and case-volume development. RESULTS: During the 38-year study period, 19 rural GSs were employed by the health system...
February 24, 2017: Journal of the American College of Surgeons
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