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Demographic challenges

Julia Twichell, Richard Pollnac, Patrick Christie
International interest in increasing marine protected area (MPA) coverage reflects broad recognition of the MPA as a key tool for marine ecosystems and fisheries management. Nevertheless, effective management remains a significant challenge. The present study contributes to enriching an understanding of best practices for MPA management through analysis of archived community survey data collected in the Philippines by the Learning Project (LP), a collaboration with United States Coral Triangle Initiative (USCTI), United States Agency for International Development (USAID), and partners...
March 15, 2018: Environmental Management
Boon Phiaw Kho, Mohamed Azmi Hassali, Ching Jou Lim, Fahad Saleem
OBJECTIVES: The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. METHODS: Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations...
March 15, 2018: International Journal of Pharmacy Practice
Cecilia Siliansky de Andreazzi, Paulo R Guimarães, Carlos J Melián
Studies have shown the potential for rapid adaptation in coevolving populations and that the structure of species interaction networks can modulate the vulnerability of ecological systems to perturbations. Although the feedback loop between population dynamics and coevolution of traits is crucial for understanding long-term stability in ecological assemblages, modelling eco-evolutionary dynamics in species-rich assemblages is still a challenge. We explore how eco-evolutionary feedbacks influence trait evolution and species abundances in 23 empirical antagonistic networks...
March 14, 2018: Proceedings. Biological Sciences
Divya Ballal, Janardhana Navaneetham
BACKGROUND: Children of parents with mental illness are not routinely included in psychoeducational and supportive family interventions provided by adult mental health systems. The family, therefore, is an important and, sometimes, the only source of information and support for them. AIM: To understand the experiences of well parents in talking to their children about parental mental illness. METHOD: This article presents the findings of a qualitative study of the experiences of well parents in talking to their children about parental mental illness...
March 1, 2018: International Journal of Social Psychiatry
Eugene M Ko, Jonathan B McHugh
This clinicopathologic study of primary oral leiomyosarcoma of the buccal mucosa involves a literature review of 15 cases with the addition of our report of a case. The demographic details, tumor size, treatment and outcome are documented for all the cases. In addition, this review examines the histologic features of leiomyosarcoma while noting that differentiation from other spindle cell tumors can be challenging, underscoring the necessity of an immunohistochemical work up for an accurate diagnosis. The unpredictability of the clinical behavior of these aggressive tumors requires, at the very least, wide local surgical excision and prolonged follow up...
March 13, 2018: Head and Neck Pathology
Yueh-Min Liu, Hong-Jer Chang, Ru-Hwa Wang, Li-King Yang, Kuo-Cheng Lu, Yi-Chou Hou
Background: Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD)...
2018: Therapeutics and Clinical Risk Management
David W Morris, Subroto Ghose, Ella Williams, Kevin Brown, Fuad Khan
Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202)...
2018: Neuropsychiatric Disease and Treatment
Jennifer M Kolb, Pamela Argiriadi, Karen Lee, Xiaoyu Liu, Emilia Bagiella, Aimee L Lucas, Michelle Kang Kim, Nikhil A Kumta, Satish Nagula, Umut Sarpel, Christopher J DiMaio
BACKGROUND & AIMS: For patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs, cysts), it is a challenge to identify those at high risk for malignant lesions. We sought to identify factors associated with development of pancreatic cancer, focusing on neoplasm growth rate. METHODS: We performed a retrospective study of 189 patients with BD-IPMNs who underwent at least 2 contrast-enhanced cross-sectional imaging studies, 1 year or more apart, at a tertiary referral center from January 2003 through 2013...
March 10, 2018: Clinical Gastroenterology and Hepatology
Juan A Muñoz-Largacha, Katrina A Steiling, Hasmeena Kathuria, Marjory Charlot, Carmel Fitzgerald, Kei Suzuki, Virginia R Litle
BACKGROUND: Safety net hospitals provide care mostly to low-income, uninsured, and vulnerable populations, in whom delays in cancer screening are established barriers. Socioeconomic barriers might pose important challenges to the success of a lung cancer screening program at a safety net hospital. We aimed to determine screening follow-up compliance, rates of diagnostic and treatment procedures, and the rate of cancer diagnosis in patients classified as category 4 by the Lung CT Screening Reporting and Data System (Lung-RADS 4)...
February 9, 2018: Journal of Thoracic and Cardiovascular Surgery
David Ulrich Seidel, Jonas Jae-Hyun Park, Andreas M Sesterhenn, Karel Kostev
AIM: The aim of this study was to analyze the prevalence of dizziness- and vertigo-related diagnoses in ear, nose, and throat (ENT) practices in Germany and the associated demographic characteristics based on data from a representative nationwide practice database. METHOD: The study sample included patients from 138 ENT practices in Germany who received dizziness- and vertigorelated diagnoses (ICD-10 code) between January 2012 and December 2015. Collected parameters included age, sex, insurance status, prescribed medication (anatomical therapeutic chemical [ATC] class), and referrals to other specialists and hospitals...
April 2018: Otology & Neurotology
Anna E Kornadt, Peggy Voss, Klaus Rothermund
Demographic changes have been linked to the expectation of cuts in government-provided social security services, emphasizing individual responsibility to prepare for old age and concomitant challenges and changes. Accordingly, the identification of psychological variables predicting preparation is a matter of theoretical as well as practical importance. We thus consider different aspects of a person's future time as theoretically prominent psychological predictors of preparation. The subjectively perceived quantity of remaining lifetime, the concreteness of future time, and preparation for life domains indicative of an active third age as well as of a more dependent fourth age were assessed in a longitudinal study in a core sample of N  = 593 participants (30-80 years old at T 1 ) at two measurement occasions 4 years apart...
March 2018: European Journal of Ageing
Helle Wessel Andersson, Aslak Steinsbekk, Espen Walderhaug, Eli Otterholt, Trond Nordfjærn
Introduction: Dropout from inpatient treatment for substance use disorder (SUD) is an ongoing challenge. The aim of this study was to identify demographic, substance use, and psychological factors that predict dropout from postdetoxification inpatient SUD treatment. Materials and methods: A total of 454 patients from 5 inpatient SUD centers in Central Norway were consecutively included in this naturalistic, prospective cohort study. Results: A total of 132 patients (28%) did not complete the planned treatment stay (dropped out)...
2018: Substance Abuse: Research and Treatment
Richa Aggarwal, Neha Rastogi, Purva Mathur, Kapil Dev Soni, Subodh Kumar, Amit Gupta, Sushma Sagar
Introduction: There have been isolated case reports and reports of outbreak of colistin-resistant Klebsiella from various parts of the world but only two from India and that too from oncology centers. We report cluster of colistin-resistant Klebsiella pneumonia bloodstream infection cases from our surgical trauma Intensive Care Unit. Methodology: The study was carried out in surgical ICU of Level-I trauma center. Retrospective analysis of all the five patients with CRK was done...
February 2018: Indian Journal of Critical Care Medicine
Gang Fang, Bin Chen, Weiguo Fu, Daqiao Guo, Xin Xu, Junhao Jiang, Jianjun Luo, Zhihui Dong
OBJECTIVE: Endovascular treatment (ET) is being increasingly used for splenic artery aneurysms (SAAs), but systematic treatment strategies have not been defined. We set out to investigate the optimal strategies for ET of complicated SAAs (CSAAs). METHODS: CSAAs were classified into three types: type I, rupture or impending rupture; type II, at the origin of the splenic artery; and type III, having an aberrant splenic artery from the splenomesenteric trunk (type IIIA) or celiacomesenteric trunk (type IIIB)...
March 9, 2018: Journal of Vascular Surgery
Ahmed Siddiqi, Nicole E George, Peter B White, Bartlomiej W Szczech, John V Thompson, Jennifer I Etcheson, Chukwuweike U Gwam, Alexander T Caughran, Ronald E Delanois, James Nace
INTRODUCTION: Periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) is a challenging complication for surgeons and patients alike. Although two-stage revision arthroplasty remains the gold standard PJI management in the United States, one-stage revision has had success in many parts of Europe. The aim of this study was to retrospectively review: 1) ultimate treatment success; 2) necessary antibiotic duration; 3) change in knee range of motion (ROM); and 4) final Knee Society Scores (KSS) in a case series of patients managed with retention of articulating antibiotic spacers following PJI...
March 12, 2018: Surgical Technology International
B Josea Kramer, Beth Creekmur, Michael N Mitchell, Debra Saliba
BACKGROUND/OBJECTIVES: Home-based primary care (HBPC) is a comprehensive, interdisciplinary program to meet the medical needs of community-dwelling populations needing long-term care (LTC). The U.S. Department of Veterans Affairs (VA) expanded its HBPC program to underserved rural communities, including American Indian reservations, providing a "natural laboratory" to study change in access to VA LTC benefits and utilization outcomes for rural populations that typically face challenges in accessing LTC medical support...
March 12, 2018: Journal of the American Geriatrics Society
Cedric W Pluguez-Turull, Jennifer E Nanyes, Cristina J Quintero, Hamza Alizai, Daniel D Mais, Kenneth A Kist, Nella C Dornbluth
Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast entity characterized by lobulocentric granulomas. IGM has a persistent or recurrent disease course and affects parous premenopausal women with a history of lactation. It has also been associated with hyperprolactinemia. The most common clinical sign is a palpable tender mass. However, the nonspecific manifestations and varied demographic features of this condition, as well as the other similar-appearing and superimposed breast entities, pose substantial diagnostic challenges...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Clare Morris, Tim Swanwick
INTRODUCTION: Postgraduate medical education takes place almost entirely in the clinical workplace, supported by healthcare professionals who strive to combine service and educational roles. Over the past decade, we have witnessed the emergence and growth of new forms of educational activity within postgraduate medical education. Under the umbrella term of "faculty development", these activities move beyond a narrow emphasis on "teaching the teachers to teach" to a wide range of interventions focused on enhancing educational climate, educational infrastructure and educational practices within and across healthcare organizations...
March 11, 2018: Medical Teacher
Agnes Norbury, Ben Seymour
Response rates to available treatments for psychological and chronic pain disorders are poor, and there is a considerable burden of suffering and disability for patients, who often cycle through several rounds of ineffective treatment. As individuals presenting to the clinic with symptoms of these disorders are likely to be heterogeneous, there is considerable interest in the possibility that different constellations of signs could be used to identify subgroups of patients that might preferentially benefit from particular kinds of treatment...
2018: F1000Research
Narges Alianmoghaddam, Suzanne Phibbs, Cheryl Benn
PURPOSE: Scant published qualitative literature exists focusing on why exclusive breastfeeding rates decline between three and six months. This study aims to develop an understanding of why exclusive breastfeeding tails off so dramatically between three and six months after birth in New Zealand. DESIGN AND METHODS: A generic qualitative methodology was employed in this study and social constructionism selected as the main epistemological framework underpinning the research...
March 2018: Journal of Pediatric Nursing
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