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Health care system

Román Rodríguez-Aguilar
The maternal mortality situation is analyzed in México as an indicator that reflects the social development level of the country and was one of the millennial development objectives. The effect of a maternal death in the related social group has multiplier effects, since it involves family dislocation, economic impact and disruption of the orphans' normal social development. Two perspectives that causes of maternal mortality were analyzed, on one hand, their relationship with social determinants and on the other, factors directly related to the health system...
2018: PloS One
Shouhua Wang, Yanqing Li, Chaozhuo Li, Yijun Qiao, Shuling He
BACKGROUND The aim of this study was to determine the need for supportive care among women suffering from breast cancer in China and to identify its potential determinants to inform the development of effective and efficient healthcare services across different settings. MATERIAL AND METHODS In a tertiary-care hospital in Weifang, China, between July 2015 and January 2016, all women attending the Breast Cancer Clinic for regular physical examinations after treatment for breast cancer were consecutively recruited...
March 21, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Peter G Bittar, Anna R Carlson, Ann Mabie-DeRuyter, Jeffrey R Marcus, Alexander C Allori
OBJECTIVE: Our objective is to describe the process of adapting a conceptual framework into a practical toolkit for one cleft team. DESIGN: This is a single-arm implementation study in a single institution. SETTING: Implementation took place at a mid-sized multidisciplinary clinic for patients with cleft lip and/or palate (CL/P) from urban/suburban and rural areas across North Carolina and neighboring states. PARTICIPANTS: Eligible participants were patients with CL/P from English-speaking families...
January 1, 2018: Cleft Palate-craniofacial Journal
David Sturgeon
Over the past four decades, UK governments have moved towards an increasingly pro-market model of healthcare provision. Under this system, patients are not only encouraged, but expected, to take increasing responsibility for healthcare decision-making and the risks that it might entail. This article investigate how and why patients make choices about their health care and how service providers help facilitate this. Between October 2014 and May 2015, the researcher was embedded as an emergency nurse practitioner at two minor injury units in order to undertake direct and participant observation...
March 22, 2018: British Journal of Nursing: BJN
Yi Dong, Kun Fang, Xin Wang, Shengdi Chen, Xueyuan Liu, Yuwu Zhao, Yangtai Guan, Dingfang Cai, Gang Li, Jianmin Liu, Jianren Liu, Jianhua Zhuang, Panshi Wang, Xin Chen, Haipeng Shen, David Z Wang, Ying Xian, Wuwei Feng, Bruce Cv Campbell, Mark Parsons, Qiang Dong
Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Rebecca Simon, Sharon W Lahiri
OBJECTIVE: To identify provider recommendations and barriers in obesity management in a multicenter academic health system with extensive weight-loss management resources. METHODS: A 26-question online survey was sent to attending physicians, trainees, and advanced practice providers in primary care specialties (internal medicine, family medicine, women's health) and endocrinology. RESULTS: The survey response rate was 26% (111/430). Of respondents, 50% were internal medicine, 24% family medicine, 16% women's health, and 9% endocrinology...
March 21, 2018: Endocrine Practice
Nathalie Devillier
The Law on the Modernization of our Health System passed in 2016 exteds the scope of the medical secrecy by creating the patients' shared health record. All health professionnals involved in the care pathway have an access to all recorded information. The patient can access to it via a dedicated Internet website. The implementing decrees of this facility determine the modalities to share the information and frame the creation of this automated processing of personal data. At last, this law creates an open and secure access to helath data in the interest of collectivity...
October 27, 2017: Journal International de Bioéthique et D'éthique des Sciences
N Laube, F Bernsmann, C Fisang
Urological implants in the urinary tract are routinely used to ensure urine flow. However, the morbidities are numerous concerning long-term derivations. Especially with the ureteral stents, failure can have considerable consequences. Since the surfaces of all urological implants are more or less ideal substrates for microorganisms, the formation of bacterial biofilms is a regularly observed and often serious complication, which in many cases forces early implant replacement. The burden on the patient and the health system are enormous...
March 20, 2018: Der Urologe. Ausg. A
Faisal Akhtar, Sabah Rehman
Congenital syphilis is one of the preventable diseases caused by the gram-negative bacteria Treponema pallidum; yet, it imposes a serious global health and economic burden, with more than half of the cases resulting in serious adverse outcomes, including infant mortality. Mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million adjusted life years (DALYs) and around $309 million in medical costs. In 2006, an estimated 9.7 million children of age less than five years died in developing countries; almost four million were neonatal deaths...
January 16, 2018: Curēus
Faisal Akhtar, Sabah Rehman
Hepatitis B and Hepatitis C have been major disease-causing agents among humans since they were discovered in the 1960s. Both cause jaundice-like symptoms initially but their prognosis and treatment are somehow different and depend upon many demographic details, such as the age and susceptibility of the patients and any other comorbid conditions. They clinically present primarily with hepatitis and can have many adverse effects or even be life-threatening at times, if not treated properly. However, their epidemiological background and findings in terms of morbidity, mortality, and case fatality rates are different...
January 16, 2018: Curēus
Saeed Asefzadeh, Rohollah Kalhor, Mohammad Tir
Background: Paying attention to patient safety is a basic right and a necessary issue in providing medical care, and failure to observe it leads to irreparable damage. One of the factors affecting an individuals' performance in an organization is stress, which also endangers their health. Objective: To determine the relationship between patient safety culture and levels of job stress among the nurses working in the hospitals affiliated with Mazandaran University of Medical Sciences...
December 2017: Electronic Physician
Mostafa Shanbehzadeh, Maryam Ahmadi
Background: The main focus of the surveillance system of AIDS in Iran is on direct clinical care for HIV, and other supportive facilities and secondary programmes have been somewhat neglected. Creating templates for reporting AIDS in Iran that can fulfil the needs of all information stakeholders, is a necessity for the Public Health Information Exchange (PHIE) system. Objective: The aim of this study was to develop a comprehensive reporting template of the PHIE system for HIV/AIDS in Iran...
December 2017: Electronic Physician
Eboni G Price-Haywood, Wanda Robinson, Jewel Harden-Barrios, Jeffrey Burton, Todd Burstain
Background: Opioid prescription drug abuse is a major public health concern. Healthcare provider prescribing patterns, especially among non-pain management specialists, are a major factor. Practice guidelines recommend what to do for safe opioid prescribing but do not provide guidance on how to implement best practices. Methods: We describe the implementation of electronic medical record clinical decision support (EMR CDS) for opioid management of chronic noncancer pain in an integrated delivery system...
2018: Ochsner Journal
Eva Ceskova, Petr Silhan
In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets...
2018: Neuropsychiatric Disease and Treatment
Lucy Mackillop, Jane Elizabeth Hirst, Katy Jane Bartlett, Jacqueline Susan Birks, Lei Clifton, Andrew J Farmer, Oliver Gibson, Yvonne Kenworthy, Jonathan Cummings Levy, Lise Loerup, Oliver Rivero-Arias, Wai-Kit Ming, Carmelo Velardo, Lionel Tarassenko
BACKGROUND: Treatment of hyperglycemia in women with gestational diabetes mellitus (GDM) is associated with improved maternal and neonatal outcomes and requires intensive clinical input. This is currently achieved by hospital clinic attendance every 2 to 4 weeks with limited opportunity for intervention between these visits. OBJECTIVE: We conducted a randomized controlled trial to determine whether the use of a mobile phone-based real-time blood glucose management system to manage women with GDM remotely was as effective in controlling blood glucose as standard care through clinic attendance...
March 20, 2018: JMIR MHealth and UHealth
Andres Luque Ramos, Falk Hoffmann, Ove Spreckelsen
BACKGROUND: Waiting times for an outpatient appointment in Germany differ between insurants of the statutory and private health insurance schemes, especially for specialised care. The aim of this study was to uncover possible differences in waiting times depending on health insurance scheme and to identify predictors for excessive waiting times in primary care. METHODS: We used data of the Bertelsmann Foundation Healthcare Monitor, which is a repeated cross sectional study dealing with experiences in health care and attitudes towards current health policy themes...
March 20, 2018: BMC Health Services Research
Alex Molassiotis, Shelley Roberts, Hui Lin Cheng, Henry K F To, Po Shan Ko, Wang Lam, Yuk Fong Lam, Jessica Abbott, Deborah Kiefer, Jasotha Sanmugarajah, Andrea P Marshall
BACKGROUND: Malnutrition is frequent in patients with cancer, particularly those in advanced stages of the disease. The aim of the present study was to test the feasibility of a family-centred nutritional intervention, based on the Family Systems theory and past research. METHODS: This was a single-arm trial assessing feasibility (eligibility, recruitment and retention rates); acceptability by patients, family caregivers and health professionals; intervention fidelity, and energy/protein intake (in one site only)...
March 20, 2018: BMC Palliative Care
Sara Javanparast, Toby Freeman, Fran Baum, Ronald Labonté, Anna Ziersch, Tamara Mackean, Richard Reed, David Sanders
BACKGROUND: Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning...
March 20, 2018: BMC Public Health
Suzanne Ramírez, Fernando Mejía, Marlene Rojas, Carlos Seas, Patrick Van der Stuyft, Eduardo Gotuzzo, Larissa Otero
BACKGROUND: Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened. METHODS: From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima...
March 20, 2018: BMC Infectious Diseases
Sabato Santaniello, John T Gale, Sridevi V Sarma
Over the last 30 years, deep brain stimulation (DBS) has been used to treat chronic neurological diseases like dystonia, obsessive-compulsive disorders, essential tremor, Parkinson's disease, and more recently, dementias, depression, cognitive disorders, and epilepsy. Despite its wide use, DBS presents numerous challenges for both clinicians and engineers. One challenge is the design of novel, more efficient DBS therapies, which are hampered by the lack of complete understanding about the cellular mechanisms of therapeutic DBS...
March 20, 2018: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
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