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Current healthcare issues

Justin M Curley, Coleen Crouch, Joshua E Wilk
Introduction: Medical readiness for deployment is arguably the most important component of personnel readiness in the U.S. Army. Administrative documents called profiles provide individualized medical recommendations to the commander regarding how to best provide for a soldier's health and welfare, and contribute to an aggregated enumeration of a unit's overall readiness to deploy. Profiles that convey behavioral health (BH) limitations thus reflect what can be called the "behavioral health readiness" of the force...
March 14, 2018: Military Medicine
Paul J Choi, Joe Iwanaga, R Shane Tubbs, Emre Yilmaz
Owing to its rarity, rhabdomyosarcoma of the head and neck (HNRMS) has seldom been discussed in the literature. As most of the data is based only on the retrospective experiences of tertiary healthcare centers, there are difficulties in formulating a standard treatment protocol. Moreover, the disease is poorly understood at its pathological, genetic, and molecular levels. For instance, 20% of all histological assessment is inaccurate; even an experienced pathologist can confuse rhabdomyosarcoma (RMS) with neuroblastoma, Ewing's sarcoma, and lymphoma...
January 9, 2018: Curēus
Gwendolien Vanderschaeghe, Kris Dierickx, Rik Vandenberghe
BACKGROUND: Today, many healthcare or dementia organizations, clinicians, and companies emphasize the importance of detection of Alzheimer's disease in an early phase. This idea has gained considerable momentum due to the development of biomarkers, the recent FDA and EMA approval of three amyloid tracers, and the failure of a number of recent therapeutic trials conducted in the early dementia phase. On the one hand, an early etiological diagnosis can lead to early and more efficacious intervention...
March 12, 2018: Journal of Bioethical Inquiry
Nilanjan Dey, Amira S Ashour, Fuqian Shi, Simon James Fong, João Manuel R S Tavares
Medical cyber-physical systems (MCPS) are healthcare critical integration of a network of medical devices. These systems are progressively used in hospitals to achieve a continuous high-quality healthcare. The MCPS design faces numerous challenges, including inoperability, security/privacy, and high assurance in the system software. In the current work, the infrastructure of the cyber-physical systems (CPS) are reviewed and discussed. This article enriched the researches of the networked Medical Device (MD) systems to increase the efficiency and safety of the healthcare...
March 10, 2018: Journal of Medical Systems
Paul Charles Cheshire, Stephen Gibbons, Jemma Mouland
BACKGROUND: The National Health Service (NHS) scores well internationally on access to healthcare. But access has been measured on methods likely to undersample the more disadvantaged. Social landlords have access to more disadvantaged groups and may be able to improve health outcomes for their tenants and reduce their NHS usage by simple interventions. METHODS: This is a randomised controlled trial of 547 London social housing 'general needs' tenants over 50 years of age...
March 8, 2018: Journal of Epidemiology and Community Health
Courtney Morris, Kathy E Green, Lilian L Chimuma
OBJECTIVE: Pilot study to assess psychometric indices of the Current Opioid Misuse Measure (COMM). DESIGN: Correlational. SETTING: Patients with varied chronic pain from a family healthcare center. PATIENTS: Inclusion criteria were over 21 years of age and prescribed opioids for any-origin noncancer pain; 46 patients were enrolled. OUTCOME MEASURE(S): The COMM, the Pain Self-Efficacy Questionnaire (PSE-Q), and the Patient Health Questionnaire-9 (PHQ-9) and a demographic -questionnaire...
January 2018: Journal of Opioid Management
Robert Basaza, Alison Kinegyere, Boniface Mutatina, Nelson Sewankambo
OBJECTIVES: The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. METHODS: We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies...
January 2018: International Journal of Technology Assessment in Health Care
Ilker Uckay, Francois R Jornayvaz, Dan Lebowitz, Giacomo Gastaldi, Karim Gariani, Benjamin A Lipsky
Factors strongly related to the risk of developing diabetic foot infections include vascular, neuropathic and hyperglycemic complications of long-standing diabetes mellitus. These infections are common and serious, posing a worldwide burden on administrative providers of healthcare, patients and physicians. The most appropriate approach to these infections is with a multidisciplinary team. This subchapter summarizes the current state-of-the-art concerning therapy, and scientific knowledge, for peripheral arterial insufficiency, hyperglycemia, and peripheral neuropathy of the diabetic foot, with an emphasis on the infectious complications...
March 2, 2018: Current Pharmaceutical Design
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
Elizabeth Mansfield, Onil Bhattacharyya, Jennifer Christian, Gary Naglie, Vicky Steriopoulos, Fiona Webster
Purpose Canada's primary care system has been described as "a culture of pilot projects" with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach...
March 19, 2018: Journal of Health Organization and Management
P Burgueño, C González, A Sarralde, F Gordo
Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionalization could benefit patients of this kind, establishing ECMO reference centers and integrating a transportation network specialized in ECMO. This type of transportation is a challenge for healthcare systems and physicians, given its greater complexity, requiring a multidisciplinary and inter-territorial approach...
March 1, 2018: Medicina Intensiva
Cigdem Sahin
BACKGROUND: Mobile health provides significant advantages to healthcare. For its wide-scale adoption and successful integration to the current healthcare system, mHealth's unique characteristics and the factors influencing the development, implementation, and evaluation of its applications should be well-understood. OBJECTIVES: The purpose of the study was to review the essential characteristics of mHealth and discuss what mHealth brings to healthcare practice, research, and theory...
March 5, 2018: Contemporary Nurse
Samantha E Smith, Victoria R Tallentire, Lindsey M Pope, Anita H Laidlaw, Jill Morrison
OBJECTIVES: To explore the reasons that doctors choose to leave UK medicine after their foundation year two posts. SETTING: All four regions of Scotland. PARTICIPANTS: Foundation year two doctors (F2s) working throughout Scotland who were considering leaving UK medicine after foundation training were recruited on a volunteer basis. Maximum variation between participants was sought. PRIMARY AND SECONDARY OUTCOME MEASURES: Semistructured interviews were coded using template analysis...
March 2, 2018: BMJ Open
R F AbuAlRub, M G Abu Alhaija'a
AIMS: To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. BACKGROUND: Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. METHODS: A descriptive qualitative approach using individual interviews and focus group discussions was utilized...
March 2, 2018: International Nursing Review
Hanh Thi Pham, Thibault Mesplède
Human immunodeficiency virus type 1 (HIV-1) infection remains a major health issue worldwide. In developed countries, antiretroviral therapy has extended its reach from treatment of people living with HIV-1 to post-exposure prophylaxis, treatment as prevention, and, more recently, pre-exposure prophylaxis. These healthcare strategies offer the epidemiological tools to curve the epidemic in rich settings and will be concomitantly implemented in developing countries. One of the remaining challenges is to identify an efficacious curative strategy...
2018: Drugs in Context
Etty Paola Cortes Ramirez, Christian Ernst Keller, Jean Paul Vonsattel
The New York Brain Bank processes brains and organs of clinically well-characterized patients with age-related neurodegenerative diseases, and for comparison, from individuals without neurologic or psychiatric impairments. The donors, either patients or individuals, were evaluated at healthcare facilities of the Columbia University of New York. Each source brain yields four categories of samples: fresh frozen blocks and crushed parenchyma, and formalin-fixed wet blocks and histology sections. A source brain is thoroughly evaluated to determine qualitatively and quantitatively any changes it might harbor using conventional neuropathologic techniques...
2018: Handbook of Clinical Neurology
Nalini N Jairath, Cynthia J Peden-McAlpine, Mary C Sullivan, Judith A Vessey, Susan J Henly
BACKGROUND: Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. OBJECTIVE: The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue...
March 2018: Nursing Research
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo, Yasuhiro Kadooka
BACKGROUND: Destination therapy (DT) is the permanent implantation of a left ventricular assist device (LVAD) in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications...
February 27, 2018: BMC Medical Ethics
Sevecen Çelik İnce, Neslihan Partlak Günüşen, Özgü Serçe
BACKGROUND: Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. AIM: The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. METHODS: This study was carried out in Turkey...
February 25, 2018: Journal of Psychiatric and Mental Health Nursing
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